obvious reasons, but will miss South Africa and many of the people who have welcomed and supported me here. The work is fascinating and highly rewarding, but also intensely frustrating - my tolerance threshold for spending half an hour on the phone trying to refer a patient to a department which refuses to answer its phone, for example, is waning. And much as there's very little in me which relishes the thought of coming back to the UK's micro-managed training programme with its endless assessments, paperwork and variety of hoops to jump through, I am really ready to be back in an environment where teaching, and feedback on how you're doing, are normal. I'm on call this evening but it's been strangely quiet all day. I actually had to attend court this morning in Port St Johns about an assault case back over New Year where I treated the victim at the hospital afterwards. In fact, they had told me the wrong day to attend and I have to come back for the actual case in a couple of weeks' time. But I managed to miss 3 hours of work and still come back to a relatively quiet hospital. I've only had one patient to see since 3pm - I've just come back from assessing a patient with known AIDS and TB meningitis, and now possible cryptococcal meningitis as well. She actually looked really well apart from refusing to speak, but I did a lumbar puncture just to make sure. Anyway the cerebrospinal fluid was hosing out through a little spinal needle - we'll have to wait for the lab results but something's up. You really never know with these patients where the immune system is totally wiped.
It's totally different these days being on call - I really notice the change of season. It's getting dark before 5pm now, and it's pretty cold in the evenings.
When I walked down to the hospital this evening, the stars were burning in the sky in that fierce winter kind of way, and the silence is really noticeable. Whereas in summer there are always noises, whether it's local guys with kwaito music on their car stereos, or the nurses giggling in their houses, or insects buzzing or dogs barking - everything now seems to shut down at sundown. But strangely, the botanical shutdown you associate with the onset of winter in Europe doesn't seem to take place to the same extent here. In fact, this part of South Africa seems to be having some kind of paradoxical springtime. Everywhere there's new flowers coming out - blue lupins, massive yellow daisies, pink and red solanum, and there's even a poinsettia in bloom just up behind our house. The coral trees have burst into bloom with clusters of crimson blossom on their bare branches. It's quite incredible. And as you walk from my house down to the hospital at night, there's an amazing fragrance from night-blooming flowers on the other side of the road. If only there were more daylight to enjoy it - I'm feeling a bit deprived at the minute as there isn't really time before or after work to run to the beach and have a swim in daylight. Last time I blogged was from Cape Town in March I think. It's been a busy few months since. Over Easter I headed back to Cape Town but overland this time, with Annelieke's sister and brother as very welcome company.
Unfortunately the enormous 4x4 pickup that Annelieke and I had bought was in the garage waiting for parts from Japan which were delayed due to earthquake-related supply problems, so we rented a little Hyundai Getz and set off, stopping with Dr Smith in PE and then hitting the garden route. I was a bit underwhelmed by the famous Garden Route, as it turns out. But the route inland from to Cape Town from George is stunning - you're on the edge of the Little Karoo which is the arid semi-desert in the interior of South Africa. The terrain and the colours were just fantastic - bright green and blue grasses interspersed with pinks and oranges, and dry, rich yellows through to reds in the earth. Plenty of distractions en route as well - great food and wine in sleepy little whitewashed villages, ostrich roaming around in fields near Oudtshoorn, and the magnificent Cango caves.Cape Town didn't let me down either. It's such a great city. I was there to run the Two Oceans Half Marathon - billed as 'the
world's most beautiful marathon' it didn't disappoint, although I'm sure the ultra marathon (56km, or 35 miles) would have been even more spectacular as the route for that took in many of the most beautiful stretches of road around Cape Town. I hadn't done a lot of training so wasn't really expecting to run it in under 2 hours, and preparing for it by running 5k then hiking over Table Mountain the night before was probably not the best plan, but managed it in 1h58 which I was pleased with - it's a long way off last year's time in Skye but I felt much better afterwards than I did then. I got to the start line a bit late (poor planning - should really have checked where it was before we had to leave at 5am on race day for a 6am start!) so was at the back of the pack, but running through a city in the dark at that time in the morning surrounded by 14,000 other runners is something else. All you can hear is the sound of trainers hitting the tarmac - the only thing I can compare it to is the sound of rain hitting the windows in a thunderstorm. Incredible. The other highlight for me was rounding a corner on the lower slopes of Table mountain to see the sun coming up above the mist out in Table Bay with its rays being pierced by the tall trunks of cypress trees. Absolutely stunning. They also had some excellent motivational posters on lampposts and pylons from the event's sponsor - my favourite said, "Pain is temporary - Glory is forever." Priceless.Unfortunately, our trip back from Cape Town was marred by an encounter with one of South Africa's many drunk drivers. We were driving on a single-lane road out in the country in the pitch darkness, and saw headlights coming towards us. As it was so dark it was impossible to tell until he was quite close that he was driving on the wrong side of the road, and both of us were
