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Wednesday, December 7, 2016

Into my second year in the U.K.

Dear Readers.

Most of you who have read my blog entries over the last year are aware that although I entered this country a year ago as a middle-grade doctor, I have had to scale down myself to the level of a junior doctor and work the same duties as before with the intent of getting back to the level of middle grade with dedication and hard work. 

I am happy to share with you, therefore, that things are slowly but surely working to improve my abilities in the right direction. In the last review I had with my designated "educational supervisor", I was told that there has been a  noticeable improvement in my skills and some improvement in my communication skills as well, but that I have to still do more in that direction. Then, about a week or two later, I had a chat with the line manager, who assured me that the department had taken a stand that they would keep me on till I wished to leave. This message of permanence has really lifted up my spirits as I know now that my job is more or less secure at the Blackpool Victoria Hospital.

I continue to stay in the hospital quarters, but it does look like I might need to move out before the end of February next year. I am hoping to find alternative accommodation before my time runs out. 

I missed doing any locum duties in the month of October as I was on annual vacation. My family arrived from India to spend three weeks with me, and the last week of October got simply washed out with all the excitement and memories of my previous 20+ days. From November, however, I began to get locum jobs once again, and with the help of the earnings from there, my savings accounts are now slowly but surely getting augmented. 

More in subsequent posts. Keep visiting and reading my posts, and if you wish, share your thoughts and comments. Thank you.

Sunday, December 4, 2016

A Year in the U.K. - My personal life

I landed at Manchester airport on the evening of the 14th of November last year. The time was around 3:30 in the afternoon, but it looked as if it was nearly dusk in Mumbai around the same evening! It was drizzling and dark. I caught a train from the Manchester airport railway station and reached Poulton-le-Fylde station at about half past five. Outside, it was dark and dreary. It was raining. I caught a cab without a metre, and was dropped outside the A&E of the Blackpool Victoria Hospital, with the driver charging me a whopping 14 pounds! 

From that day, when I was hit by the British winter in full force, until today, as I write this, I have certainly come a long way. I have had some really unique experiences, and am in a life that is quite different from the one I lived in my two previous lives - in India, and in Saudi Arabia. This post is about how my life has changed in the past year.

From the hot, dry deserts of Saudi Arabia to the pleasant monsoon climes of India and then to the temperate Atlantic-weather of Blackpool has all been overwhelming, really, Within a few days of my arrival, I experienced cold winds on the Promenade while doing my first shopping for essentials. The next three months were all new territory for me. In December, I attended my very first Christmas party organised by the nurses of the Paediatric department. It was - kind of - exciting to be able to be in the company of so many people, most of whom I didn't even know. And then, to be asked to join them all in a dance. And to partake of a Christmas meal with prawn cocktail, a drink, a fish entree and then a sinful chocolate dessert. Quite a lot of fun.

The days I have walked 10000 steps ... ahh, wasn't that amazing. I took part in the 5K challenge (running 5 km) on behalf of the Blue Skies Fund (the in-hospital registered charity) - with just 30-40 other participants on a cold, wet morning. And the days I went around Blackpool, exploring its roads, the Promenade, its restaurants, and its unique flavour. Those linger on as really good memories. 

Then there are my peregrinations in and around Stanley Park, the urban park that acts as a nature reserve in addition to being a recreation park in Blackpool. It has football grounds, a cricket ground, gymnasia, children's outdoor activities and a large water body with avifauna all around the year. It allows adults to fish in these waters for fresh-water fish. The park affords the bird-watcher with ample opportunities to observe birds all around the year. This includes the water birds, of course, but also so many tree species, some of which I saw for the first time in my life. I have, of course, tried to document all the birds that I could with my Canon DSLR.

I then joined the Royal Society for the Preservation of Birds and visited many bird parks and reserves around Blackpool. The most memorable one will be the Turbary Woods Birds of Prey and Owl sanctuary at Preston, but others also featured. 

My travels took me to the Peak District where I walked part of the famous Monsal trail, and to Cumbria and the Lake District, where I visited Windermere lake and town. I also saw a lot of Preston, Manchester, Liverpool, Buxton, Silverdale, Lancaster, and a few more towns near about me. My travel was limited, of course, by the fact that I own no car, and I get a few days of weekend leave to do my travelling. Be that as it may, I have travelled more in the last 1 year in the UK than I did in India over the previous 50+ years (I am, of course, talking of travel on foot, and only for leisure).

Next, on to my culinary adventures. Well, I have mostly persisted with Indian style cooking, but occasionally, I have tried English cooking, and it has nearly always turned into a less than satisfying experience. Eating out, on the other hand, has been very fulfilling. I have tried, for the first time in my life, authentic, low-price Greek, Italian, Jamaican and French food. And I have enjoyed every such encounter. The most memorable one for me will be eating at Nuncio in Blackpool, an Italian restaurant where they served me excellent seafood risotto. Another one to not forget would be the Greek food I had at Othello's in Blackpool.  Among Indian restaurants I visited, how can I not recall the food I had at Manchester at Chennai Dosa, or the one I had at Imli in Lytham? There are others too, but this blog post would run into several pages if I carried on.

Shopping is a treat in the U.K. There is something for every budget. There are numerous pound shops that deal in thousands of articles that sell for a pound. Then, there are mid-level places where you can find decent merchandise for a low price. You won't have to pay a king's ransom for shopping at such outlets. They include H & M, Primark, TK Maxx for clothes, Sainsbury's, Morrisons, Lidl, ASDA and others for groceries, Boots for Pharmacy, the thousands of corner shops run by Asian guys that sell recharges, newspapers, daily provisions and so on.

The major difficulty I have had is in terms of finding regular company when I am not working. This is the price you pay when you decide to work in a foreign country without your family and friends. I have made a lot of casual friends, and tens of Facebook friends, but when it comes to real friends with whom you can spend an evening over dinner or invite to your place to have fun, I have had just a few of them. One of them, a certain Michael Siong, was a gem of a person. I miss him, as he moved on from Blackpool, first, to London, and now, he is in Scotland. 

