The Dr Tabubil Files: The Grey Nomads

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback.  It's a fantastic place, and together we have collaborated on a series of guest posts  all about living and working in the Red Centre.  Enjoy!

Hey Tabubilgirl -

So i had some patients in with me (gray nomads) that i needed by boss to review for me.  As they left they made some comment that i didn't catch.

            Anyway, later on i called my boss about another patient, and he goes, "you've got fans in Port Maquarie.  They think you're sh**t hot!"

            Heh.

            I have fans in port Macquarie.

The Gray Nomads are the retired men and women who close up their houses and spend months out of every year on the road in caravans and camper-vans, exploring Australia.  As the baby boomers age, the pastime is becoming increasingly popular, and brings with it into the outback the ailments and illnesses of the elderly, at a scale that really hasn’t been appreciated out here before.  Most grey nomads usually present with the influenza and want some antibiotics, but occasionally we do get one with cardiac failure - such as the dear old soul who, when she thought about it, “was supposed to get that echocardiogram before setting off on this 4 month journey across the outback.”

Oh dear.

            There was also the elderly gentleman who arrived at the clinic delirious with the flu: so incoherent and muzzy that he managed to drive his car and caravan right into the back parking lot (reserved for the clinic staff), ignoring the multiple signs marked “Do Not Enter.”  Our car park has a long, narrow entrance, leading to a very small lot at the back.  It's big enough for about seven cars, if they’re very friendly with each other, but it is definitely not large enough for a trailer.  We noticed his arrival when we heard a loud bang.  The building shook.  I, of course, thought that the nearest mine was blasting that day, but they don't blast that close, do they?! Turns out not -  the gentleman had backed into a supporting post for the building. 

            It was a close call, and once everyone had panicked and moved their cars out of his way in a real big hurry, he managed to find his way out. I thought that I had done a few10-point turns in my day! He topped my record by far.

The Dr Tabubil Files: The Mines, the Miners and Bulk Billing

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback.  It's a fantastic place, and together we have collaborated on a series of guest posts  all about living and working in the Red Centre.  Enjoy!

The patients here in Cloncurry are typical for a small town in cattle grazing country, with a high and regular flow of tourists (Grey Nomads and Backpackers) coming through. I have my regulars, who are already disappointed I’m only there for 10 weeks (yay!) and I see a fair amount of the transient population - the workers from the more remote stations, and the men and women who work in the mines nearby.

            The countryside around Cloncurry seems to be littered with mines.  The mother load around Cloncurry is copper.  Just recently, though the Great Australian Mine has just found a rich body of Gold that will yield some spectacular kilo loads per tonne and keep the mines in cash for a long time - even if (or when) the copper runs out.  These miners are young men and a few women who, once finished with school ( at 16 if they drop out, 17 or 18 if they graduate) sign a contract with the mines for a very large starting salary - AUD $80 000 a year.

            Occasionally it can be frustrating when these young miners ask for a little too much.  Occasionally they'll present to the clinic with a medical complaint, and expect to be bulk billed (Bulk billing is what happens when you are on medicare, our national health-care scheme, and the whole bill is taken care of by the medicare plan.)

            Apart from that, I  LOVE bulk billing.  This generally applies to people on a pension, or under the age of 16, or  people who have a DVA Veterans card or some other sort of concession, but up here we have some reasonable discretion about when and how to use it – like if they have come in on a recall for results, or it was a hellish day and the patient waited for 2 hours for us to be free.  Or, in my case, when I stumbled upon a patient’s recent personal tragedy, and made her cry, by saying, in a really bright voice - “Are there any preexisting conditions in your family?” 

            And she burst into tears and said “My brother is in a full body traction cast!  He fell off of a quad-bike last week!!”  and cried and cried and cried.

            I felt so awful. I spent 15 minutes just sitting there and holding her hand and listening while she told me all about it.  It was so sad.  I definitely bulk billed that one. 

People come from all over to work in the mines - from all over Australia, from all over the world.  I love my job – I meet so many people.  My favorite part of a consult is the moment when I say:

            "Hello – who are you? And where are you from?" 

            Because I get a story.  People will come up to the mines for six months, or for a year, for two years, on a sabbatical from an academic job, because they're on the run from a spouse or some other family situation, and they'll make enough money to go home for a while, and then they'll come back again.  Again and again and again.  The outback seems to get into your blood.

