Well I am coming up to the end of my Probation, the end of Ramadan, the end of my 41st year on the planet and the beginning of EID holiday. So I thought I would have a quick reflection of life here in Saudi Arabia. I am sitting in my room staring into the dark with the mass of orange lights guiding the speed freaks in the Turbo lane to a near death experience. The mosque has just rung out the last prayer for the day so we have a bit of silence for the next 8 hours.

A few days back I read through my own blogs since coming to Saudi. And apart from the typos, of which there are many, it is interesting to see what I have become use to, and what has become even more insane.

For Monty Python fans imagine the 'Holy Grail' scene where the witch is being compared to a duck to prove she is a witch. Well many conversations here take that form....for real. A few examples:

1) Rod v the Bank Teller

Rod: Why is Maryborough written on my account details?

Teller: It is your address

Rod: No, I don't live in Maryborough

Teller: But it is in the address column so it must be your address

Rod: No I really don't live there; it is in a different state

Teller: maybe the man at the main bank thought you lived there

Rod: Ahh..no..can you fix it please?

Teller: Sorry sir it cannot be fixed because it is in the computer.

2) Rod v Surgical Registrar

Rod: Thank you for reviewing this burn on the child (partial thickness 8% chest from hot water 24 hours earlier)

Dr: Could you remove the dressing?

Rod: Sure (notices the dressing is stuck and prepares to irrigate off)

Dr: Why is the dressing not removed?

Rod: It is stuck. I am going to irrigate it

Dr: Just pull, it is OK

(Sheets of skin peel away with the dressing)

Dr: get me some saline to remove this dressing

Rod: That is what I am doing

Dr: OK all is good dress it with vasgauze

Rod OK Dr, could I have some analgesia for the child?

Dr: yes I am writing a prescription

Rod: Sorry, I meant now before I do this dressing as it will hurt

Dr: There is no need for analgesia now, burns only hurt during the inflammatory response.

3) Rod v Patient (this happens in various forms all the time)

Rod directs patient to bed (for the purpose of the blog, conversation is translated into English)

Rod: Please sit on this bed

Pt: Will I be admitted?

Rod: The doctor needs to see you first

Pt: I need to be admitted

Rod: Really, the doctor needs to talk to you first

Pt: You need to take blood

Rod: Maybe, let us see what the doctor orders

Dr: hello, what is the reason you came to hospital

Pt: Pain...you should take blood and admit me

Dr: Do you have Diabetes, high blood pressure.......

Pt: Maybe, take blood and see

Dr: OK, FBC, UEC, LFT, and fluid

Pt: I want a cannula, but it is not allowed to hurt

Rod: I will be careful but it will hurt a bit

Pt: (burst into tears) I don't want any pain, I just want blood taken

Rod: thinks (I wish this place had a psych ward.....for me)

And finally

4) Rod v Parent

Parent: I wish to go outside for a cigarette

Rod: OK but your daughter (7 years old) needs to stay here as she has a cannula

Parent: She wants to come with me

Rod: (knowing the parent wants to go home and return later) I am sorry sir it is against hospital policy to leave ward with a cannula

Parent: Oh come on pleeeeeease

Rod: No I am sorry, if you want to quickly go out for a cigarette one of the female nurses can watch your daughter in the bed.

Parent: Just take the cannula out and stick a new one in when we come back, she is use to cannulas it doesn't matter

But away from the Monty Python side of the place I am slowly adjusting. That is not necessarily a good thing as it means my skills are rapidly disappearing too. Nurses here do not do ECG, nebs, O2, suctioning, assist any airway insertion, dressings, or initiate any medications at all.

However we do not have to double check fluids, but do have to countersign Panadol. The largest dose of morphine I have seen given is 2mgs IV in total for cardiac chest pain. There is no analgesia pre-suturing and no Emla pre cannulations, except for doctor's children.

Nurses do all cannulations as very few doctors know how as it is not in there scope. Also nurses are expected to dutifully hand doctors any paperwork they request. Even if they are literally standing next to the file.

I am getting good at cannulating children as the youngest person I have cannulated was 4 days old. And there are still no tourniquets in the hospital. Gloves and Penrose drains are the go.

There are so many things that are so different here. I expected difference, but logic is completely lacking. However, Saudis NOT in National Guard are great. National Guard is basically a job creation project for the Bedouins to get them out of the desert. Regardless of attendance at work, they won't lose their job. In their eyes they own the hospital so often tell the staff what treatments they want.

I know I am sounding cruel, and I have become very sarcastic here, but it really is a bizarre place. And sarcasm becomes a survival skill.