Mountains & Milestones

Hatta mountains, DubaiMountains & Milestones

How’s your week been? My third week in Dubai has proven to be one of professional milestones in addition to some real life mountains. The week started fairly uneventfully with work as usual on Sunday – the new Mondays – and was, as is commonplace with Monday’s back in the UK, a pretty hectic one. I am really feeling more and more settled in the new job and kind of feel as though I have been here longer than just a couple of weeks, which I am taking as a good thing. One thing that is clear from working so far is that the hours I worked in the UK didn’t really have much on those that I am working here. It seems that you are actually expected to earn your money here! We are, in principle, supposed to be able to have about two hours off for lunch, assuming we finish everything by 1pm, which given how busy the clinic is and how long our surgical list can, and has, been often isn’t the case. An hour and a half is more like it on a good day, with less if it’s been especially mental, before starting consults again at 3pm. Consults end at 7pm, although we often get extras or late arrivals, meaning that a finish closer to 7.30pm is more the norm. All in all, that’s nearly 12 hours at, or near, work and at least 10 hours per day, or 50 hours per week – not quite the 38 hours a week that many are used to. Still, the perks are there, with year long sunshine and views of the iconic Burj al Arab to enjoy as I eat my lunch 🙂

I have, save for one unfortunate occurence on Tuesday, been much better at arriving on time, or actually early, for work, which is so much more professional than walking into the clinic with the clients, as seemed to be the case previously. The unfortunate morning I refer to was one in which I ended up taking a different road out of The Springs, the area of Dubai where I live, and which ended up taking me further and further AWAY from Dubai instead of closer and closer to work. I have a sat-nav so rather naievely assumed that I could rely on it to get me out of the fix that I had found myself in. Well, it did eventually get me to work but the problem was that the route it appeared to favour involved taking me, what seemed like, half way to Al Ain, with the Burj Khalifa becoming a distant point on the horizon. At the last minute it seemed to sense my panic, as the ‘estimated time of arrival at destination’ changed progressively from pre-8am (ie no worries – you’re safe) to after 8am, or “yep, you’re so going to be late!” I am rapidly coming to the realisation that sat-navs out here should only ever be considered a fall-back, safety option, for those times when you really just need to get close to a vague area or hit the ‘get me home’ option, and not the accurate, reliable guides as I have previously considered and found them to be. As I say, the device eventually seemed to take pity on me and prompted me in that rather patronising tone that sat-navs the world over seem to have been programmed with, back towards Dubai, with the chosen route taking me directly past Downtown and the Dubai Mall, into Jumeira – basically, the opposite side of town to which I would normally approach work. No wonders I was late! All I could do was make the grovelling, apology call that we all hate having to dial in and accept the looks of quiet disappointment and ribbing about alarms not going off that were clearly inevitable. Grr. Still, the rest of the day went fine, especially as I was on surgery that morning, which meant I got to flex my scalpel skills for a decent period of time, something I had been yet to do so far.

If I were pressed for a preferred discipline between medicine and surgery, I would say that my leaning is definitely towards surgery. I just like the ‘see it, fix it’ air that surgery has compared to the hidden mysteries of medicine and the reliance on tests, medicines and ‘monitoring responses’ that comes with the discipline. It was somewhat frustrating, therefore, that my first few ops were just that: frustrating. I was advised at my practical interview back in November that my cat spay incisions were too big, something that I hadn’t been aware of really until then, as a) I had always managed to remove the ovaries and uterus quite soundly, and b) all my patients had, as far as I was aware, made a speedy and uncomplicated recovery. Still, in the interests of self improvement and towing the party line I was happy to try and downsize my window into cats. The theory is sound: make a tiny little stab incision in the left flank, as normal, in the correct place (this, as it turns out is most definitely the KEY), use a spay hook (something I have rarely reached for in the past, preferring to visualise the uterus) to exteriorise the organ blind and crack on with the neutering as per normal. Spay one: frustrating! Malcolm had to scrub in to find the uterus and get me started, which considering I have done this procedure umpteen times before made me feel a little impotent. Spay two: no less frustrating, although the fact the cat turned out to be pregnant and Scott had to enlarge the incision to exteriorise the uterus did make me feel a little less like a tit. Spay three: I reverted to making (slightly) larger incisions, as I normally would have done in the past, and found my mojo again. Although I had vowed to ‘spay my way’ at that point, I did perform one under Monique’s watch and with her instruction on hook use actually managed the blind exteriorisation and so was able to perform the op through a teeny tiny little hole. It did make for a much faster closure and an almost imperceptible closed incision, so I daresay I shall be converted after all.

Surgery wise, this week was a bit of a milestone moment, as Thursday saw my first case of the afternoon being a young cat who had become acutely off colour and had been vomiting. Although the cat was apparently not normally happy about trips to see us, the fact he kicked off so wildly at any attempt to palpate his abdomen, coupled with his history of vomiting and pyrexia (temperature of 40 Celcius), made the only sensible option to gas him down, run bloods, including Felv/FIV as he was a confirmed fighter, and have a good old feel of him under GA, with radiography an option depending on what we then thought. Thankfully the owners were fully on board and just wanted the best for their cat, so with the cat asleep we set to work. Our concerns were compounded by the fact that even under GA he reacted noticeably to palpation of his cranial abdomen, and when we X-rayed him we saw that he had a lot of small intestinal distension. A further palpation revealed a firm palpable mass, or certainly a mass effect, exactly where he had been reacting and so a call was made to the owner to advise exploratory surgery that same afternoon. With the risks and estimate (4500 – 6000 AED, or roughly £800-1200) understood and accepted, time was blocked out and I set about finding out what was going on with our little feline friend. This was the first non-routine surgery that I had done since starting with Al Safa and so the pressure, it seemed, was on, not that I necessarily felt it though. After all, a clinical decision had been made, with the considerable assistance of Anni, who was brilliantly supportive and happy to do the surgery herself, and I had performed just this same procedure previously back in the UK. As such, the training kicks in and you just go through the motions. So, abdomen entered, it was time to do some exploring. All in all it was somewhat less exciting than we had expected, which is sometimes how these kind of cases pan out. The swelling we had felt was either the firm, reactive mesenteric lymph node we found and which was biopsied, or the area of distal jejunum-ilium that appeared distended and contained what appeared to be firm material. A decision was made to perform an enterectomy, with the subsequent release of gas instantly improving the appearance of the local intestinal tissue, and the palpable material rather disappointingly proving to be nothing more than faecal. Still, we removed it as it was pretty firm and I would have felt uneasy leaving it in place, especially considering that the rest of the intestinal tract, including liver etc, all appeared normal. So, with single enterectomy performed, lymph node biopsy taken and the cat closed up, it was now time to basically wait and see how our patient fared. I won’t know until I go back to work on Sunday but fingers crossed that it was nothing more than a particularly nasty and acute viral enteritis, or something similar. We will see I guess.

