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.

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.

One more week down the line

I have now completed three months in the UK. The last week has been staid, but the work has always been challenging. The real pressure was during my taking of the Newborn Life Support (NLS) course on the 12th of the month. This is a full-day training-cum-assessment course that prepares the health worker to know how to resuscitate (= revive) a newborn baby after birth or soon thereafter (but within 1 month of birth) when they fail to breathe on their own. 

The course format was teach, teach, teach, then interact, interact, interact, and finally, sit for an assessment that included answering 50 multiple-choice questions in a paper, followed by practical demonstration of the skills learned by the candidate before one or more of the faculty members, who sat in as examiners to evaluate the candidate. The teach part consisted of didactic lectures where the faculty went through power-point presentations, teaching us the knowledge of how newborn resuscitation works. The interaction involved creation of scenarios where the faculty taught us how to do the resuscitation on different cases, followed by simulations, where the candidate learned how to do it hands-on. Finally, we had assessment, which we needed to pass in order to get a certificate of the NLS course. 

During the course, I met several doctors and nurses who were not only from our hospital (where the course was conducted), but from different parts of the region of NW England. Knowing them was the cherry on the pie. It was interesting to meet the faculty as well. One of our local consultants was the director of the entire course (Dr. Kate Goldberg). Our Advanced Neonatal Nurse Practitioner ANNP Liz Morrison was a faculty member too, as was another one of our Neonatal nurses. We had tea breaks, a lunch break and a lot of fun in between. All in all, it was a fantastically conducted course. I am happy to report that I cleared it. 

In other news, life for me goes on. My duty begins with my arrival in the handover at half past eight. It culminates in the evening handover, usually between half past four and five. However, I try and stay past this time to work and get more experience under my belt. Making friends is the pleasant side-effect of working here. I must mention that I miss the doctors who left for other posts at the end of January. In particular, I would miss the following names - 

a) Dr. Elisabeta Ene (Letty): She is a Romanian doctor training here since the past several years. A very nice person, Letty and I vibed well with each other. She has moved to a neonatology post at Burnley.
b) Dr. Ahsan Ul Haq: This very skilled Pakistan-origin doctor has been in the UK for over 12 years, and he has moved on to his new post in Burnley as well.
c) Dr. Michael Sharrat: He is a very knowledgeable and skilled second year Paediatric resident who taught me many things. 
d) Dr. Selma Mohammed: She is a very capable Sudanese doctor who has also moved on to her next post at Burnley - which makes her the third middle-grade doctor to move on to Burnley. 

Two other middle-grades continue to work here at Blackpool, viz. Dr. Yogesh Kuba (a fellow Indian), who is now a permanent staff member here, and Dr. Evelyn Chia (A Malaysian Chinese), who will move on after 6 months. 

From the foregoing, it is clear that we have a mixed-origin work force in our hospital. This makes working here a fun experience. 

That is about it for today. I hope you enjoyed reading this post. 

P.S. I believe in sharing my experience with health professionals who are interested in taking the same steps I have taken over the last five years. Hence, if you wish to have help in moving to the Saudi Arabian health service or the UK one, do not hesitate to write to me. 

Change of blog name due to change of perception

After nearly two and a half months in this new country that has become my working nation, I am humbled in more ways than one. I thought I would be "flying high" in spite of being overworked and tired. Well, to be honest, I AM enjoying myself in my new role. However, I am firmly grounded in Blackpool, and certainly not flying high. Here are some reasons:

Firstly, some issues with my contractual arrangements with the administration of the Victoria Hospital at Blackpool have led to them appointing me as a day-time doctor with no emergency duties. This has freed me up from night and emergency duties, enabling me to be free on Saturdays and Sundays. However, this has also meant that I get paid only my standard salary, with no extra payment for doing calls and emergencies. This is a situation that has caused me some grief as well as some happiness. Let me explain how. The grief is naturally because it means that I will be saving less money for  the needs of my family, for my old age and to pursue my hobbies. The happiness lies in enabling me to be free to do things that others who have emergency duties etc. cannot because they are stretched to their limit. Also, when I first arrived here, I did not know how steep my learning curve would be in the NHS. Sadly, I realised this after some weeks. Although I have enough experience to manage routine stuff, my practice in India or in Saudi Arabia had not prepared me for the immense complexity of doing structured medical practice as it is done in the UK under the auspices of the NHS. Shared care between district hospitals and central hospitals is so deeply entrenched and so systematic here, that one feels overwhelmed. Also, the superior care that children receive here means that survival rates of children with chronic, complex disorders is very high, and understanding their management is really difficult. 