And that's about it for this post. Do let me know your opinions on how you found it. Comment, if you wish, in the space below. Share it with your friends if you wish, Thank you so much.

Wednesday, November 23, 2016

A Year in the U.K. Looking back on my professional life

I would be fooling myself if I said I am at the top of the world. Well, yes, I am in a much-coveted place, that is true. However, when it comes to defining where I am on a professional level, I must say that I have a way to go, indeed. The reason I am writing thus is that it has been a challenge for me to adjust to the way the NHS works and the way the British people communicate with each other. 

Of course, I have "improved", which means I am now doing things the way they should be done in the U.K. (which is not always the right way of doing things) and the process of unlearning what I previously knew about Pediatrics has been more than a little difficult. To make light of it, I am now practising "Paediatrics" and not Pediatrics. What this means is that the British method of healthcare is different not just in the spelling, but also in the details. I have often wondered how it is that medical care can vary so much in the details even though both systems of medicine across the Atlantic rely on much the same sources of knowledge and the same sources of research. Then I realised the difference lies in the basic way of approaching illness. Whereas the American system of medicine relies heavily on acute care, the British method is all about hanging in while the patient roughs it out through the ups and downs of his/her illness. Also, the NHS is a government-facilitated system where the citizen pays nothing. Hence, a cash crunch causes a very difficult problem of not being able to deliver healthcare where it is needed most. On the other hand, the American system is mostly based on private enterprise. 


But beyond all this, at the root of it all, is the way the healthcare is tailored in consonance with the wishes of the patient. In this most important respect, the NHS is completely different from medical care anywhere else I have worked. The patient has the right to agree to, disagree with, question, and critique any care they may be receiving or be about to receive. They can, if they are mentally competent, reject treatment of any kind, no matter how strong the evidence for the use of that modality of treatment may be. The only exception is when the patient has lost their mental faculties or where a certain treatment is life-saving. This act of "putting the patient first" and keeping them in the "centre" of care makes the NHS so different. A woman may not want to breastfeed her baby even if she has a lot of milk coming in, and that is her right. In the same way, if a patient chooses not to have chemo for his malignancy, that is his right. The fear of medico-legal issues is very strong too, so if you as a healthcare giver goes against the patient's wishes, you can be penalised or even prosecuted. 


On a more personal level, how has it been for me. It has been a year of mixed fortunes, but I am, as I said previously, slowly inching towards professional competence. I still have some issues that need sorting out, but I am hopeful I will be able to cross those hurdles over the next several months. At some point, I should be able to return to my middle-grade level. I am hoping this does not take more than six months more, or else, it will be difficult to sustain myself at a junior level. It will also make future promotions and move to any other country that much more difficult. So, let's see how that goes. 


And that's it for this post. Do share your views and comments if you wish. Thank you for reading this and for your encouragement that I will constantly need. 

Friday, November 4, 2016

Back on the job, and advent of winter

It has been over a fortnight now since my family vacation ended. And yet, it seems as if it was only yesterday! What a time I had. We had never taken such a long vacation and it was definitely worth it. And the funny part is that we never realised how time flew. We saw over 15 different places, and some of them were unplanned route diversions where we saw and did amazing things. Above all, this hugely enjoyable vacation did not even cost a big amount of money. I must have spent about 6500 GBP in all, a very reasonable sum indeed. 

And now, it's back to work. The autumnal fall of leaves is now done with, and trees are almost barren. There is a cold nip in the air, the more so in the past few days. In fact, it has rained quite a bit in the past 48 hours or so. Darkness descends upon the firmament as early as, say, 5 o'clock in the evening. When you wake up in the morning, you just don't feel like shrugging off the duvet and rising and shining! What keeps you going, though, is the awareness that if you don't wake up and start soon, you will most likely be late to reach your place of work. This can be a tricky situation, especially if your bosses are aware that you pretty much stay on the hospital campus - and are still late, even if by a few minutes. 

It has been a busy week or two, with the Paediatric ward filling up with infants and children experiencing breathing problems right, left and centre. The best thing that happened to me was that I was placed as the only junior doctor looking after the neonates in the special care newborn unit. Of course, there was a consultant who took the rounds with me, but on a couple of days, no consultant was available, and I took the entire round by myself. On that particular day, I felt as if I had stepped up a bit. I continued doing the neonatal rounds until the end of the week, which was earlier today. 

And that is how it goes. I will probably not be gainfully employed over the weekend, but, as they say, tomorrow is another day. 

Thursday, October 27, 2016

Brief note on my last month - vacation and fun with family in the U.K.

My family arrived to spend three weeks with me in the UK on the 30th of September. We had a great time travelling across thousands of miles of England, visiting over 10 destinations. We even saw a bit of Scotland. It was three weeks well spent. I returned to my duty on the 18th, but my family stayed with me in Blackpool for a further two days, enjoying the local attractions and going on a spree of shopping. When I finally left them at Manchester airport on the morning of the 21st, it was a bitter-sweet parting. My return to work had already effected a few days earlier, but on those last two days, my heart had been with my dear wife and daughters. When I returned to work on the 21st, I plunged myself again into my work, and it has been over a week now. 

Where did we go? We visited Bath, Oxford, Stonehenge, Castle Comb, London, Cambridge, York, Durham, Edinburgh, Ambleside, Windermere and finally, Blackpool. We also made day trips to Liverpool and my family went to Manchester as well. We also visited Preston to see the Birds of Prey Sanctuary at Turbary Woods and Hadrian's Wall and the Roman Vindalonda Village while we were en route to Edinburgh. Finally, we did a day-long bus trip to the Scottish Highlands to reach the southern end of Loch Ness. A really fantastic schedule - and it all went off without any major hitch. 

There were a few minor issues, though. At Bath, while checking out, I fell down a flight of steps, my large bag following me down the steps and staying just short of landing atop my head. My back took a beating, though, and even as I write this, I still get the odd jolt of pain down the spine. The other setback was that I had a minor scratch on a rented car ... and had to pay some damages to the rental company. Other than these two incidents, a great time was had by us all. 