One thing that I was reminded of with that case was the fact that we don’t have the option of reaching for the good old opioid analgesics, instead having to rely on a combination of torbugesic and low dose petcam, a non-steroidal, which would never normally be my first choice in a gastrointestinal case. Still, with options limited and the cat in need of pain relief, all we could do was prescribe gut protectants and keep the cat comfortable as best as we could.

Whilst we’re on the theme of the clinic, we had our newest recruit start today: Scott, or Aussie Scott as I think he will probably have to be known, owing to the fact that we already have a Scott and so it is likely to get very confusing without the use of a prefix of some sort. As he is from Australia then I reckon the prefix ‘Aussie’ seems ok. He seems like he’s going to be a great addition to the team and it has been fun to be able to pass on some of the pearls of wisdom that I have managed to glean from my three weeks here already, such as advice on driving and places to consider getting an apartment. We both headed down to Knowledge Village on Thursday to get our Emirates ID card biometrics done, following my wasted attempt earlier in the week at the ID Authority building, and it seemed like we both had the same initial concerns, questions and excitement about making the big move to a completely new, and in many respects, different country. As such, it should be good fun a) having another new recruit along for the ride and at a similar level of experience as me, and b) another bloke, as veterinary is obviously very weighted towards the fairer sex so its never a bad thing to have a few more guys around for some banter and just to avoid overdosing on oestrogen, which is an occupational hazard!

Other notable cases of the week included the following:
1. Two kittens that were presented for toxoplasmosis blood testing as their owners were concerned about the risks owing to the fact that the lady was pregnant. They were advised that there was, in all reality, more risk of contracting it from unwashed vegetables and the fact that her husband had already assumed kitty litter duties was the best step to take. They did, however, duly receive their full check-ups and restarted their vaccinations, including rabies.

2. A stray cat, that had been presented by the lady who regularly fed him, due to the fact that his tail was basically black, necrotic and essentially in need of chopping off. The issue with this particular case was the fact that there was marked swelling and fluid right at the base of the tail, meaning that the surgery, which was most certainly needed, would have carried significant extra risk of post-operative complications and wound breakdown. As such, it was near on impossible to give a realistic ‘final cost’ for the case. Thankfully, the initial couple of days of antibiotic and anti-inflammatory that was given seemed to make a marked difference and at the recheck the ‘owner’ was feeling much happier about proceeding to surgery, even with the same concerns and risks present. As such, the cat is scheduled for admit on Sunday.

3. A really sad case of a young (10 month) old dog that came in for further investigation of persistent vomiting and weight loss. The same dog had previously undergone exploratory abdominal surgery and was discovered to have a pyloric stenosis, which it was initially assumed may have progressed. However, on running the bloods – which we routinely run on all patients scheduled to have anaesthesia, unless the owners specifically ask for them not to be run – it was clear that the dog had severe renal pathology. In spite of checking for possible Addison’s disease (the great pretender), the diagnosis of renal dysplasia and failure was made and the very upsetting, but correct, decision to euthanase was taken, something the owners were understandably devastated about. No one ever expected that a dog of such a young age, and who was outwardly still bright, would have kidney disease and so it really came as a shock.

Apparently, according to both Malcolm and Monique, I have thus far managed to handle a few of the clinic’s known ‘difficult’ clients well, in as much as they actually allowed me to see their animals, listened to me and responded positively. Being informed of this was obviously quite gratifying and I just hope that if I can manage to ‘win over’ the challenging clients then the others should prove to be less of a concern. I daresay the very fact that I have even mentioned it here will mean that next week I get a client that kicks off and ends up hating my guts. Lets hope I am wrong, eh?

Cycling & Pushing the Boundaries

Socially, the week has been a busy one with another trip to the Nad Al Sheba cycle track on Monday evening, although that looked like it might have been in jeopardy as Monique, and most of the nursing team, ended up in theatre that evening with a Great Dane GDV. Thankfully, I was not actually needed and so was able to drive up there to meet Kevin and another Dubai Tri Pirate member, Hassan, who had completed the Abu Dhabi Long Course Triathlon, in spite of suffering three punctures on the cycle leg, which is super unlucky. I cycled well and must be getting fitter as four laps, for a total of 32km, felt good. We even ended the evening with a short run, just to help loosen the legs. Who knows, maybe the prospect of signing up for an Ironman in the near future isn’t such a ridiculous notion.

There had been plans to head to the auto track on Wednesday in order to take advantage of the fact that they open the racetrack to cyclists but Kevin had to cancel and as my hire car has proven to be unsuitable for transporting my bike (the back seats don’t fold down!) it meant that I didn’t even have my bike with me. Still, it did mean that I had the chance to head out for my first proper run since arriving, and I managed a good 10km around the area in which I live, taking me very close to the marina area. I had been concerned that the heat would considerably affect my ability to run but I posted a pretty respectable time so I can only assume that my heat tolerance must be improving.

Today was the big test as far as cycle fitness went as I joined Kevin, his girlfriend Adriana and three other Pirates – Tyrone, Reggie and Hassan, all of whom are currently in training for imminent Ironman races – for a ride through the mountains near Hatta. I had, initially, hesitated in accepting the invite to join them as I wasn’t sure if I was actually fit enough, but was reassured that there was going to be a support car with us so that if I wasn’t able to finish then I had the option of jumping in. The start was a rather unsociable 5am pickup from the house, followed by an hour’s drive out to the desert, with a couple of coffee stops en route, before arriving at our rendezvous point as the sun was coming up. Simply knowing that we were about to start cycling whilst most people were still tucked up in bed and hours from hauling themselves up was quite satisfying, and I felt really pleased that I easily kept up with them all for the first 80km, only finally accepting my limitations as we started the seriously big climbs that my legs simply were not going to get me up. I did, however, hop back on the bike on the return but did finally have to tap out for good about 15km from the end as my legs simply were not going to give any more. In light of what happened on the drive back to meet the remaining cyclists on the road I am quite glad I had been in the car.