Sometimes, files of such children can be as thick as eight to ten inches! Going through such files has enabled me to understand how the system works ... and believe me, it does. That, alone, has been more educative than all the medical text books that I have read in the past three decades. 

In the balance, therefore, the experience has been very, very satisfying, and I have only now begun to enjoy doing what I am doing. 

The second reason has to do with the availability of so many new things around me. I have been shopping here and there, mostly online, and the range of stuff available here has been astonishing. Every business, whether it is a grocery store, a barber, an electronics outlet, or a restaurant, has a website with a lot of interactive capabilities. They will all have a twitter account, a facebook page, an online store, and so on. It is not merely a web-presence that they are seeking, but a full experience for the prospective customer. This, in itself, is so remarkable, because it does become difficult to resist buying something or the other on each of these sites. I have sometimes ended up adding stuff in my cart that I do not need, and it has taken me some resolve to cancel my purchase and exit. On some occasions, though, I have been unable to resist, and the end result is the growing inventory of things in my house, both in my clothes cupboard and in the kitchen, apart from electronic gadgets, utility items, books, and what not. 

In the balance, I am really enjoying myself, but I do need to balance my life with saving more money and spending less. 

And now, the final reason: finding friends and colleagues from so many different nationalities and walks of life. But more on this in my next entry. 

Do respond in the comments section with what you think of this entry. Thank you. If you are unable to comment, do write to me through the shared link on twitter or facebook, or email me on drtaher@gmail.com

About how I am getting along at work

In my previous post, I wrote about my efforts to get fit. Today, I am going to share with you what I am doing at work. When I last wrote about this, I did share with you that I was still on a steep learning curve, and that it sometimes got overwhelming. Well, as I write this today, I will confirm that as far as those view-points are concerned, nothing much has altered. However, my acceptance of them has enabled me to try that much harder to overcome the obstacles that I thought initially to be insurmountable.

Yesterday, I was successful in cannulating the vein of a child for the sake of blood collection; today, I was able to do a test known as a lumbar puncture - something that one does to collect the fluid around our brain and spinal cord to check if there is neural infection.This is one test that relatives in India often do not give consent to, but here, in the UK, they are already aware that it is a necessary test to confirm or rule out infection in the coverings of the brain, or the meninges. This is a potentially serious form of neural infection, which can even be lethal if it occurs in a weak or small child.

Then, today afternoon, I trained with one of the advanced neonatal nurse practitioners, Ms. Liz Morrison, in examining well babies on the post-natal ward (where they keep mothers with recently delivered normal babies).

Now, to be honest, it isn't that I have not cannulated veins or done lumbar punctures or examined healthy babies. I have done all those things during my residency training nearly 32 years ago! And, during my years as a consultant, I kept doing those things off and on - but rarely on a daily basis. That led me to being less confident that I could pick up those skills again. Thus far, I have had difficulties in drawing blood samples from children, or in doing their lumbar punctures,  both of which I had done countless numbers of times during my training in the nineteen-eighties. Lack of continuous practice has blunted my experienced hands. There is another aspect to this as well. Techniques and the tools we use to do these collections have also changed. Needles are sharper too. In the UK, parents are allowed, nay, encouraged, to stay in the room with the child during blood collections and cannulations. All these things are unfamiliar to me, and cause me disturbance that comes in the way of my efficient performance. 

Thus, the last few days have really helped me to become a lot more confident and comfortable with the tasks I am expected to perform, May this confidence help me to convince the others on the clinical team, both, my juniors, and my seniors, to have faith and to believe in my capabilities. Amen.

On the positive side, I am very comfortable when I am asked to see patients in the Paediatric Clinic. This is because most of the consultations are of patients who are "cold", i.e., they have no acute emergency requirements. When the consultants are good to me, I get immense opportunity to learn from them. Usually, they are always good, but, at times, especially when there are many patients, the consultants do get a little impatient and flustered. I can understand where that is coming from, so it's fine. I remain patient and abide my chance to go into the consultants' examining rooms and listen to them and their conversations with the patients and their carers. They will also go over the cases I have seen and make course corrections where they find my plan to be in-consonant with the needs of the patient, or, in some way, not in line with what they think is correct. This is an immense learning opportunity and I am quite happy with it.

Any threats to me? Well, if I don't ship up in the next few months, I might get into trouble, but I sure don't think so, as I am an eager learner, and I guess the more I stay on the wards and do my work, the better I will get at my skills.