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Nepal: A Trip To Dhakalthok

As I mentioned in the first blog post, our group was fortunate in meeting with Peter, the founder of Tsering’s Fund at his hotel. We had arranged to meet him for dinner and when we arrived we saw a huge truck being loaded with rice, tents, tarpaulins and various items useful to a village in need. Peter said that they were leaving the following morning for the home village of his friend Raj. This village had been completely flattened by the earthquake and had suffered fatalities due to the damage.

Sara and I saw our chance to do something useful with our time, so we cheekily asked if we could tag along. Less than 5 minutes later we had a jeep and a driver sorted for 6am, so with half an hour before dinner we went shopping. We decided that in our roles as health professionals it was in our interests to do our best to promote good hygiene and cleanliness, so that was the focus of our shopping trip. We went to a tiny shop 5 minutes walk from the hotel and began our mission. The main items on our list were things like soap, shampoo and toothpaste so that the families could look after themselves. We wouldn’t have dreamt of going out to a village with just these supplies but tagging along with 3 tons of rice seemed more appropriate.

As a side note we heard stories of medical teams swooping in to remote villages with all sorts of medicines and dressings but with no food, and bearing in mind some of these villages had been unreachable for weeks, to have a truckload of bandages and antibiotics turn up when your village is starving, is next to useless.

A minor dilemma we had was about exactly what products would be both suitable and the best value. Luckily it’s common for shampoo to be sold in sachets in Nepal, so that was perfect. Bars of soap were individually wrapped, toothbrushes sealed, it was excellent. But then the issue of sanitary towels raised its head. Disposable towels run out and create waste. Reusable products like washable towels need to be properly cleaned to minimise the risk of infection. Unfortunately we had to go with the wasteful option.

As we loaded our bags up and explained why we were emptying their shop, the owners suddenly became really excited and started throwing in donations of their own, as well as really decent discounts on the items we were buying. It was so incredible to watch them scurry through the shelves and then dig out a bag of hair clips or some other luxury item that they wanted the girls of the village to have.

With 5 full bags of sanitary goods, water bottles, rope, reels of hose, books, pencils and of course, toys, we dragged ourselves back to Peter’s hotel for dinner. I think they were quite surprised at how much stuff we managed to accumulate in less than an hour, but of course we were annoyed that we hadn’t thought of tagging along sooner, because we could have spent a whole day buying even more!



Soap, shampoo, sanitary towels, pencils, paper, colouring books, toothbrushes, toothpaste, hair bands and clips, water bottles, hose reels, scrubbing brushes, balloons and bouncy balls.

Soap, shampoo, sanitary towels, pencils, paper, colouring books, toothbrushes, toothpaste, hair bands and clips, water bottles, hose reels, scrubbing brushes, balloons and bouncy balls.

We spent dinner listening to the amazing stories that Peter’s team had to tell; Eric’s adventures rafting in Tibet, Pem Dorjee’s life as a Sherpa (he got married on Everest!) and Peter’s never ending efforts to improve the lives of Nepalese children.

Inspired and excited, we all retired early for the 5am start the next morning.

The drive to the village was long and uncomfortable but at the same time gorgeous and breathtaking. We weaved our way across the mountain roads, and across what used to be roads before the quakes hit. At some points there were piles of rubble 2m deep where landslides had covered the road, which we had no choice but to drive over. There were times when I was doubtful we’d get through, but then I remembered that the truck had literally just steamed on ahead, so of course we’d make it.

The convoy on our way to Sindupalchowk

The convoy on our way to Sindupalchowk

Obligatory "looking at the map on the car bonnet" photo

Obligatory “looking at the map on the car bonnet” photo

We arrived at the village at about 9am, and a crowd began to form around the truck. Peter (a dentist) began handing out sweets to the kids and got completely mobbed. We walked around the village, shocked at the utter devastation. Everyone here had suffered loss, many were lucky and had only lost their homes and their possessions, others lost cattle and livelihoods, some lost wives, husbands, mothers, fathers and children.


Someone lived here once


The view from the village was breathtaking, but the devastation was everywhere.


Every family was affected by the earthquakes.


This crack in the ground appeared during the earthquake, one woman told us that scalding water shot out of the ground and burned her arm.

One infant was pulled from the rubble, alive, but something about his eyes hinted at a possible neurological injury. It was those like him, who survived against the odds, that kept the others strong and determined to rebuild. The road to the village had only just been cleared, so outside aid hadn’t yet reached the people there. The village’s school was completely destroyed but materials were salvageable, and tents were provided as a temporary measure. The biggest house, a two storey townhouse sorta building was still standing but completely unsafe.


This infant was pulled alive from the rubble after being trapped for several hours.