Adriana had also had enough before the end and so we were both in the support car as we we were signaled by Kevin to slow right down. The issue, as became clearly apparent, was that there had been a really bad accident on the highway in front of us in which a jeep had hit the central barrier and flipped. There was a moment of real concern as we approached due to the fact that we couldn’t see Hassan and so thought that he might have been involved. Thankfully he came into view and was unharmed but was looking after the driver, who was sitting by the side of the road clearly shaken and with a nasty cut to his head. Apparently the driver had, for whatever reason, swerved into the outside barrier before then swerving back into the central reservation, having lost control, which then flipped the car. This had apparently happened mere metres from Hassan himself, meaning that by sheer good fortune he had been unscathed. Given the shite luck Hassan had already had that day, with two punctures, the second of which pretty much exploded his tyre on a speedy hill descent, it was almost as if some higher force was trying to really screw his day up. Thankfully he made it back to the car safely and two punctures were the worst of it.

The accident did highlight some rather unfortunate facts about the Emirates and driving. The first is that many people choose not to wear seatbelts, refusing, it seems, to believe that they actually do save lives, and the second being that lots of people drive way too fast and way too erratically. There really was no good reason why the car in question should have swerved, lost control and crashed the way it did, and with no other vehicles involved, it seemed to be purely down to driver error and excessive speed. I am not sure I am ever going to get completely used to the style of driving here, with a much higher level of aggression and recklessness displayed, but one thing is for sure and that is it does make you become a more defensive driver, with the general rule being that it is sensible to just assume that everyone around you is about to do something stupid and make the necessary moves to counter the risk.

The cycling itself was brilliant and although I didn’t complete the entire route I feel chuffed to bits that I got out there and rode well for 90km – considerably more cycling than I have even done in the last year. And in mountains too! In the heat! Not too shabby even if I do say so myself 🙂 The mountains themselves make for quite a stark, barren landscape, made up of crumbling, jagged rock, with very little in the way of vegetation, like we are more used to seeing in the UK and Europe. The addition of wild donkeys, goats and camels along the way just added to the unmistakable fact that we were very much cycling in the Middle East and not Surrey! I am currently writing this bit sat in front of the Burj Khalifa and the Downtown fountains, and was fully expecting to be walking really stiffly but have thus far been pleasantly surprised by how good my legs feel. We shall see if I still feel the same tomorrow, although I hope so as I have a kitesurfing lesson booked and really want to be in top form to get up on the board.

Family Meetup

This week saw me finally meet my 2nd cousin in law (I think I have that correct), Eyad, who I had been in touch with prior to heading out to Dubai. We had not managed to meet up until this week and so it was a really pleasant surprise to receive a message from him asking if I wished to join him and some friends at one of their houses for dinner, also meaning that I would get to meet his vet friend (Jayna) whom he had been telling me about. It rather helpfully transpired that the friends in question (Richard and Alia) lived literally around the corner from the clinic, on Al Manara Road, and so a short drive later found me parked outside their stunning villa, complete with amazing flowering frontage, and I met everyone before Eyad actually arrived. The food that Jayna prepared was incredible and a great example of her Greek origins, with amazing stuffed peppers, lamb, sweet potatoes and some really incredible courgette fritters. Unfortunately I cannot for the life of me recall the actual Greek names of the dishes but suffice to say they were delicious. I felt very welcomed by everyone and by the time Eyad arrived I had already had a chance to chat with Richard, who is currently recovering from a knee op, his fiance, Alia, Jayna, who is having a bit of mission getting all of her veterinary registration documents sorted, and Bakh, who, according to one observation, could have been my brother. I think the fact he has dark hair, was wearing glasses and was slim were the only features that warranted this comparison but as a brother from another mother he was cool.

One of the great things about the climate here in the Middle East is that it lends itself perfectly to social gatherings in the garden, and we sat outside both before and after dinner just enjoying the stunning garden that Richard and Alia have developed over the past year, and just chatting. Its been marked how little TV I have actually watched since moving here, with most evenings either being spent out doing something physically active, such as cycling, or hanging out with friends, such as that evening. The only things I have spent time viewing on a screen have been the occasional film or trip to the cinema, and I must admit that I am really enjoying the shift away from just spending dead time staring at a TV screen.

On talking with Jayna, it became clear just how helpful it has been having my registration and visa dealt with by the clinic, and the fact that much of it was able to be done whilst I was still back in the UK was a very good thing. Unfortunately, and rather unfairly, for her she had been told by her clinic to move over to Dubai and basically go through the whole process herself, which has meant at least two months of treading the often frustrating and drawn-out path of trips to various Ministry departments and not really being able to work. It would have been a mission if I had been expected to do the same and, besides, it seems really unfair for an employer to expect their brand new employee to know what to do, especially if they’re not originally from the UAE. Still, she seems happy and is now, by her own admission, rather an expert on the whole process. We joked that she could hire herself out to other new vets to help them get registered!

Bakh, I discovered, lives in Oman and was talking about the diving opportunities over on the east coast, which are apparently plentiful and stunning. You can dive off the coast of Dubai in the Arabian Gulf, but in the summer the water becomes uncomfortably warm whereas, due to the ocean swells that pass Oman, the water remains comfortable for diving in the summer. Apparently you can routinely see turtles, sharks and a whole host of other marine species, which I definitely plan to check out at some point. There really is so much to do outdoors here that it seems you could easily fill an entire year with different sporting activities each weekend. Although it would be easy to become unfit and overweight here if you chose to simply indulge in the plethora of food options and remain completely sedentary, especially given how easy it is to drive everywhere, I can’t imagine not being even slightly more active here than you would be back home, given how plentiful the activity options are and how incredible the weather is.