And then there are patients from the really wealthy cattle families.  One family in particular is the tenth richest family in Queensland.  Based out of Cloncurry, they own a full third of Queensland's grazing country.  Their trip in for a checkup is racked with hardship – do they fly their private plane to town, or drive up in their Bentley?

Bulk billing is fantastic – I really got into the swing of it, until the boss had to come and tell that I needed to ease back a little.

            "Dr Tabubil - we appreciate that you're being a compassionate doctor, but  – this is Cloncurry. Not Brisbane.  If they look like they can afford it – charge them.  If they look like they can’t afford it – charge them anyway.  Chances are their private jet is waiting for them at the airport to take them back to the muster, which is why they look like they've been rolled on by a horse and they smell like the back end of a stable.  They are working millionaires."

            Of course, there are people here in town who really can’t afford it.  But the reception staff knows who they are and they probably have a concession card anyway.

Even so,  when some eighteen year old kid comes in  after I’ve seen him throwing bills on the bar the previous night in the pub and looks at me and says -

            "SO, can ya, like, bulk bill?" 

            Well, when that eighteen year old is making 80 000 dollars a year, I generally sigh, and smile sweetly, and say “Oh, NO, I’m sooo sorry.  It’s just not applicable.”

The Dr Tabubil Files: An Introduction to Cloncurry

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback.  It's a fantastic place, and together we have collaborated on a series of guest posts  all about living and working in the Red Centre.  Enjoy!

Cloncurry is a very pretty town.  She's a small town -  a little Queensland town of three thousand permanent inhabitants, a thousand kilometers inland from the east coast, and a hundred and twenty kilometers from Mount Isa - the nearest big smoke, where the trans-Australian highways meet.  But she's always been big for her size.  She's a cattle town - the local seat for the surrounding cattle stations  (editor's first note:  Stations are what Australians call Ranches. They get awfully big - Anne Creek in New South Wales covers 34, 000 square kilometers.  By contrast, the country of BELGIUM is less than half that size!) and she's a mining town. There is a great deal of mineral wealth in the outback and Cloncurry is the Big Night Out and the party town for the workers at half a dozen of Australia's largest mines - The Earnest Henry Mine,  Eloise, and Cannington are some of the more well known ones.    In World War 1, most of Australia's copper came out of the mines around Cloncurry, and until the 1960s, the town was jumping.  The second half of the century saw something of a quiet patch, but things are starting to jump again, as the mining boom gets into full swing.
            Cloncurry may be isolated, and very far away from the other cities - and towns - of Australia, but with all the wealth from the mines that comes into town, Cloncurry is a town that has pride – an army of street cleaners keep the streets swept and clean.  Verges are trimmed, mowed, and filled with flowers, store fronts are tidy, and the corrugated iron is freshly painted.  (And half of everything is made out of corrugated iron.  It's the rural material of choice - for roofs and sheds and house extensions - the third bedroom of the house next door to mine  is made out of corrugated iron) and the shopping can be equal to anything you would find in a larger town - There’s a library, a large police station, and two shops selling cowboy duds, where I bought my Akubra - the classic Australian cowboy hat.  

            There are two supermarkets. One of them, the local Woolworths (editor's note - Woolworths is a major general supermarket chain in Australia) was a surprise to me – it’s better organized and stocked than many of the more upmarket supermarkets in Brisbane. The fruits and vegetable are beautifully presented, and they’ve got everything you could want – tofu, prosciutto, organic butter even, city stuff like that. Everything except for currants. There are no currants.  A café started up six months ago, and three weeks ago a hair salon opened as well.  (It’s for women only at this stage. Men have to get pretty elsewhere - or else, men are already pretty.  Hmm….) We have two boutique shops selling all of the knick-knacks and novelty items you can get in Brisbane.

            There are no tumbleweeds, but when the wind kicks up, it sends willy willys (editor’s note: twisters or small tornados) tearing down main street and through the gardens behind people's houses.  

The shire council lent me a house for while I'm here in town.

It has an amazing view.

Cloncurry is deep in Queensland's bush land and right now it's the dry season.  The Chinaman Creek Dam is a kilometer out of town.  It’s got a few backed up streams draining into it, and when you go tramping through the bush chasing flies, they look like something straight out of a Hans Heysen painting.    
            I expect Clancy to step out from behind a tree, kick dirt over his fire, whistle for his horse and as the lowing of the cattle fills the silence, he would settle into his saddle, adjust the brim of his hat and gaze out at the endless plains. 
            Waterfowl abound, to be frightened into flocks by the jet skis and motorboats that the miners play with on the weekend, and when you drive back to town, wallabies startle and skitter out of sight, blending into the red dirt so that all you can see is moving dust. 