We were shown around the village, led over piles of rubble where houses once stood, and told stories of loss and heartbreak. Then we got the balloons from the car. When the kids realised we had goodies we got mobbed. They were already eager to play around and loved having their pictures taken, but when they were given the toys, the atmosphere became electric. Balloons inflating as far as the eye can see, balls flying through the air, smiling faces… It was incredible.


The kids loved having their photos taken

The kids loved having their photos taken




Who knew an Angry Birds colouring book could bring such joy?

After cheering the kids up for a while, we asked the women to line up to receive their (somewhat less exciting) goodies. The queue stretched back forever, but we got through it quickly, filling open hands with shampoo sachets, bars of soap, sanitary towels, hair bands, toothbrushes and toothpaste.


Then we stood aside while the guys with the truck got to work. 3 tons of rice and ton of lentils, distributed to each family. Not long after, I looked past the truck and saw a line of villagers carrying their rice to their makeshift homes. It was quite a sight.


3 tons of rice!


Family names were called, rice was distributed, then the next came forward.


The entire village came out to receive food and aid.


The rice was carried home.

Then came the awkward bit- the famous Nepali hospitality. These people who were poor before their homes were destroyed insisted on cooking us all lunch. We couldn’t say no because that would be rude, but taking food from those with nothing was excruciating. And really really tasty.


The truck was empty so the kids piled in.


The TASTIEST dal bhat ever. Also the guiltiest.


It’s kind of natural to smile for a photo, except when you’ve lost everything.

We left shortly after lunch, cramming ourselves back into the Jeep for the long bumpy journey back to Kathmandu. When we got back to Peter’s hotel, we all sat outside and talked about the day. The two photographers Wes and Eric looked through their cameras and showed us their favourites, competing against each other for the best photo of the day. Wes had been swamped by the kids, so his photos were mostly of bright colours and happy faces, while Eric walked around and spoke to the adults who had lost their homes, so his were more dramatic and evocative. Both sets of pictures showed our experiences perfectly, and captured the emotions vividly.

While we looked through the photos, black clouds crept above us and thunder rumbled menacingly, while flashes of lightning lit up the sky. We took that as our cue to put the expensive photographic equipment away and go our separate ways. I wanted to walk in the rain for a while, the events of the day had affected me and I wanted some time to process them. My colleague S didn’t fancy retiring immediately to the hotel, so we walked for a while around Boudhha, seeing how different the landscape was when the sun wasn’t shining. We observed a Buddhist ceremony in a tent outside Boudhanath, and then walked back towards our hotel, past one of the vast tent cities that had sprung up in a nearby park.


Boudhanath Stupa


These impromptu housing estates were genuinely astonishing, as they popped up in every open space, and the inhabitants didn’t fit one particular class or caste; they were all just people who had been made homeless by the earthquake. We saw a couple of teenagers sitting in a large tent playing Angry Birds on iPads, while next to them was a bit of tarpaulin draped over some bamboo housing about 8 adults and 5 children. The government had opened up public parks and spaces to allow people to put up tents, and even military grounds were covered in tarpaulins, but some of the more exclusive hotels had increased their security to prevent anyone from camping on their lawns and being an eyesore to the guests. This was even more shocking considering that some of the more “famous” aid agencies had booked rooms there for their staff and volunteers.


The reality of life under canvas was even more stark when the rain started.


Even roundabouts were covered in tents.


Some could afford to buy tents from the trekking shops, others made do with tarpaulins.


Tundikhel Park, a sacred and special ground became home for many.


Even the slums were damaged when the earth shook.

We continued walking in the rain, enjoying the fact that we weren’t inhaling dust anymore (Kathmandu is a really dusty and polluted city at the best of times so when half of the buildings are in pieces, the dust is a real problem) and talking about what we wanted to do next. After about 2km we were both a bit tired and facing a long walk uphill when a car pulled over in front of us blocking our path. It’s a fairly safe city, but instantly my heart raced, wondering what was next. Tsering wound her window down and exclaimed “who do I see walking around in the storm?” and ushered us into her car. We gratefully accepted.

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Nepal: The Hospitals

So after my ranty overview, here’s some info on the hospitals I visited and my impressions of the medical care I witnessed.

Bearing in mind the rest of the team had already been to about 10 hospitals by the time I arrived, we were starting to run out of options!

The first hospital I visited was Patan Teaching Hospital, a large facility to the south of the city. The most striking scene was the sea of tents outside the building. Apparently the hospital had sustained some damage, but the main reason for relocating outside was due to fear of aftershocks, and people didn’t feel safe above the ground floor.

Tents in the courtyard, replacing damaged and unsafe areas of the hospital.

Tents in the courtyard, replacing damaged and unsafe areas of the hospital.