Talking of activities, I was supposed to be having another kitesurfing lesson today but as is the way when relying on Mother Nature, there appears to be no wind (although there was plenty yesterday, which was definitely apparent on the bikes) and so plans have changed. It has meant that I have been able to catch up, however, on CPD and editing the new book, and also just relax, something that it is important to remember to do. We’re heading out later for afternoon tea at one of the fancy hotels down in the Marina and plan to check out the sheesha cafes at the same time, which should be good fun and a great way to end the weekend. Talking of recreation, I purchased a copy of Time Out magazine earlier in the week and picked out a new cafe that they had reviewed to go and grab some dinner in before heading along to the cinema at Dubai Mall, as they were showing a final screening of Silver Linings Playbook, an awesome film by the way.

It was really nice being able to just cruise along to hang out at a beachside cafe in the late afternoon and then make a very short trip to the breathtaking scale and visual feast of Downtown and Burj Khalifa for the evening. Its always easy to become blasse to your immediate surroundings when you live somewhere but it is good every now and again to sit back and really appreciate the fact that you have the good fortune to actually live somewhere as incredible as Dubai. The hour or so that I spent before the film screening was such a moment for me, as I watched the crowds of tourists and Dubai residents all enjoying the amazing views and thrills of the fountains and the mall. In fact, I am gravitating more and more towards the option of renting in Downtown instead of the Marina, for a number of reasons. I think many of the decisions we have to make in life start life based on assessment of facts and research but ultimately the final say comes down to gut feelings, and for me Downtown is ticking more boxes on a visceral level at present. It just feels a little closer to ‘real’ Dubai compared to Marina, although quite what is meant by the phrase ‘real Dubai’ is difficult to pinpoint. I have a couple of months to decide anyway so we’ll see – maybe I’ll change my mind completely and find myself in another villa someplace.

Right, afternoon tea is calling so I should answer. Laters….

Oops… I did it (not quite again)

Burj al Arab, DubaiOops….I did it (not quite again)

As you may have guessed by the digital silence on the blog for the past week it has been somewhat of a busy one. The good news, however, is that there should be lots of fun and interesting things to tell you about.

The working week for me now starts on a Sunday, which I must admit I still haven’t gotten used to, meaning that my mind and body are still very much in ‘downtime’ mode when the alarm goes off at what feels ridiculously early. The fact that I haven’t been sleeping brilliantly probably doesn’t help matters – I am still adjusting to the heat and seem to have a choice to make most nights: either sweat it out or freeze with the air-conditioning running, something that I have opted for on several occasions, although this does come with a price, which is that you make up with a mouth and throat drier than the desert in which I know reside. Still, come the summer months, when the temperature apparently hovers almost continuously at a sizzling 40 degrees celcius, or higher, I am going to be more than happy to trade a dry throat for some comfort. Anyway, I digress. So, the alarm now goes at 6am each morning, with plans for this to gradually be pushed back as I start to get out in the cool(er) mornings before work to train, and after the usual pre-work preparations – I’m really not going to bore you with details of how I get ready for work – it’s in the car and a forty or so minute drive from The Springs to the clinic, in an area of Dubai called Umm Suqeim, which is but a few blocks back from the beach itself and the famous hotel in the shape of a huge sail, the Burj al Arab. In fact, I often pop across to the small mall across the street at lunchtime and am able to sit there gazing at the surreal sight that is the Burj. I still haven’t become used to it, even after two weeks.

The clinic is a pretty busy one and the appointments start fairly punctually at 8am, with the expectation being that we’re in a little earlier, especially if we have any in patients to attend to first. I have been consulting pretty much since starting, although have done a couple of neuters as second, relief surgeon, on one morning after a couple of hours seeing clients. This is really to help me get familiar with the computer system – not that tricky actually, although it’s the various pricing codes that are always the sticking point when you move to a new place – and to allow me to familiarise myself with the specifics of vaccinations, and other Dubai-specific matters. There are, it transpires, certain conditions that we see more of here in Dubai than I would have seen back in the UK and a few that we really see hardly at all, such as ehrlichiosis.

drawing up a dog vaccineVaccinations are something that I have now done dozens of since joining and the key points to remember are a) everything gets vaccinated against everything each year, so no two year this or staggered vaccination patterns. Basically the authorities have decreed that dogs and cats are to be fully boosted each year, including against rabies, which does make choosing which vaccines to give much simpler. In order to get their annual Municipality tag, which is effectively a registration and must be worn on a collar at all times, they have to have a readable microchip, so every animal is scanned, and then a valid rabies vaccination. We can then issue new tags in house. We actually have a few clients who visit us from outside of Dubai, such as Abu Dhabi or Al Ain, and so they don’t require a tag. It’s only animals local to Dubai that are required to have one.

With cats, the same principles apply as do in the UK, in as much as pure house cats are not routinely given FeLV vaccine, but any cats that do venture out are strongly advised to have the vaccination, as we see a lot of FeLV/ FIV positives here. The cats just seem to be a whole lot more feisty and have serious attitude, so the fact that FIV is rife comes as no surprise to be honest. In fact, the new challenge, it seems, is to remain cat scratch or bite free each day. I had one vaccination consultation where the cat was fine, albeit with very gentle and calm handling, right up until the third and final injection, when it literally switched and went feral on me, scratching me but thankfully not landing a teeth shot. Although getting bitten by a cat must suck anywhere, it’s more of a pain here as any of the antibiotics or, God forbid, hospital treatment that would invariably be required ends up coming out of your own, private pocket, as there is no NHS here and we are not covered by any work-provided health insurance. Personally I think it would be fair for any ‘work related’ injuries that require treatment to be covered by the clinic, but that’s not the deal so its extra important to take care. Even the kittens here are little savages, and I had one spirited little stray to jab the other day, which made for a real challenge – good luck rehoming that one!

EM image of Psoroptes miteIn terms of the species split, its fairly even on the dog versus cat front, with the odd small furry and rabbit thrown in for good measure, much as back home. I’ve seen a couple of rabbits in my first two weeks, the first unfortunately requiring euthanasia as a result of being really badly affected by psoroptic mange, to the point that it’s paws were all thickened and crusty, and it had small facial abscesses where it had been scratching itself. It was also ridiculously thin and clearly wasn’t going to handle the pretty intensive treatment that was needed in order to try and resolve the issue. In the UK, all we would do in such cases is some ivermectin spot-on, with it clearing quite easily. Not so in Dubai, where mange seems to have some oomph and rabbits need systemic ivermectin, anaesthetic to bathe and remove the crusts and scabs, antibiotics to manage the skin infection, and ongoing regular treatment, often with a poor outcome anyway. Diet, as ever, is another issue for rabbits here, with the same poor understanding about optimal rabbit nutrition being prevalent as it is anywhere. There’s no reason why we can’t change that though.