going at speed. He didn't show any sign of returning to his own side of the road, so at the last minute our driver swerved on to the other side of the road to avoid him. Unfortunately, at the exact same moment, the driver appeared to notice his own error and decided to move back into his own lane and within a few milliseconds had crashed straight into our bonnet. My own recollection of how much we spun is not all that clear as it happened very fast and I think I may have briefly lost consciousness. But when I emerged from my airbag we were in the undergrowth on the wrong side of the road, facing the opposite direction, the car bonnet was smoking and hissing, and my door wouldn't open as the whole left hand side of the car and most of the bonnet were crumpled. Amazingly, we all walked away from it although one of the girls in the back had a severe concussion and a nasty facial laceration. The guys from the recovery crew who came to pick up the cars (both completely written off) said they'd seen much less serious accidents where no-one had been left alive. All I had was a bit of neck and back pain for a few days and a bit of dried blood in my nose the next day. Plus some fairly traumatic memories. But extraordinarily grateful that we are all alive.
I was only back at work then for a week and a half before heading back to the UK. It was so good to be able to spend that time
with Gemma, as well as hang out with her family and mine. Especially great to see my sister and brother-in-law who are expecting their first child in the next few weeks... We also did a bit of a blitz on wedding plans - it's amazing how much you can organise in a week, without really even working that hard at it. It's the little things that keep surprising me though. Like spending £48 on postage stamps. Yikes. And apparently wedding cakes cost about £300 - who'd have thought?? Just before I left Isilimela it was, very sadly, time to wish Annelieke, my colleague and housemate, farewell. She finished up here at the end of April and headed off to New Zealand. It was a sad day for the hospital who have lost a very talented and incredibly hard-working doctor, and for many of us who will miss a good friend. But she has seen the hospital through an awful lot of difficult changes on its road to improvement and I think is entitled to rest on her laurels for a bit!
It's also been election time here in South Africa. The weeks leading up to it were interesting - I didn't hear anybody talking about any political issues like you would in the UK before elections, and indeed I'm not sure people cared that much. It's a real ANC area here so perhaps no-one really bothers because everyone knows what the result will be. Every time I see Jacob Zuma's
face on the posters it reminds me of an anecdote from the Hitchhiker's Guide to the Galaxy where the story is being told of a planet where the human inhabitants are ruled by a minority class of lizards who they all hate but continue to vote for, regardless. When someone asks why they keep voting for the lizards, someone says that if they didn't vote for a lizard, then the wrong lizard might get in. A fairly apt description of why we vote for any politicians at all but Zuma in particular strikes me as particularly lizard-like - even his smile on those posters is completely disingenuous. It's very easy to criticise another country's political system, and I know my own country's is far, far from being perfect. But things here just seem to be almost comic, if they weren't so tragic. For example, a senior ANC figure publicly claimed that Nelson Mandela's health would fail if people voted for anyone other than the ANC. It just seems such a cynical ploy to exploit people's lack of education by appealing to their emotional tie to the person they see as the father of the nation. I guess these types of issue are probably inevitable in a nascent democracy, and no-one would by any means want to put the clock back to the days where the majority of people in this country had no political voice at all, but it is so disappointing to witness the irresponsibility of politicians exploiting the very people they are meant to represent with that kind of underhanded tactic. Reading back over what I've written, it seems pretty clear to me that this whole year has been a pretty informative experience,
on so many different levels. I'm really grateful for what I've been able to experience here and for the small amount I've been able to achieve. People here are so grateful - even today when the police officer in Port St Johns found out I was leaving Isilimela for good at the end of next month he was extremely, almost unnervingly, upset. So I'm planning to enjoy my last few weeks and get as much out of it as I can. Thanks to everyone for keeping in touch, and stay tuned for the final installment some time next month...