To read more about this phenomenal trip, do await the link backs from my travel blog. Thank you for your patience. 

To see a few snapshots from the long vacation, do visit this link.

Monday, September 26, 2016

Learning and Teaching - two sides of the same coin

There is a student inside all of us. And a teacher as well. Everything that we see is a form of learning. Everything that we do is a form of teaching, provided there is someone who is with you at that moment. For me, the presence of anyone who is receptive enough is stimulus to want to teach. Conversely, if I think I need to learn something, I would explore whatever is happening around me to seek the best and imbibe the information.

Guys, you all know me. I am always curious to learn. My chief go-to sites are www.coursera.org and www.edx.org. They conduct several MOOCs - (Massive Open Online Courses) in all areas of teaching and from universities from all over the world. Joining and auditing the entire course is, of course, free. The courses run for about 5-10 weeks. It consists of mandatory stuff  like taking a pre-course survey, attempting the end-of-the-week writing assignments or quizzes, watching all the video lectures, etc. The amount of time you need to do the "homework" is about 4-7 hours/week. If you want to collect an authentic certificate of having done the course, you might need to send a payment using your credit or debit card etc. These payments are really not large. For example, in the UK, it works out to around 40-60 pounds for the "Verified Certificate".

So, which courses am I currently doing? On Coursera, I am doing a course on Astronomy. On FreeLearn, I am currently doing a Patient Safety and Quality course from the University of Bath. And, finally, from the  edx site, I am enrolled on the "Humanitarian Response to Conflict and Disaster" - a close look at the global problem of providing effective humanitarian aid to those at the forefront of a war that they did not bring upon themselves. 

Three courses simultaneously, did you ask? The answer to this is YES. It does get a bit busy sometimes, but I am coping with it all. And really enjoying myself. 

Which brings me to the second side of the coin of education, i.e, teaching. As I am not a trainee, I do not do formal training. However, I do a lot of informal teaching. I taught a pair of IIIrd year medical students today itself. It was a bedside teaching on lumbar puncture in neonates. When you teach, you get the immense satisfaction of sharing your knowledge with others. It almost feels like you are donating to someone else. A sort of charity, if you may call it that. But it's more than that. When you teach, you also learn. And this line is for those who teach. You revise your knowledge, of course, but you are also forced to check your knowledge in real time. By doing this, you become an even better teacher than what you had been before.

Tell me your own experience as a teacher and as a student. Thank you for reading this installment.

My first drive in the UK

It was something I had to do in preparation for my family's upcoming visit to the UK next weekend. I already had an International Driving Permit. Now, all I had to do was to rent out a car. The previous week, I had gone to the one and only car rental agency located in the town - Enterprise Rent A Car - but I was refused a car as they did not have a car to spare. Hence, I booked a car online on last Wednesday, and I picked it up as per the online booking on Saturday morning at around half past nine. 

It was an Opel (Vauxhall in the UK) Corsa with manual transmission, but this is where its simplicity ends. It was a 3-door hatchback, with one door on the trunk and two side doors. It was in excellent condition. I attached a satnav from Garmin on to its front glass and drove it initially to the hospital and to my home, and then, all the way via Motorway to North Manchester, where I had to go to do a locum shift for one afternoon. 

The car performed very well. I reached my destination in about an hour and a half, and this included a few stops - once for petrol and once for a few purchases from a convenience store. My duty shift ran from 16:00 hours until 23:00 hours. My return to Blackpool was from 23:15 hours until 00:40 hours. I reached my home safely, and without any major difficulties. 

The entire journey and the two extra days that I kept the car with me (from Saturday morning until Monday evening) cost me about 80 quid. But at the end of it, I am confident I can drive anywhere in the UK with, or without family. 

Thursday, September 8, 2016

Ten thousand views... and growing

Thank you, dear readers. Your support has allowed my blog to reach an amazing figure of 10K views. Yes, sharing my posts with social media helps. What I want is for you all to read my posts and to take away what you think is beneficial to you. Some of you are inspired by my writing skills; yet others are searching for some help before they, too, take a plunge to come to the U.K. for work; some simply want to keep a brotherly/sisterly/friendly eye on their friend/colleague; yet others are looking to see how a lone person can enjoy himself in spite of the many challenges that he faces day in and day out. Be whatever it may - I am here to inform, entertain and inspire you all. 

Through my earlier blog on my life in Saudi Arabia, I have definitely inspired many of my Paediatric colleagues to work in the Middle East. One of them is now in Saudi Arabia; another, in Bahrain. A third is making plans even as I write this. With this new blog - the one you are reading - I hope to inspire a whole new bunch of doctors. These doctors have the knowledge to work anywhere in the world. Some are hesitant because it is unlike their own culture; others are worried that their incomes will fall; still others are scared about the racist undertones of British society. I am always available to help you understand. However, the final decision must be yours. 

Earlier today evening, a Muslim Egyptian doctor who has now cleared his MRCPCH called me to tell me that he has a job offer from a hospital in Wales. His dilemma is very clear: he wants the freedom to work in an advanced country like the U.K. (currently he is in Dammam, KSA), but he is worried about the cultural differences between the Islamic culture that he and his family are used to, and the permissive, Christian culture that prevails in the U.K. While I did explain to him the shortcomings of this advanced country to give his family the shield that he so desires. He is not sure if he will find a mosque; if he will be able to access Halal food; if his wife will be able to adjust in an open society; if his children can stay away from the harmful influence of a disruptive, over-permissive society; and so on.

These are valid questions, and there are no easy answers. I tried to explain whatever I knew to the best of my ability. However, I could not answer all his questions because there are some areas I am myself unaware about. I request you, dear reader, to help me with your input wherever you can. Thank you so much.

Please leave your comments and enter your insight. I need your answer to just one question. How does my blog affect you: does it entertain? inform? educate? inspire? Are you someone who is my friend/relative/colleague in real life? Are you here to make sure I am all right? Do my words comfort you? Do they make you anxious? Worried? Thanks in advance for your input.

Wednesday, September 7, 2016

Completed a year since leaving Saudi Arabia ... and why NHS is so admirable.