So, you’ve had some insight into the professional side of things here in Dubai. Now comes a story that may make you laugh, or possibly scowl disapprovingly. Either way I would like to point out that it was in no way intentional and will not, repeat not, be happening again.

wine glassesOk, so last Monday I was invited out by one of our clients, Simon, who had kindly offered to give me the low down on Dubai given as I am a newbie in town. He had an extra ticket to an exclusive wine tasting being held at Hotel H, one of the many fancy and swanky hotels here in Dubes and so, after a (typically) manic day at work, whereby I didn’t actually think I was going to get away on time for the event, I dived in a cab as it screeched up to the clinic and the two of us darted for the venue. A quick splash of water to the face at the hotel was the best I could do to try and mask the fact that I probably still smelt faintly of ‘animals’, and off to the hotel restaurant it was to meet our host and other guests for the tasting. This will give you some notion of how small a town Dubai actually is: the host for the event and the very first person we met was none other than my friend Majid’s friend, Laurent, who I had literally met for the first time the previous evening! I recalled him telling me that he was in events and marketing and so, here I was, able to see first-hand exactly what he was talking about. The company he works with, Lime & Tonic, are a specialist events company who host really cool, unique events – I recommend checking out their site, especially as they have a presence all over the world. The format for the evening was that we were going to sample about six different wines, from a number of locations and all selected by Hotel H’s gifted new sommelier, Valentino Minotti. In fact, we were handed rather large glasses of incredible sparkling wine as we arrived, and these were kept topped up in expert fashion. Before I knew what was happening, we were being presented with an incredible Merlot, and all before we had even officially started the event. I think you can guess where this story is heading….

Fast forward a brilliant evening with some incredible wines, equally delicious food and some riotously fun people, including a guy and girl from MyDubaiMyCity, a couple of Aussies and a Brit, who has been over here for a number of years and writes a great blog of her own, Debbie. I do have recollections of Simon leaving and in hindsight that should have been my cue to do the same. All I can say is that my brain must have just been in full-blown holiday mode, given that I am still adjusting to the reality of the fact that I actually now LIVE here, and so going home didn’t seem like it needed to be done. Anyway, eventually we left, hopped in a taxi that went via TECOM to drop Debbie off and then to my place in the Springs. I do remember being sick, checking that my alarm was set for 6am and then, well, then it went blank. That was until I woke to the sound of my phone ringing and the sight on the screen of a) the time (0905!!!!) and b) the caller (my boss!!!!). I was awake at that point! I could not believe that I had allowed such a thing to happen, and less than a week into a new job too. Needless to say, I couldn’t apologise enough, leaped into a shower and then found a taxi to whisk me to work over an hour late and feeling like my brain was trying to peel itself away from my skull. If you have never suffered a hangover in the heat then you haven’t really experienced the full force of a hangover, full stop. The only other time I felt like that, albeit that time it was a tad worse, was in Ibiza during my final year holiday with my original year of vets. I remember waking up feeling the desperate need for water but at the same time feeling too decrepid and ‘in pain’ to haul my carcass up in order to go downstairs to the shop to buy some, as you had to do due to the tap water being pretty much unpotable. So now, here I was, being taxied in to do a full day’s work at a busy clinic, in a country where alcohol is tolerated behind closed doors but where it is illegal to be ‘drunk in public,’ and where it is not unheard of for taxi drivers to take offence at people who are clearly drunk and promptly drive them to the nearest police station. Not my proudest moment!

All I could do was just keep my head down, do my job and accept the huge avalanche of ridicule and ribbing that inevitably poured my way. Thankfully, I actually felt pretty normal by the early afternoon, and even managed a 32km cycle at the purpose built Nad al Sheba track that evening. I was granted a pass for this, my first offence, and it was very gracious of Malcolm and Monique to see the funny side in it all, although I assured them numerous times that it was totally out of character and not something that would be happening again. In fact, I think the lessons to take home are that a) I definately can’t handle my drink (already knew that) and b) it is a bad, bad idea to do anything that involves alcohol on a ‘school night.’ In all seriousness, the law on drink driving here is very clear: zero tolerance, and even though I knew not to drive the next morning, there is always the danger that there may still be traces in the blood the following evening, with even a trace marking you as instantly guilty. As such, I think I can envisage my contact with alcohol to be limited to the odd one or two beers and only ever on a weekend. If at all.

On the subject of driving, that is one thing that demands some serious attention here in Dubai. The roads are very similar to the system employed in the States, and my journey to work and, well, anywhere really, involves traveling on the six lane monster of a highway that is the E11, or the Sheikh Zayed Highway, which runs the length of the UAE west coast, linking Dubai and Abu Dhabi. Although there are clearly marked speed limits on all roads, very few people seem to ever stick to them and it is a bit of a free for all on the roads, with lots of tail-gating, flashing of lights, beeping of horns and swerving in and out of spaces, with undertaking a given. In fact the journey to and from work each evening is an adventure all in itself. One thing that it takes a lot of self-discipline to avoid doing is gesturing at bad, or rude, drivers, such as those who speed up behind you and flash their lights for you to get out of the way. I will be the first to admit that in the UK, if I had someone do that to me when I was in the fast lane doing a decent speed, then I usually just sat there and, if they persisted in flashing or beeping, they would then get a flipping of the proverbial bird, which if anything always manages to make me feel better about the whole unfortunate interaction. Not so here as gesturing in any way to another driver that could be perceived by that person to be offensive is illegal and can land you in hot water, regardless of the circumstances. As such, it is just best to ignore the idiot behind you, signal to pull over out of their way and let them speed off on their merry little way. The problem is that I am now not even sure if it’s ok to wave in order to thank someone on the road, for the fear that any gesture could be construed as insulting. As such, I have become more of an active head nodder, which I don’t think you can get into trouble for(?).