We have a fantastic General Practice clinic here in Cloncurry. We have 6 full-time GPs, the same number of doctors as in Mt Isa, which has a population of 20,000 - almost seven times as large as Cloncurry.  The scale is deceptive.  We have a smaller permanent population, but we draw from the surrounding towns and stations and the mines and at present, there are7,000 permanent patients on the clinic's books.  Ironically, the scale of our facility means that people will come the 120 km from Isa to see a really good GP, because our waits are shorter than in  their local clinics. 

            Our clinic has two medical superintendents, one of whom is the principal practitioner of the practice, a practice manager, four general practice registrars (doctors on training programs, studying and working toward a specialty) and me - a resident (or junior doctor, not yet in a training program).  There are generally also two medical students here on-and-off out of James Cook University in Townsville.  So we are very well staffed!

            My position is a provisional training position for second-and-third year residents interested in taking a registry in General Practice.  We work a 10 week rotation, and there is always one of us here in Cloncurry, all year-round.  I’m not particularly interested in GP, but this post sure beats a second-year rural relief post as the only doctor for hundreds of miles in any direction in a tiny small town clinic for five weeks straight, which is what most residents get on their mandated rural rotation. 

            The GPs here also run the hospital on the edge of town, so the day starts with a ward round every morning.  It’s a real GP luxury to be able to follow up the patients that you have admitted from clinic.  The hospital has 22 acute beds (the remaining 3 are used by the nursing home patients as the nursing home doesn’t yet exist) and even a padded cell.  The cell has been out of use since the seventies, but the padded room with the foot-thick wall makes a great storeroom for hospital supplies!

Here is a view of Cloncurry, taken from the lookout on the way out of town.

This is the Chinaman Creek Dam.  It's the dry season right now, and the dam isn't very full, but there's enough water to sit and watch the birds.

And again.

And a spray of eucalyptus, just the way Clancy would have seen it.

The Dr Tabubil Files: A Letter from Dr Tabubil in Cloncurry

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback.  It's a fantastic place, and together we have collaborated on a series of guest posts   all about living and working in the Red Centre.  Enjoy!

Dear Tabubilgirl -

Soooo… Auntie A's  sister-in-law drove her camper-van up through Cloncurry the other day.  She called me at the clinic, but i had a list of patients to see and I couldn't duck out to see her, and they were only here for about an hour.  But we chatted on the phone.

And she was very excited.  She was very excited -

About...

the man with a pet bull!!!

I knew exactly what she was talking about - I'd driven past him on the way to work that morning!   He had his bull on a leash and was walking down the road.

She saw it in town just before she called me - a bull that was waiting while its owner had a drink at the pub.

I heard the back story this afternoon…

The guy has owned the cow since it was a tiny bub, destined for the abattoir.  He rescued it, and hand-reared it and now it's registered as a pet dog in the township of Cloncurry (no joke) and it will sit on the curb outside the pub while the man is inside drinking rum. He likes to eat carrots and apples. He weighs 770kg.  His owner is, as Cloncurry says, "bat-sh**t crazy".

The end.

Dr Tabubil hasn't been able to get a photograph of the bull, but he DID appear in the Queensland Police's News of the Weird a couple of weeks ago.

Here's a screen-grab:

The Road Runner Roadhouse in Cloncurry  If you'd rather go to the link direct, and see the rest of the gallery, click here.  The bull is on slide number 14.

The Dr Tabubil Files: Taxis and Kangaroos

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback.  It's a fantastic place, and together we have collaborated on a series of guest posts  all about living and working in the Red Centre.  Enjoy!

 Yesterday I took a taxi.  I gave the driver an address, and -

            "You Australian?"  He said.

            "Si."

            He wasn't fooled. 

            "I knew it."  He said.  "Now, you can help me  with something."

            "You sure?" 

            "I have a question:  Do Australians eat a lot of crocodile?  Is it, like, beef, over where you come from?"

            I was, to put it in Australian, stumped.

            "Wellll…" I said.  "And.  Er.  It's not that we - "

            "Do you know the supermarket on the corner of Manquehue and Apoquindo?"

            "Si."

            "In the meat section there they sell frozen crocodile.  From Australia.  And I've been wondering.  Do you guys eat it all the time?  The way we have BBQ and hamburgers and steak for dinner?"