This is a reminder to me that I left the Kingdom of Saudi Arabia on the 3rd of September 2015. Hopefully, it would be my first and only stint of working in the Kingdom. The major takeaways of that stint of nearly 4 years were  the fact that I was able to perform Umrahs and Hajj; that I was able to save some money; that I was able to emancipate my family from being dependent on me; and that I completed the exams that would serve as my stepping stone to enter the United Kingdom (I am talking about the M.R.C.P.C.H.). 

I am unable to say which of these four achievements have led to the maximum benefit to me and my family. I would probably say each of them had their own merits. Spiritually, I came closer to Allah with my Umrahs and Hajj. Mentally, I was able to study further and get qualified with an additional, U.K. approved, post-graduate qualification. My family's "independence" served to liberate me as well. Today, my wife Nishrin and my children, Inas and Hannah have become largely independent and only occasionally have to consult me. Finally, the bank balance has permitted me to take positions in some investments within my country, something that I could not have done earlier.

Since my arrival here in the U.K., I have learned to adjust with the entirely new and unfamiliar system of medical practice. I have realised that I have a long way to go before I will get accepted by my bosses. I am currently learning a lot of skills by working at different trusts in the North Western part of England (and occasionally at other trusts in the U.K.). These skills include communication skills, cannulations, lumbar punctures, planning therapy, child protection, and a lot more.

Over and above this, I am beginning to understand how the English health system (the NHS) functions below the belt. Its underbelly, if you understand what I mean. Initially, I struggled to work, especially when it came to managing the out-patient clinics. Now, don't get me wrong. I have had a clinic for nearly 25 years in India before I went to Saudi Arabia. Nothing prepared me, however, for the kind of patients you see in the U.K. There is acute paediatrics, of course. In the clinics, however, it is all about chronic stuff. Things that can stay in a child's life for years, if not decades. Until 16 years of their life, they are ours to see. In some cases, especially with children having chronic, incurable illnesses, we continue to manage them even when they cross that age. After this, however, they transition to adult medicine. In India, the most we could do was to see them until they turned 13. I did have a few of my old loyal parents who came to me with their 15 and 18-year-olds to have them treated by me, but it was legally untenable. 

However, it is not just about age, or the chronicity of problems. It is about the range of diseases and problems that are totally different from a tropical country like India. Additionally, it is the inherent knowledge patients have about their own illnesses and about their own biological stuff. Finally, it is about how to communicate with them. British sensibilities are completely different from ours. What we discuss with patients openly in India has to be said privately and with much more empathy, for example. The risk of being sued in courts always hangs upon you wherever you work, but it is definitely much more in the U.K. compared to India. 

There is yet another, very crucial difference. In the U.K.. there is a huge infrastructure of community and outreach services that have no comparable example in India. A child with cerebral palsy, for example, has to spend huge amounts to even reach a level of mediocre care in an advanced city like Delhi or Mumbai. Even then, when it comes to successfully rehabilitating that child and integrating him with society, we can hardly do anything. In the U.K.. the system is so advanced that the child gets automatically eligible for a range of rehabilitative services. For example. even his home can be modified at government expense to get him to have a ramp to ride his wheelchair on. If a child with excessive illness related to pollution applies, he and his family can be given an entirely new place to stay by the government. Of course, the family will pay off whatever they can over years and years, but care to the child will not stop because the family does not have the means to fund it.

Child protection is a big thing and abuse of a child sets off a chain of governmental remedial actions that include but are not limited to removing the child from the influence of his abusive relatives, handing him over to an appropriate foster parent, or hand him over to court, which will then place him appropriately, police action that is swift and commensurate with the degree of the abuse, and so on. Social care services will then continue to monitor the whole thing ... until the child can be, if feasible, returned to the family - or be kept away for as long as is needed. 

With such services spread nationally, it is not difficult to understand why the U.K.'s NHS is considered to be one of the best health services in the world. And the services are 90% free to the people - not just British or English citizens, but also legal residents and immigrants after their stay has been legally sanctioned. 

This is all I will be writing about in this post. Do leave your comments below. 

Thanks for visiting, reading and interacting with me.

Sunday, August 28, 2016

Weekends doing locum work

As the weeks roll by, so does my routine of working outside Blackpool in other NHS trusts. While it is always professionally profitable to work as an on-call doctor with a bleep (which sort of trains me to work with deadlines and take a few decisions rather than just be around), it is also financially rewarding. This is because the NHS suffers from shortage of doctors across all categories and almost everywhere in England. 

This weekend being a Bank Holiday one (the holiday is on Monday, and probably because banks need a day off every 6 months to reconcile their accounts), I ended up working three instead of two nights. While my Friday night was at Tameside General Hospital, located east of Manchester near Ashton-under-Lyne and part of Greater Manchester, I travelled to Birmingham to work at the Birmingham Children's Hospital for the next two nights. I am writing this from within the BCH as I await patients in the Emergency Department of the hospital where I am posted. 

The ED is quite a busy place staffed with doctors dedicated to the ED. In addition, they have a clinical decision unit or the CDU where the Paediatric SHO (that's me) and Registrar work to see patients referred by the ED staff to us. Last night was actually very busy, and my registrar and I were busy seeing one patient after another as the night melted into a new morning. Today, it has been a gentler start, with 2 infants born within a day of each other at the same hospital but unknown to each other coming with different but insignificant complaints. Both of them have now left the hospital as their problems were not suggestive of any major form of trouble. 

The work area is divided into the actual ED with 12 cubicles, 5-6 observation bays and a treatment area, the CDU with 3 beds, a General Observations Bay where patients can be kept for up to six hours, and a Paediatric Admissions Unit (the PAU) where children who need longer hospitalisations can be shifted. There is a quiet, efficient hustle-bustle as children come in, are seen by the nurses, then the doctors and then sorted out to either go home, be transferred to the observations bay, or admitted into the PAU. Every one working here takes a break at around half past two or three a.m. when the work is lightest, but this is not always possible, so things can get rough and people can miss their break. There is a small room with a wall-mounted TV, a refrigerator, a toaster, a tea-pot and a microwave oven where people can go to relax. It all adds up to a fairly interesting shift of duty indeed. 