The working days here are very long, with 8am starts and finishes of 7pm, or often later. Granted, if we get the morning’s ops and consults done by 1pm we can theoretically have a little under 2 hours off for lunch, but its rare that happens, as anyone in practice will be able to attest to. As such, by the end of the working week I am finding myself feeling pretty cream crackered. This may be one reason why I ended up feeling a little under the weather this week, as I suspect the mild fatigue just added to the challenges my immune system is having adjusting to the new food, water and environment in general. There’s a whole world of new bugs out there to start getting used to, and that fact seems to have conspired against me a little over the past few days. Either that or I am having one of my classic reactions to Subway sandwiches?! (we had really nice sandwiches provided at our CPD evening the other day, which was run by Dr Rachel Ballantyne, with the talk being on Eukanuba urinary diets and urinary crystals). I have no idea what it is (all psychosomatic i’m sure) but every time I eat at Subway I always end up feeling ill. I just can’t explain it. Weird.

Kitesurfing in DubaiThankfully, the fatigue and general feeling of malaise hasn’t impinged on my weekend too much and I got out for a kitesurfing lesson yesterday afternoon, which was awesome. The beach on which the lesson took place happened to be hosting a kitesurfing competition which, despite making it a bit crowded, especially when added to by the legions of sunbathers who chose to put themselves at risk by soaking up the rays on a kitesurfing beach, looked amazing. The sight of scores of colourful power kites and their boarders speeding off, set against the backdrop of azure blue seas and the view of the Burj al Arab made for quite a fantastic view. The lesson itself ended up being more of a refresher of the course I took in Wales back in August, and we went over safe kite handling on land before progressing on to body dragging in the water. Before I knew it, two hours was over and it was time to pack up the kite, with thoughts heading forward to the next lesson in a week (wind permitting), in which the plan is to get out on the board. That is one of the major advantages of living and working out here: the great weather, which means that fun, outdoor recreational activities like kitesurfing and skydiving are serious options. This fact means that working a busy, hectic week is way more tolerable, as you know you’re going to get some serious fun in at the weekend. My instructor was a guy called Craig, who is originally a joiner from the Isle of Man, who came over to Dubai with his wife and did his instructors’ qualifications, meaning that his office is now the beach. Not a bad way to earn a living, something he’ll be the first to admit.

The other great thing I managed to do yesterday was get hold of some tickets to go and see Metallica, who are due to play in Abu Dhabi in April, and who I have been eager to see for a long while now. Thankfully, it seems the only gigs that really sell out quickly here are pop, such as Justin Bieber, which means that unless you leave it right to the last minute there is none of the usual desperate panic to get concert tickets that you get back home. And no touts as far as I can tell. Which is awesome as touts really are a scurge on the music and entertainment industry. The tickets had sold out online but it seems that if you have the get-up and go enough to head to any of the Virgin Megastores, such as the one in the colossally huge Dubai Mall, then they normally have plenty of tickets, as was the case this time. Roll on April!

Talking of Abu Dhabi, today was a bit of a bind to be honest. I had planned to head down nice and early to watch a load of friends, and some people from work, compete in the big triathlon, as well as do some big star spotting. In fact, I was up at 5am and in the car super early only to be met the other end of an hour’s drive by road closures, no signs or directions and, most annoyingly of all, blank looks from the very same people closing the roads. At one point they ushered me through a set of cones and I had the uneasy feeling that they had directed me onto the course and so had visions of being met by a hoard of disgruntled cyclists. Instead, I just had to admit defeat and turn the car around, heading straight back to Dubai. The upside is that I now know where the concert venue is. Oh, and Ikea 🙂 So, no triathlon but it has given me a day at home to catch up on the writing, so not a major drag then.

Anyway, that’s pretty much it for this week. Until the next exciting installment….

Scaling New Heights

Sat Nav systemScaling New Heights

I have a taste of what weekends are likely to look like here in the Emirates and I have to say that I like it. As mentioned before, weekends officially start on Friday and run through to include Saturday, with the working week recommencing on Sunday. It was very novel to be able to lie in, albeit not much of one and nothing compared to the ‘norm’ which apparently involves staying up very late on Thursday and not surfacing from bed until the early afternoon on Fridays. I guess this Friday was a little different in as much as I had the car to collect, although the decision to elect such an early time to pick it up was a smart move as it meant I had relatively quiet roads on which to get used to driving here in Dubai. One tip I would certainly give any new driver here is to go and make a sat nav one of your very first purchases and definately have it on you before you head out onto the roads for the first time. The last thing you want to be doing on new and foreign roads is missing turn offs, cutting across busy intersections at the last moment and generally getting lost and stressed. For the sake of a hundred quid or so it’s small change and should keep you much safer. Besides, you’ll probably save the cost of the device in petrol not wasted by driving around getting aimlessly lost.

I had been reading Outdoors UAE magazine, which Kevin had in the villa, and had picked up the November issue, which had a focus on climbing. As a much enjoyed past-time back in the UK I had wanted to keep it up out here and so searched for the options. Unfortunately it doesn’t seem as though there is a huge amount of choice as far as indoor climbing goes, with most of the action occurring outside and in the winter, when it is warm as opposed to uncomfortably hot and humid. There are, however, a couple of places to get some indoor wall climbing fixes and I headed off to The Pyramids, opposite Wafi Mall and the Raffles Dubai hotel to check out what they had on offer. I booked an hour’s slot with one of their climbing instructors and found they had a couple of relatively high faces and some bouldering set in a corner of what is actually a health centre/ gym. Thankfully I was able to find some shoes that (just) fit me, although I did have to change into one that was a little too big for my right foot midway through climbing as I was actually in agony. Basically, my instructor, a lovely lady originally from India, acted as my belay partner whilst I top-roped a few of the routes that she suggested, starting off relatively easy and getting progressively tougher as the hour wore on. I felt quite pleased by how swiftly I got back into the groove and climbed pretty well, even if I do say so myself. The penultimate route did, however, prove a little tough and I had several false starts as I just failed to keep good traction on the wall, owing in large part to the small, fingery holds and features being something that I am not overly keen on, preferring the bigger, meatier holds and overhanging routes. Still, once I got into it I managed to do a pretty good job of navigating the route and descended hot, sweaty and tired but ultimately happy. I was able to wear my GoPro during the session as well, meaning that I got some fun footage of the routes being scaled and which I daresay I will never get around to editing – much like my snowboarding clips!