            "Um."  I said.  "We do eat it, but not very often, really.  We mostly eat beef, just like you do.  And lamb.  Mostly you see crocodile up north - where they have crocodiles, but everywhere else you mostly see it in restaurants. It's sort of a tourist thing. You know: come to Australia and eat a crocodile!"

            "Oh." 

            We drove three blocks in silence.

            "We do eat kangaroo, though."  I offered.

            "Really?"  He put on the brakes and turned around in his seat.  "You really do?  There's this movie - with that blond woman - Nicole Kidman, and that man who's in a lot of superhero movies - growls a lot and grows his fingernails -"

            "Hugh Jackman?"

            "Maybe.  So the movie is about Australia a long time ago - in the 1930s - and they drive across the whole country in an old jeep and at one point they see a flock of kangaroos and the man stops the jeep and picks up his rifle and stands up in his seat and - blam!   He shoots a kangaroo.  Just like that.  And he says 'Right. That's dinner.'  Just like that!  So - really?"

            "Mostly we buy kangaroo in the supermarket with all the other meat, but pretty much, yeah.  They're not exactly endangered species, most of them.  Mostly, they're road hazards.  I used to live in the outback- just like in the movie you saw - and at dusk the kangaroos wake up and come out of the bush and go boinging across the road and if you're in a car and one is coming  - bam!"

            "Really?!?!"

             And all the way across town he asked questions about koalas and kookaburras and crocodiles and snakes and spiders, and for some reason, he seemed to get the impression that none of the meet-cute animals in the tourist adverts were  worth the bother of going to Australia to meet-cute in person,  if it'd mean he'd have to put up with some of the smaller, slitherier things I told him about.

Huh.  People are funny like that.

In all seriousness - the snakes and the spiders might give you the visceral wobblies  in that unreachable spot in the small of your back, but as far as genuine outback hazards go, the kangaroo is way at the top of the list.  Kangaroos on rural roads scare the bejeezus out of me.  They've got no road-sense, a hell of a lot of momentum, and they come out to play when you can't see them coming.

Back when she first moved to Australia, my sister Dr Tabubil had a boyfriend who I thought was just the coolest thing on the whole continent.  His parents ran a cattle farm a few hours from Brisbane, out where Dr Tabubil said "there are like, a million kangaroos per square meter," and he drove an ancient ford sedan that was pocked and dented and dinged six ways from Sunday.

            "Every time he drives home"  Dr Tabubil told me "He gets hit by at least two of them.  Per mile.  They just come doinging out of the bush into the road and -"

            "Bam!" I said. 

            It was so exotic that there just weren't any words.

            When I came home to Australia myself, and moved out into the real bush, I got an education.  We had a friend who drove up from Adelaide one afternoon, and when sunset hit, he finished the last 150km at a crawl with his eyes swinging back and forth across the brush on either side of the road - and he got hit by a kangaroo anyway.  I saw the car.  The front right corner was a write-off, and all along one side of the car, from the driver's side door to the rear bumper, there was a long wide hollow that marked the tail of a Big Red Kangaroo.  Eight thousand dollars worth of Big Red Kangaroo.

            Right now, Dr Tabubil is working a rural placement at a clinic in a town called Cloncurry.  Cloncurry is a cattle-and-mining center a thousand kilometers inland from Brisbane, as deep into the red center as you can get. 

            She likes it there.

            She wrote to me:  "The town has less than 3000 people, so it's a lot smaller than where you lived when you were in the outback.  Only seven blocks square.  But  the 'population' doesn't count all the miners and the grey nomads (retirees in caravans) that come through.  Heaps and heaps of them. The practice has 7000 permanent patients, out of the mines and the stations around it, and people will drive  hundreds of kilometers to see a doctor."

            The shire council issued her with a house, and a car, but she's only allowed to drive it inside city limits. Ten months ago, the last locum doctor drove the car five kilometers out of town and hit a kangaroo.

Saul's Vanilla Icecream

Saul likes to serve home-made vanilla ice cream with his Apple Tartain.  And his Crepes Suzette.  Here's how he does it.

Anglaise Sauce

This vanilla sauce can be used as a base for an ice-cream, or, with a little brandy or Grand-Marnier added to it, poured it over fruit cakes and fruit salads!

If you're using this anglaise as a base for ice-cream, you can toss anything into it before you put it in the churn: strawberries, peanut butter, honey etc. etc. etc. 