While I worked with a ST 5 (a middle-grade middle level registrar) yesterday, a Greek man by the name Vas, today, I am working with a Bangalorean ST 8 registrar Ratna. Working with both of them (so far) has been enjoyable. 

I have been granted accommodation within the hospital. I had some excitement yesterday when I first came in. My access card that opens doors within the hospital (which I was given by the hospital security within an envelope marked with my name) was not working; then, the room I was allocated was really the worst of the rooms within the multi-room flat that I was allocated to stay in; and, finally, I could not find my way to reach the reporting area. One by one, each of these problems got sorted out. Hence, today, it has been smooth work with no hassles. 

Earlier in the evening, I woke up from my post-on-call slumber around half past four in the evening, and decided to walk around the area. I noted a few interesting things. One of them was a no-vehicle, pedestrians only zone built BELOW the level of the roads where there was a large open space, trees, lawns and various pathways that led to the different roads around the area. There was a large group of local youth that sat under a big tree. I was really impressed with this level of infrastructure. 

I then stepped into a Jamaican restaurant (Aunt Sally's Caribbean Food) and had my first ever Caribbean meal. It was delicious and I was forced to buy some more meals to carry back to Blackpool for later consumption.

Will post photos later ... thanks for reading this. Do post your comments, as I really appreciate it!

Thursday, August 18, 2016

Blackpool Air Show, 7th August 2016

On this Sunday, I had no locum shifts anywhere, and so, took this opportunity to be a spectator at the Promenade for the Annual Air Show. I arrived at the Promenade near the Tower at about noon and whiled away the time doing stuff. I even paid £ 4.00 to enter a small model fighter plane to experience a virtual flight in a fighter. The crowds were slowly collecting. The air-show was slated to begin at about half-past one in the afternoon. I travelled by tram to the southern ends of the promenade, where I had snacks and a drink at the McDonalds that is located here. I had just boarded a return tram when the first aircraft arrived for the show.

Here are some photos from the 4-hour long show that kept us asking for more.

Before starting

At the promenade, early hours


The legendary Typhoon aircraft



Red Arrows work in pairs



The full audience by afternoon

The raging sea

The Gyro-copter

Mobile shops

Carnival atmosphere


Charities also market their stuff: this is for carer volunteers

Sunday, August 7, 2016

Weekend visit with family to Lavasa, Day 6 and 7 of my Mumbai visit

This was a visit to remember. I booked the Hotel Waterfront Shaw online through www.booking.com. The drive to Lavasa is via the Mumbai-Pune Expressway. Once you reach Wakad, you go off the expressway and go to Lavasa via Hinjawadi. 

The Waterfront Shaw

The promenade

Bridge over the artificial canal
The drive is very straightforward until you reach the final 20 km segment, which is a ghat that you have to drive over to reach village Dasave, where Lavasa has been created by Sharad Pawar. It is an expensive weekend getaway that Punekars come more frequently to - and they don't even stay here overnight. There are plenty of things to do here, such as dining out, visiting a gym, participating in water sports (closed due to monsoons), cycling, indoor sports, etc. 

The hotel itself was excellent in most respects. It is located soon after entering Lavasa (you need to pay INR 200 to the local municipality to enter the resort. They call it parking charges :-P). There are breath-taking views over the valley, and most people come to the top stopping at different places to take photos, admire the valley views and perchance eating corn on the cob (there are at least a hundred outlets on the road where this is sold at exorbitant prices). 





All the structures along the waterfront are similarly designed and it makes for a beautiful view. The hotel is part of the same long chain of buildings. The rooms were actually large, self-contained apartments with a kitchen, a living room and a bedroom. We had booked two adjoining rooms, of course. Although we did not get rooms facing the waterfront, it did not matter as the facilities inside were very good. There are several themed restaurants, and we took the first meal of Saturday and the next days' complimentary breakfast at the American Diner. We took dinner from a smaller place, while we did not get a chance to visit their Indian restaurant, named the Chor Bizarre. There was also a Grandma's Bakes outlet for baked stuff and cakes, and some other outlets (including one that made and served Lebanese food). Just next door was a Cafe Coffee Day, where I had the opportunity to have one cup of coffee late in the evening. 






During the afternoon, we strolled, had hot bhajiyas and tea, cycled on single seat and double-seat tandem bicycles and visited a games center, where we played Table-tennis. 

All in all, it was a weekend well spent. We checked out after breakfast on Sunday and returned to Mumbai by the late afternoon, Hannah and I driving in turns. 

Thursday, July 28, 2016

Day 5 of 8 in Mumbai. Enjoying the rains

It's raining, it's pouring, the old man is snoring ... Yes. This is what I was humming to myself all through yesterday as I went about attending to chores that I should complete before I return to the United Kingdom.Today, I had a pretty busy day, what with meeting a guy in connection with personal work. This meeting, supposed to last for a couple of hours, lasted three hours. In addition, I spent time with a dear friend Dr. Ashish Shah, an ultrasound specialist at his new clinic in the Ashoka Shopping Centre. He was, as usual, very cordial and forthcoming. 

During my previous visit in Feb-Mar this year, as well as during the current visit, my main activity is bonding with my family, of course, but also, rejuvenating ties with my hundreds of friends, relatives,and others. This time, I have already had conversations with my brothers, mom, some of my uncles and aunts, friends, and others. In particular, I am going to mention some by name. They include my Paediatrician friend Moatasim Solkar, my old radiologist friend Muhbeen Shaikh, and my neighbour Iqbal Bhinderwala. I have yet to have many other conversations. I also met Dr Shirin Shikari and her immensely interesting spouse Mr Tofique Shikari a few days ago, and am meeting my school friend Farhad Khursetjee on Monday. Other interactions will pan out as they will ... but all in all, I am sure I will return with some distinctively sweet memories. 

I also procured my International Driving Permit - something that I should have done many months ago. Armed with this, I hope to drive my first car in the U.K. This might have to be a second-hand car to begin with. Let's see. It will be another four or five months before the validity of my Indian car driving licence will run out, and I will have to get a U.K. driving licence.