Wafi Mall, DubaiWafi Mall itself was pretty much deserted, something I found odd considering it was the weekend, although it did mean that there was not much in the way of competition for seats at a cafe I found for a spot of dinner, a drink and some much needed web surfing and Facebook catch-up. A good first day to the weekend I would say.

As I had a car I was pretty keen to get out to Skydive Dubai in order to kick start my freefall account as a new resident. As I wasn’t sure when they would be sending loads up, and mindful of the fact that the weather can often change quickly ending jumping early, I set the alarm for 6am, promptly snoozing it for an hour, and decided to head out after confirming that they were in fact jumping. The journey proved to be a little bit of a challenge, especially as the skydive centre in the desert wasn’t actually on the sat nav, and with no obvious landmarks coming up I had to use some initiative and guesswork. The first attempt to head to Al Ain, the road to which the drop-zone is located, felt wrong, as I ended up on the motorway towards Abu Dhabi, which I was fairly certain was incorrect. In hindsight, based on the way I returned home, it may well have been ok but I wasn’t really prepared to take a chance, not this time anyway. A quick call to the DZ whilst driving back through the Marina proved less than helpful and so the next plan was to aim for a landmark that I recalled seeing en route when Chandy drove me out in November: the Meydan racecourse. This got me as far as the cycle track, which I will definately return to try out, especially given the fact it is free to use, and after getting some directions from a friendly cyclist, found myself on the road I knew I needed all along: the E66 (route 66), otherwise known as the Al Ain road, which I knew for a fact would take me directly to the DZ.

The drive out along Route 66 takes you past some of the major local landmarks including the Meydan Racecourse, the venue for the richest horserace in the world, the Sevens stadium, which was built as a venue for the Rugby Sevens tournament which is run each Winter and also is used as a venue for a number of other events, including music concerts. The road also drives past the camel racing track, which made for some double taking the first time I passed it. The sight of camels running along with people on their backs was not one I was really prepared for, in spite of being aware that camel racing was a big deal here in the UAE.

The Skydive Dubai desert drop zone looms out of nowhere and is in a state of constant change as construction continues on the wind tunnel and hotel which are being built and which will make the site one of the premier skydive resorts in the world. The DZ itself is lovely, with some fantastic landing areas, fringed on all sides by the desert, and first class facilities, including two huge packing areas and a cafe. As this was my first trip back since my day of helicopter jumping back in November I requested a re-orientation and was shown the important areas and talked through the landing patterns and DZ rules by Ivan, one of the instructors.

Michael SchumacherAs we were walking outside a sight that I was certainly not expecting met me: there in front of me stood none other than the F1 Champion and all time motor racing great, Michael Schumacher! There was absolutely no mistaking the guy and it turned out that he was out with his family getting some jumps in and, by the looks of it, putting his son through the AFF course. In many respects it makes sense to see F1 drivers involved in skydiving – they are, essentially by virtue of the job they do, adrenaline junkies and so skydiving must be a perfect release for them. After all, what other activity is going to come even close to the sheer on the edge thrill that you must get from racing at the speeds they do?!

I saw Michael a few more times during the day, including finding myself standing right next to him and his two sons and daughter (I am assuming thats who they were) whilst I removed my chute following my second jump. In hindsight I should have just been bold and said hi, instead choosing to act as though he was just another regular skydiver, which I told myself he was. I guess the reason I didn’t say anything was that I wasn’t sure if he would have found any approach annoying, considering that he must get gushing fans hounding him all of the time and was likely just looking to spend some time out with his family without being bothered. I realised after leaving the DZ that, in actual fact, the worst that could have happened from being polite and saying hi was that he didn’t say anything back and ignored me. I could have lived with that. In hindsight I very much doubt that would been the response, as he seemed to be in very good spirits, and I am still kicking myself for not seizing such a great opportunity. Still, it doesn’t change the fact that I now have something in common with one of the greatest F1 champions ever, and that is really cool 🙂

My jumps were fun, as expected, and saw me complete two solo belly skydives, focusing on just getting back into the swing of freefall and canopy control, something that felt awesome to be back into. I ended the day having completed jump number 49 and feeling ready to get my B-licence nailed. Unfortunately, the Palm DZ is still on a D, or 500 jumps, limit whilst construction continues, but I am hoping that it will revert back to a B-licence DZ soon as it is most definately the Holy Grail of DZs to aim for. The ultimate aim is to be able to jump with either my little bro or dad whilst they do a tandem, which I reckon would just be such an awesome experience.

Skydives complete, it was back to Dubai and The Springs for a spot of afternoon chilling by the pool and getting some reading done. I am now convinced that it is so much easier to study having taken a refreshing dip in a pool and to sit and read whilst baking in the sunshine than it is sat at some dull desk someplace, and found the task of reading my CPD notes a pleasure. Go figure!

Safa Park in Dubai
Safa Park, in Dubai

The evening’s entertainment choice was to head along to Safa Park, a fantastic expanse of well maintained and beautiful parkland in the centre of Dubai and overlooked by the beautiful downtown skyline, including the truly mesmerizing Burj Khalifa, which twinkled away like an icicle in the sun, to watch Majid deliver a talk. I had initially expected the talk to be given in a lecture theatre and for Majid to be the only speaker. I was pleasantly surprised to find that the venue for the event, known as Pecha Kucha, was The Archive, a charming little library-come-cafe near Gate 5 of the park – the opposite end, incidentally, to where I had parked and entered, not that it mattered as it mean’t I got to stroll through the park itself, which was lovely at night.The format for the event was that there were a number of speakers during the evening, all with twenty slides that stay on the outdoor screen for twenty seconds, meaning that the presentations were all pretty slick and short. The topics ranged from subjects as diverse as ‘Moving Art’ to Majid’s talk on ‘The Secret Lives of Vets,’ focusing heavily on the important work of vets in protecting us humans from the very real threat of zoonoses. The atmosphere was really chilled, with everyone sat outside either on standard chairs, which were arranged in an amphitheatre style set-up, or on one of the beanbags, cushions or carpet that were to found at the front. Food was available in the short interval, with the burger I got being too big to finish, and as already mentioned, the atmosphere was just really great, with a very impressive turnout and a pretty eclectic crowd.

Majid introduced me to some of his good friends, and I also had the pleasure of meeting his beautiful new wife, which was a real honour. One of his friends, Paul, was the person hosting the event and I offered to give a talk myself at the next event, something that I reckon would be a lot of fun and for which I already have an idea.