Note:  If you are adding a sugary ingredient, cut down on the sugar in the base recipe.  If you are adding alcohol, keep the amount to a minimum or it will affect the freezing and cause the mix to separate. 

Yummy example:  To make rum 'n raisin ice-cream, soak raisins overnight in just enough rum to allow the flavor to permeate the fruit.  Toss the mildly alcoholic raisins into the anglaise at the very end of the cooking process - allowing the hot anglaise liquid to fully rehydrate the fruit.

Ingredients:

1 Cup Heavy Cream

1 cup milk

1/2 cup caster sugar

5 egg yolks

1 vanilla bean split and scraped, OR 1 overflowing tsp of vanilla seeds.  (NEVER use the cheap vanilla flavoring on the supermarket baking shelf.  You may as well go buy Dairy Bell ice-cream, and then there is no hope for you at all.)

In a small saucepan, and over a moderate heat, bring the cream and milk to a gentle boil.  Do not walk away!  The milk WILL overflow as soon as you turn your back.  (If using a small pot over a gas stove, do not let the heat get high - or the flames will run up the sides of the pot and scald the milk.) 

            The anglaise must be prepared over a water bath, so set a pot of water to boil - you want only an inch or two of water in the bottom of the pot so that there can be an air space between the boiling water and the bowl of ingredients.

            In a cheap metal bowl, whisk the egg yolks and the sugar.  (These must be whisked immediately upon contact - or the sugar will begin to cure the yolks, and you will have nasty flakes of dried egg throughout your anglaise.)

            As soon as the hot milk mixture begins to boil, remove it from the heat.  Whisking continuously, gradually – very gradually - add the hot liquid to the egg and yolk mixture.  Adding the hot liquid very slowly will stop you from ending up with rich scrambled eggs instead of a smooth sauce.  (Which might be nice to try as well.  Go ahead.  I dare you.)

            Place the mixture over the water bath and whisk continuously.  You must keep the liquid MOVING.  If the sauce at the sides of the bowl begins to solidify, stir it back in - you don't want scrambled vanilla eggs.  Stir until the mixture holds –

            Test by dipping a spoon into the sauce.  Remove the spoon, turn it over and drag a finger through the sauce on the back of the spoon - if the clear line holds free of sauce, the anglaise is ready.  Remove from heat.

            Important Note: Because of the egg and dairy content, an anglaise is very susceptible to bacteria growth.  Unless you plan to use it within an hour or two, chill quickly in an ice bath or over a bowl of ice.

Speaking of Cooking - A Recipe for Apple Tartain

There were a few things I'd meant to post before we left Australia that didn't quite make it up (on account of being busy packing and all the associated nonsense.)  Here's the first.

In our very last cooking classes before we left Australia, Saul-the-French-Chef taught us to make Apple Tartain.  It was a very Saul  sort of dish - an apple tart distilled to its essence: many apples, much butter, equal parts sugar, more butter, and a little slice of pastry - buttered delightfully.

            And though the tartain was ambrosial, it was the Nurses who Will Not who made the evening noteworthy.

            The Nurses who Will Not are a three nurses from the maternity ward of the local hospital, and weekly, they profess themselves horrified at every single scrap of evidence that cooking involves objects and processes biological. 

            I've nothing against dietary principles, but these ladies don't do meat, vegetables, carbs or basic mineral supplements.

            Raw meat and vegetables leave them appalled, and as for dairy - the obscenity of anything that comes out of the squeezy bit of a cow leaves them glagging and glaaaking and quoting heart-healthy statistics before the stove like they're reciting scripture.

            Saul smiles blandly and deploys butter like pre-emptive military strikes, and the rest of us are flummoxed as to what these women are doing in a Cordon Bleu cooking class in the first place.  Our initial suspicion was that they'd thought the class would be theoretical.  But after the first class, when they kept coming back -  imagine an unusually specific fundamentalist religious group, hanging around a skateboard park, casting dire looks across the half-pipe and passing out tracts on the sins of playing x-sports on Sundays.   As far as we can tell, these medical ladies have identified Saul as the Anti-Christ of Nutrition, and we've started to suspect that they're only staying around in the hopes of driving him entirely demented.

This evening, they didn't disappoint. As the slabs of butter came out of the fridge, the Nurses started shrieking.

            "O Lord!  O LORD - he's at it again!" They tittered, collectively.