That's it for now. Do keep visiting and reading.

Wednesday, July 27, 2016

The journey back to Mumbai, a retrospective entry ... do read this one!

I started my travel at around 5 p.m. on Saturday the 23rd. Going by train to Manchester airport, I was aware that I would have to spend about 3-4 hours inside the airport. This time, I carried with me just one suitcase and one laptop bag. En route, my baggage will increase, as it always does!

Due to the onset of vacation time in the U.K., tickets to India weren't so cheap. I finally managed to find a trip that was reasonably priced; the catch, however, was that there would be a layover at Istanbul airport for over 13 hours. I left for Manchester airport by train, arriving there at around 6:15 p.m. I would be travelling by Turkish airlines. The flight time was 23:40 hours, and I had to while away my time in the airport, having food, relaxing, surfing the net, etc. until it was time for check-in to be announced. It was at about 11 p.m. that we finally collected at the gate from where we would board the aircraft awaiting us. (By us, I mean my fellow passengers, of course).

The actual boarding started after another 15 minutes, and the aircraft finally took off near around mid-night. I saw the newly made Disney movie Jungle Book. Food on the flight was quite okay, consisting of beef pattice on rice, bread, butter, dessert and, finally, tea.

I reached Ataturk International airport at around 05:30 a.m. The arrivals lounge was quite busy even at that hour. Transit passengers were all directed to the transit counters and then the international lounge, where I have been waiting since then until now, when I have begun to write this draft that will eventually appear on my blog.

I have had the occasion to meet a few people. The first was a mother-daughter duo travelling to Boston, Massachusetts. Mom and Dad live in Dhahran in KSA, where the dad is a university teacher. They have four children, two of whom are already married and settled in the U.S. One is a younger son, who is with the parents. The  last is the daughter who was accompanying her mom today. She has secured admission to a course on Politics in the University of Maryland, and they were flying there for her to start her course. They had a wait of over six hours.

After they left, I was joined by a Nigerian student of Hotel Management. Sarah is pursuing education in this course in Cyprus. Currently, she was travelling to her home country to meet her family. She, too, has a wait of nearly eight hours at the airport.

For lunch, I had a chicken hamburger with potato crisps and a diet coke. My new friend could not find something suitable and settled for just fries and a coke. Perhaps she would eat a more substantial meal later.

I have had the pleasure of meeting yet another interesting man, Philippe RenĂ© Nsoa, a Cameroonian judge by profession.  This gentleman was returning home from a work trip to Malta, where he had gone to attend a judges' workshop. The sad thing was that he missed his flight yesterday evening, and has to wait until today evening (a total of 24 hours) at the airport. Additionally, he had to shell out €200 to purchase a new ticket.

In the later part of the afternoon, I had the occasion to meet Anjum, a Kenyan British person of Indian origin. This young, recently married girl is an auxillary nurse working in the community at Manchester. She had been to Male to be with her in-laws, and had arrived at Ataturk around the same time as me, and sitting just a few tables away from where I was during the entire morning. Now, she is returning to Manchester on an evening flight.

Wikipaedia would give you the exact details of this airport. What I wish to state here is that it is a very busy airport, huge in size, and handling at least 700-800 flights a day across its nearly 500 departure/arrival gates. The food court is FULL of travellers, and the tables at the side where people like me sit down to spend the whole day, perhaps placing our heads on the table and napping, and looking at the thousands of people who are all around me.

I did manage to buy a few things to take home, and will share pictures of the same in my subsequent entry. That's all for now ... so, as always, thanks for visiting and reading this entry. Although it was written "live" , I will be posting it a few days later after I am back in Mumbai and in my home internet network. 

Mumbai meri jaan

I reached Mumbai three and a half days ago, on a wet Monday morning. Actually, the Gods were smiling, as I made the last stretch home in a cab without any rain. No sooner had I stepped into my home than the rains burst upon us! My welcome was a very warm one, with Inas and Nishrin up at the early dawn hour. They quickly settled me onto a chair and served me hot chai. Hannah slept on, as she had slept late the previous night. After some cleansing, washing and bathing, I went to sleep, waking up at half past nine to be welcomed by Hannah, who was, by now, up and about and getting ready to go to work. 

I slept in through most of the morning and into the early part of the afternoon. In the evening, I went out for a few small errands; on the way back, I purchased food from Apoorva, which we had for dinner at home. This repast consisted of grilled fish (a large Rawas), prawns gassi and appams. It was thoroughly enjoyable. 

Tuesday saw me calling my relatives and close friends. In the evening, we went for dinner again, this time, to Chetana Restaurant at Kala Ghoda. This is a fine vegetarian place. While Hannah and I had a standard thali, Nishrin and Inas settled for dal-dhokli and a vegetable kadhai with chapatis. 

On the Wednesday morning, I went to the local RTO to apply for an international driving permit - something that I should have done when I first went to the UK (but had not). After this, it would be a mixed evening of meeting, eating and a movie -- but about all this, in my next post, as I haven't reached those events yet. 

Saturday, July 23, 2016

And, so, am travelling to Mumbai tonight ...

It's that time again. I am travelling to Mumbai tonight. A rather quick decision on my part to go and meet my family ... and this time, a layover in Istanbul for 13 hours. I will, therefore, arrive a day later. See you all guys from Mumbai there ...

Monday, July 18, 2016

Easing into the second innings of my old job

My readers - I am grateful to all of you for your good wishes. I am aware that many among you have been disturbed by the recent posts where I have hinted at emerging problems with my work here in the U.K. I had given news that I was going to have to shift to a new job from August. I am happy to tell you that I won't be shifting after all. The recent months have seen my skills go up significantly. I am now able to understand the complexity of working with the UK's NHS system much better than where I was, say, in May 2016. 