Overall, as far as weekends go I can say that my first official weekend in Dubai has been brilliant and I know that I have barely even begun to scratch the surface of what is on offer here. In fact I have already been identifying events and concerts that I fancy going along to, including some pretty tempting acts coming up at the venues on Yas Island in Abu Dhabi, including the legends of rock, Metallica, who I definately have to see! One of the challenges, I reckon, of living here in Dubai is working out how I am going to fit in all of the fun whilst also having to work. Ah well, not a bad ‘dilemma’ to be faced with.
Talking of work, I’d best log off now as its an early start to head to the clinic for the first day of the working week tomorrow.

Laters….

Chris 🙂

Practicing in Dubai

Burj al Arab, DubaiAs many of you may know, I have recently made the big move from the UK to the Middle East, where I am now practicing as a small animal vet in Dubai, part of the United Arab Emirates. It is a move that has been many months in the making, with a lot of paperwork and organisation involved before being able to finally get on the plane and head over to a new life here in the sun and heat. In terms of Vet School Success, I intend to continue my work on the subject of vet school applications and careers from over here, such is the wonder of the world wide web 🙂

I thought it might be of some interest to you to offer an insight into the work of vets over here, compared to the UK where most of you will be seeing practice, either as a point of interest alone or because you might one day see yourself packing your bags to work and travel in far flung lands. Either way, I hope you find the following interesting. If you want to read more about this new Middle Eastern adventure ‘Dune Under’ then feel free to head on over to my personal blog (The Nerdy Vet), where you can get the whole exciting story as it unfolds, chapter by chapter.

So, what are the main differences between doing the work of a small animal vet in the UK and here in Dubai? Well, there are a number of differences, spread across a number of specific catagories. These are:

Paperwork

In order to work as a vet here I have had to provide a lot of paperwork, from notarised, legalised and equivalised copies of my GCSE, A-level and degree certificates, to signed and similarly legalised accounts of my employment for the past five years. In order to work as a vet here you have to show evidence of a minimum of 5 years of work experience, so it is not currently an option for someone fresh out of university.

Exams

Believe it or not but I have to sit an exam in order to be fully registered here. I was due to sit it a couple of days after arriving but ended up missing that one and so am yet to do it. All it means, however, is that I am currently not able to be in the clinic as the sole vet, so its not really something that is impeding my ability to work effectively anyway. The exam itself is a range of short and long answer questions, primarily on UAE guidelines and laws relating to veterinary, and a lot on notifiable diseases, many of which I hadn’t read about since vet school itself.

Health Check

They’re very cautious about who is let in to work in Dubai, and pretty much the first thing I had to do on landing was head to a clinic for a full health screen, involving a blood test and chest X-ray, looking for TB. Needless to say I passed, otherwise i’d have been put straight back a plane for London!

Working Conditions

It is hot – very hot – outside and thankfully we have the luxury, or rather necessity, of air-conditioning, without which it would soon become uncomfortable to work properly. At the time of writing, the average daily temperature is about 30 Celcius, although it is just heading into Spring now, with Summer being the time when the temperature really ramps up. I have been informed by numerous people here that the Summer here is a whole other ball game, with temperatures of 50 Celcius the norm, and humidity approaching 90% plus! Basically, too hot and humid to spend any real time outside, which just seems nuts coming from the UK. We shall see and I will report back on how I am faring. Unless I melt, which by the sounds of it is a distinct possibility!

Animals

Not a huge difference in terms of the species I get to see, with most of the clinic’s work being with dogs and cats. However, many of the animals, and especially the cats, have a little more attitude. The cats I have met so far have generally been psychotic and ready and willing to bite and scratch at the slightest chance given. The career-long run of avoiding cat bites that I have been so careful and keen to avoid may, I fear, come to an end at the teeth of a Dubai cat. Antibiotics and swear box at the ready!

Drugs

Not a comment on the social scene but rather the relative difficulty there is in getting many of the medications that I had taken for granted back home in the UK. Instead of being able to just put in one order with a single supplier, and get stock the next day, here the clinic has a Herculean task of dealing with multiple suppliers, with orders often having to be placed and paid for months in advance. Certain medications, such as opioid painkillers and benzodiazepines, such as diazepam, are simply illegal and so completely unavailable, which has demanded a bit of a rethink on analgesia and seizure management.

One good thing, however, is that without any form of Cascade system in place, we are very free to use whichever drugs we feel would be best for our patients, regardless of whether they are specifically licensed for use in animals or not. That certainly makes treatment options a lot more interesting, and there are some medications which are used here that I personally have no experience of prescribing, meaning that I have some serious learning to do.

Vaccinations

Basically, we vaccinate against everything, including rabies, every year. Animals also have to be microchipped and have a new Municipality tag, which is basically a Government registration, each year. This is supposed to be worn on the collar and is issued at the same time as rabies vaccination is boosted.

Diseases

Given the climate, we see a fair amount of infectious and parasitic disease, with blood infections such as ehrlichiosis and haemobartonella encountered far more than I ever would have seen in an entire career in the UK. Tick borne diseases are common, whereas fleas are fairly rare – quite the opposite to the UK. In terms of skin problems, we see a lot of ringworm and ear mites, and I have already seen a really severe case of psoroptic mange in a bunny, that resulted in it having to be euthanased.

Referral

There is very little in the way of options to refer complicated cases here, with the closest decent orthopod down in Abu Dhabi. This means that a lot more of the caseload we see remains in house for us to do the best we can for our patients. As such, there is all likelihood of seeing some very interesting cases, many of which would probably have been referred out the door back home.

Lifestyle

Kitesurfing in DubaiThe lifestyle, especially in the winter months when it is nice and pleasantly warm outside, is great, with opportunities to really indulge in the kind of leisure activities that you would normally have to wait until the summer for, or freeze, back home in the UK. These include kitesurfing, which I was doing only yesterday, and skydiving, which I was doing last weekend. We also get some amazing sporting and music events coming to the area too, with big name acts to see and tickets that don’t sell out in five seconds flat.

So, that is just a bit of a potted account of the main differences that I have found as a new small animal vet here in Dubai. If you have any specific questions about any of it then feel free to send them over, or ask away on the Facebook page.

Until next time