            Saul put on a deeply blank face and commenced to cook.  He peeled and sliced the apples, dropped them into  a bowl of water and lemon juice, set a cast-iron skillet over a gas flame and set to melting butter and sugar -

            The nurses scowled and huffed their way through the demonstration, until the apples were simmering with the butter in the skillet, and Saul had  picked up a spoon to begin teaching us the accompaniment. 

            "We'll do an anglaise custard."  Saul said.  "And a note here, although I hate to have to say it, when you make an anglaise, try not to use a really thick cream - " (He sighed a little in regret.) "It tastes fantastic, but there's just too much fat in it.  You'll split your sauce."

            The scowls became a row of deeply tucked chins and mouths folded up like purses.

            "Well, there you go."  They said.  "Well there you go."

            "Finally some sense, don't you think?"

            "He's learning something at the last, isn't he?"

            While Saul whipped his anglaise with slightly more than necessary vim, Nurse #1 turned to her compadres-in-denial and said - very sotto voce  - "Are you coming back next term?"

            One of her compadres snorted and said in a scarcely less audible voice - "I hardly think so.  He's so lax.   In his…standards."

            They eyeballed the happily bubbling pan of apple and (mostly) butter on the stove below, and they snorted and pursed their lips some more and looked at each other with righteousness in their eyes.

            Saul eyed them right back and flipped another hundred grams of butter into the frying pan, and began cracking eggs.  Double-yolkers.

            The Nurses urrgh-ed and glaah-ed in disgust. 
            "It's so….. biological!"  One of them moaned, with her hand pressed to her mouth.

            Saul smiled.

It is a very good Tartain, and taken in moderation, would make an excellent addition to a dinner table once every six weeks or so.

            In defiance of those who eschew all dairy on glakker-y principle, and in praise of all standards that reckon that a whole brick of butter is never enough, here is the Recipe for an Apple Tartain.  And on Friday, the recipe for Vanilla Ice-Cream to accompany it.

Apple Tartan

I kg Granny Smith Apples

Bowl of Water

Juice of Half a Lemon

1 tsp cinnamon

Generous slab of butter

1/2 cup sugar

50-100 g butter (Depending how non-heart-friendly you are feeling) plus 1 tablespoon of melted butter for brushing onto pastry

Two small non-teflon-coated skillets

Baking paper

One sheet of puff pastry, chilled.

Place the puff pastry in the fridge to chill, and pre-heat your oven to 220C (400F).

Peel  1 kg of Granny Smith apples.  Juice half a lemon, and add the juice to a bowl of water.  Core the apples and slice thinly, then place the apple slices in the water to rest until needed.

Heat a small non-teflon-coated skillet  and drop in a generous slab of butter. (Go on, don’t be shy.  Add some more.  It’s good for you.) When the butter is melted and sizzling, add the apple slices, half a cup of sugar and 1 tsp cinnamon.  Cool until the moisture from the apples has boiled off and keep cooking until the contents of the skillet have caramalized to a dark brown color.

While the apple is cooking, make a cartouche.

Short version: Using baking paper, cut a circle with a diameter that matches the diameter of your skillet.

Fancy cordon-bleau version: Take a square of baking paper whose side is the diameter of the pan you  will use to bake your tartan.  Fold it in half.  Fold it into quarters.  Fold it again - and keep folding until you have as narrow a triangle as you can fold without the paper slipping out of shape and sliding every which way.  Cut off the wide end of the triangle.  Unfold your paper - hopefully it will be in a circle!  (If not, try again.  It's only paper!)

Take another small non-teflon-coated skillet - or other shallow circular baking pan - and spray the bottom with a non-stick cooking spray.  Lay the cartouche on the bottom of the pan. 

When the apple has caramelized, remove the puff pastry from fridge.  Lay the puff pastry over a plate roughly the dimension of your baking pan and using the plate as a template, cut the puff pastry to fit.  (Don't remove the puff pastry from the fridge until you're ready for it.  You want to use it CHILLED.)

Spoon the caramelized apple on top of the cartouch in the pan.  Drape the puff pastry over the top of the apple and press firmly into place.  Brush the top of the pastry with melted butter.  Work fast - the heat of the apple will retard the rise of the pastry if you wait too long!

Bake for 20 minutes or so until the pastry is golden brown.  Remove the tartain from oven and let it sit for 2-3 minutes (otherwise the tartain will fall apart when you turn it) Turn pan over onto plate and serve with home-made vanilla ice-cream.  Enjoy!

* A variation.  Once out of the oven and while still hot, flatten the puff pastry with a tea-towel and you have a lovely biscuit crust.