As a result, I have been re-offered a new contract with the Blackpool Hospital. I will not be working as a registrar until I can prove my talent. However, I will stay on, and continue to work Mondays to Fridays as a senior house officer (with a reduced annual salary, of course), until I am adjudged to be skilled enough to re-take the registrar posting. This will allow me to grow professionally with the same team with whom I have begun my first innings in the U.K. I am hoping that I will continue to do locum jobs on weekends, and thereby augment my knowledge and income as I am doing currently. 

This is the news as of now. Do watch this space for more details and new happenings. Thanks once again for reading and for your good wishes. If you like - do leave your comments.

Thursday, July 14, 2016

Medical Professionalism Matters

On the evening of the 12th of July, I had the unique opportunity to attend a workshop on the captioned topic. The venue was the Museum of Science and Industry at Deansgate, Manchester.

This was a joint programme of many organisations led by the UK's top regulating body, the General Medical Council. Other organisers included the British Medical Association, the RCGP, the RCP, and others. The thrust of this event was to interact and formulate a blueprint of what professionalism means to doctors and other healthcare workers in modern times. There were discussions related to several aspects of this; they included talking about proper communication, having compassion in care, being ethical and responsible, being concerned about self-development (professionally and otherwise), being safe and having a paramount concern for safety in healthcare, being a team-worker and being resilient. 

There was a keynote speaker, Prof. Jacky Hayden (@Hayden.Jacky), who spoke on several aspects of qualities of being a good health professional. Her talk was brief but it highlighted all the important issues and set the tone for the next programme - a series of group discussions. During these group discussions, a moderator from the GMC collected thoughts from the participants at each table on a specific aspect of the main theme. Thus, there were tables where, for example, communication was discussed; or, where the discussion related to patient safety, or, to doctors' advancement as scholars and innovators in their field. I enjoyed these group discussions tremendously. There were professionals from all walks of the medical field, right from junior doctors like me, to stalwarts like Pali Hungin, the president of the BMA, sharing ideas freely on all these topics. Each table sat for 20minutes, then we changed to another table, with another topic for brainstorming. 

Supper was served after these discussions, and this was then followed by a panel discussion where the panellists took questions sent by participants. The entire discussion was very illuminating. One of the speakers was Dr Umesh Prabhu, (@DrUmeshPrabhu), a Paediatrician from Wigan. He is a highly innovative person who has made a mark on NHS through his work related to Patient Safety in Healthcare. Do look him up on Twitter.

To read more about this event, and the issues raised therein, do visit www.gooddoctors.co.uk.

Thank you.

P.S. For non-medicos, who are not interested in this post, I apologise sincerely. 

Wednesday, July 13, 2016

Some unique experiences in my locum posts

The last month and a half have seen me hopping from one trust to another, gaining experience working as first on-call with them, seeing patients before they are seen by registrars, starting IV lines, attending delivery calls, and so on. There has been some addition to my savings as well, and that is definitely not something to be scoffed at. The result of these peregrinations has been satisfying. I have made new contacts at different hospitals. I have gained insight into how things are done. My practical skills are improving. The one other thing that has kept me interested in doing locums is that I am seeing a more diverse range of illnesses and learning more about how to manage them. 

To a layman, the prospect of seeing more illnesses and suffering might be intimidating. To a doctor who is learning on the job, it is very exciting to see newer problems and learn how to tackle them. In the process, I have enriched my knowledge. To give you a few examples, I worked at a tertiary care centre in Manchester. There, I saw a whole range of children with complex problems. I was able to, for the first time since I came to the U.K., understand what happens to children we refer to the tertiary centres from our own trust in Blackpool; in fact, I even met a few of Blackpool's patients receiving their treatment in Manchester. It was very educative. 

In Bolton, a few days ago, I met the first Bohri family with their sick infant. In fact, this family was the first Bohri family I have met since I came here to the U.K.! I was humbled. It was an unique experience. They were as happy to meet a doctor who is Bohri himself. Of course, it is nothing dramatic to meet a Bohri - in fact, it is normal to meet our community's people almost anywhere on the planet. But for me, on this particular occasion, it was the first time ... and so, unique.

My work at a trust in Greater Liverpool was another highlight. This is the hospital at Whiston. They have the most fantastic facilities for on-call doctors - a fully furnished room to spend the night in. No other trust offered that opportunity, and it was definitely something that was unique.

Were there other memorable things? Of course, there were. At every place I worked, I found something or the other that was different from my own place in Blackpool. Not everything elsewhere was always better; however, most registrars and consultants I worked with were very cooperative and willing to support me. That was very surprising to experience, since, in my past, when I was in India, team work and cooperation at this level is unheard of. As they say, Indians often try to pull each other down than lift each other up when facing a difficult situation. I learned a lot here. 

If I had to describe the above post in just one line, I would say that working in the NHS is an opportunity no one should miss if they can help it. It is not perfect, and it is facing a lot of difficulties, but the work culture here is so beneficial for one's personal development that it has to be experienced to be believed.

Thank you for reading this post. Do share your thoughts in the comments section by clicking on the "Comment" button. I shall eagerly await your input.

Tuesday, July 5, 2016

Catching up with my life here in the UK

Dear readers,

Due to various challenges that I have been facing here in the past few months, I have been unable to really do extraordinary things ... things that livened up my life in the UK in the first five months. However, my rather unexciting life has still been an enjoyable one ... at least to me. In the first place, it has been interesting to see the British people here as they went in to vote whether to remain within the EU or to vote to leave it. The results were not as resonantly in favour or against ... the spread between the victors (Leave) and the losers (Remain) was just 4% ( 52% vs 48%), but the political repercussions have been enormous. Both the leading parties - the Conservative party, or the Tories, and the Labour party (or simply, Labour) - are in a turmoil. While the Tories have to choose a new leader because the current PM has resigned (Mr David Cameron), the Labour Party led by Mr Jeremy Corbyn is also facing trouble as the MPs of that party have voted to give Corbyn a boot. 

Of course, the financial markets have fallen, and the pound, even more so. I remember exchanging a British pound for over 98 INR when my first salary was credited to my bank account in January. Now, it is at 88 INR. A fall of over 10% in just six months! Indeed, more pain is expected in the coming months. 

Summer, the most awaited season here, has been playing truant. The weather remains uncomfortably windy and chilly even though it is now July. It has been particularly difficult for me for 2 reasons: while I have lost quite a bit of weight (which means loss of the insulation cover of fat), the central heating in our flats has been switched off since the first of May. As a result, I now sleep with three covers over the upper half of my body, and a blanket atop that! Even then, I keep feeling chilly. The temperature is in single digits even as I write this. Oh, how I miss the heat of Mumbai! Or even Al Muwayh, for that matter (hee hee). 

Finally, I will end this with one more topic: how I am getting along. Most of my documentation for transferring to my new employment is now complete, but a few more things need to be completed. Just when I am preparing to move, my consultants are beginning to realise that they are about to lose a person who may lack some of the skills registrars possess, but who has the breadth and depth of knowledge that is really enviable. They haven't, of course, voiced that opinion publicly, but I can see that they see the improvement in my skills and understanding of the NHS. The writing is on the wall, however, and what has been done cannot be undone. I am ready to move to the new job. My experience with locum jobs in different parts of the country has really enriched me and given me the confidence to face the new challenge of working as a Senior House Officer. 

And that is where I wish to end this post. Eid Mubarak to all my readers. And a happy day to everyone as well.  Thank you for reading my blog. Do leave your comments down below. It will encourage me immensely. 

Saturday, July 2, 2016

June has ended

Dear reader,

A lot has happened this last month. I was staying away from writing as my career was not going the way I would have liked it to go when May ended. I am happy to say that the month of turbulence has finally ended and there is some clarity as to where I am going next and what I am going to do. 

First of all, my apologies to all of you for not posting more often. I was really weighing my options when May ended. One of them was to keep looking for new jobs within the U.K. The second was to leave the U.K. and explore other countries to seek a new job. This would have included middle Eastern countries like the U.A.E., as also countries like Australia and NZ. Eventually, though, I decided to stick with the U.K. and work for some more time here and see if I am able to sustain myself. 

I am therefore happy to inform you that in most probability, I will continue my work here in the U.K. from another hospital, this time in London. I have received their letter of offer. The reason I am unable to confirm the job 100% is that I will need a new Tier 2 (General) visa to be able to earn the right to work. For this, the hospital must grant me a Certificate of Sponsorship. With that in hand, I have to approach the government of the UK for a new visa. Once I have that visa, I can move on to the new job. 

My work at Blackpool will end when July ends. During this month, I will continue to try and improve my skills, as I have been doing this last month. What changed for me in June is that I began to do locum jobs every weekend. I am very pleased to share with you that I have now worked in several new locations within the U.K. This included my work in Preston, Bolton, Whiston, Abergavenny and Manchester. I have now worked as a Neonatal SHO, a Paediatric SHO, and a Tertiary care SHO within England and Wales. Importantly, these jobs are giving me more and more confidence to work in the NHS. Additionally, they are paying jobs as well, so I get paid extra money for having done them. Payment is official and comes to me net of taxes. 

Many of my friends admire my commitment and resolve to make a success of whatever comes my way. I do not call it such big things. I call it my credo. My reason for existence. My basic nature. Try and try, then try even harder to succeed. Never give up. There will be days when you might want to give it all up and return to your safe zone. Don't do that. The advantage adversity gives you is something immeasurable. Keep reaching out for the stars.

Thank you for reading my entry. Do share your comments.

Monday, May 30, 2016

A week down the line, and I am beginning to change ...

One of the wisest things I have understood is that Change must begin with one's own self. This is something that, despite knowing about it, does not get readily accepted by many who nurse their ego instead of recognising that this is the ONLY way to develop oneself. With me, it has been a gradual process that began about 4-5 months ago as I continued to struggle with the skills of a middle-grade doctor. At that time, I thought that I would improve merely by watching others at work and by being humble and willing to learn. I read a lot, took online courses on different topics pertaining to paediatrics, and, at times, stayed after duty hours to continue to learn on the job. 

How little I knew at that time that while these were good methods to acquire knowledge, they weren't enough. What I needed was to be able to handle the required tasks myself, with professional supervision, so that my skills improved. Yet another insight that I got over the past few months was that I had perhaps been wrong to accept a middle-grade job without mastering skills of a more junior grade doctor. All the things I had been doing were nothing compared to the essential need to perform tasks that described my job in a competent way. 

It was at  that point that I decided to really think hard about where I was going. I was assisted in this by my consultants who shaped my thinking and made me accept that I should probably be better off seeking to work as a more junior grade doctor and then climb back up. The process led me to meet my line manager and submit a letter of resignation with a plea to allow me to look for a job elsewhere, since, according to him, there were no vacancies at the junior level in Blackpool.

I began to apply for a new job about a fortnight ago; so far, I have appeared for a few interviews and am still waiting to be accepted by one of them. I do not know if this effort will, or will not, be successful. However, I will keep on trying till someone, somewhere, recognises my abilities and is willing to supervise me to work in their institute as a junior doctor.

An Indian medico friend of mine asked me why I was struggling this way when I could well be a consultant in India. I told him that this was an effort on my part to work in the UK with the NHS, one of the world's best, most rigorous health care system. Yes, it is true that the NHS is reeling from financial difficulties, and the managers are looking to rejuvenate it by a) cutting expenses and b) partly privatising it. None of this has come to pass as yet, but this is where the thinking is at the moment. My desire is to be a better doctor professionally. I am not worried if I have to return to India at some point in my life, as I know that the skills and training I acquire in the NHS will only make me a better doctor and be looked upon as being so.

I have also been working as a junior grade doctor on weekends. I did two night duties a couple of weeks ago, and have just done a few day duties this weekend. Both these were at the Royal Preston Hospital's department of Neonatology. This hospital has an advanced neonatal unit that looks after the smallest and the sickest of the sick newborns in the region. The experience has been really eye-opening. The work was not very taxing, but I have learned a lot of new stuff while listening to the consultants and watching them, the registrars, and the expert neonatal nurses go about performing their tasks. 

And that's basically it, for now. Thanks for reading. I will welcome your comments and feedback as usual.