In the first few days after the initial quake the hospital, like most others, became very busy with mainly orthopaedic patients suffering from injuries to their extremities. An orthopaedic theatre, run by a combination of local staff and overseas volunteers, had been established outside in a tent. When I was told about this my first question was “Do you have a C-arm in there?!” Yes, but no lead. And really close to other tents and working environments. Luckily (!) due to the atmospheric temperature being in the 30s use of the C-arm was limited due to risk of overheating. But it was certainly a sight to behold!

A temporary orthopaedic theatre outside the hospital. With C-arm. In a tent.

A temporary orthopaedic theatre outside the hospital. With C-arm. In a tent.

Inside the building’s radiology department was a quite fancy DR unit (nicer kit than we’ve got at home!) but it wasn’t busy enough to warrant using both rooms. The CT scanner was fairly busy, but that was about it.

Newly installed radiological equipment.

Newly installed radiological equipment.

Patients were lined up in the ground floor corridor and outside in the tents. Ex-fixes and casts were the main repair strategy as nailings and ORIFs take too long and increase the risk of infection. Generally it seemed that more complicated injuries were less survivable although cardio-thoracic operations were being performed.

The next hospital we visited was about an hour’s bus ride from the city; a small facility specialising in plastics and reconstruction. We’d never have found it if we weren’t being taken there directly. Surrounded by utter devastation, this two-storey, beautifully presented building with a single radiology room (CR X-ray) and single radiographer, along with a small orthopaedic, plastics and surgical team, were performing near-miracles during normal circumstances, and were genuinely incredible in the crisis situation. Literally saving life and limb, with fantastic rehab facilities, I was genuinely impressed. The only thing they admitted to lacking was a radiologist, but this could be solved remotely fairly easily.

The entire radiology department!

The entire radiology department!

The only other hospital I chose to visit was Tribhuvan University Teaching Hospital, where I spent the morning sitting around discussing radiation safety standards with some of the more senior radiographers, and a couple of hours in the afternoon observing a complete lack of any in the actual department.

The layout of the general X-ray rooms was a single corridor with four rooms coming off it. The exposure consoles were in the corridor (!) and patients entered from a door on the opposite side of the room and exited via the console corridor (!) where they waited to collect their printed films and reports.

There was a wooden (not lead) screen in the corner of the room where patients would change into a gown (multiple use, not a clean one per person) while the previous patient was being examined. I assumed it must have been made of lead, but upon closer inspection it wasn’t. One thing that has always struck me about Nepal is that for a country with a very modest culture, there is absolutely zero expectation of privacy. At one point a 40 year old woman was dressing behind the screen when the radiographer brought in a teenage boy to change into the gown she had literally just taken off.

Relatives are expected to do everything for the patient, it’s common in countries like Nepal for nursing duties to be performed by a relative so when you are admitted there will be a couch or narrow gurney for your mother or daughter to sleep on. This extends to moving and handling- the Radiographers do nothing. Pat-slides in CT are done by the family while the clinical staff watch. An elderly lady, probably about 80kg was brought into the X-ray room by her granddaughter who was maybe 15 years old and all of 50kg, and she was expected to haul grandma out of the chair and onto the X-ray table. I couldn’t bear it so I helped move her, and was actually told not to, lest they come to expect it. Shocking. I pretended not to understand and continued anyway, but it was really awkward.

In fact to be honest the radiographers didn’t do a whole lot. They call the patient in, shout at them to get into the correct position, move the tube, open the collimators and go press the button (I won’t even go into the exposure factors they were using except to say 70kV/30mA for a chest??) then the CR cassette is put into a cubbyhole with the form and someone else collects it for processing. How are you going to improve your image quality and do things like reduce dose with collimation if you never see your image? I mean, shit it was fast! Patient in, press button, patient out. No repeats, no adapting technique; I was desperate to ask a radiologist how the hell they report these films with any confidence, but I chickened out.

The only saving grace is that the equipment was half decent so at least its modernity would (hopefully) have a dose reduction effect. They had a fancy new DSA suite, which was installed shortly before the earthquake and when they checked on it afterwards the C-arm had lurched across the room and smashed into a cabinet and the carbon fibre table had split down the middle from where it then smashed into the C-arm. Apparently the actual innards of the machine were fine though, and the controls were fully working so that’s good I guess.

Their new CT scanner (a Siemens 256 slice) was working hard since their old 16 slice broke down, and they had big plans to get a 3T MRI and DEXA suite which is great, but how about some proper changing cubicles first? And perhaps a lead coat or two for the relatives that accompany the patients?

It was especially frustrating because earlier in the day I had spoken with some of the more senior staff about implementing protocols and DRLs, and using IR(ME)R and IRR99 as the basis to write their own safety guidelines. Maybe it’ll trickle down if it happens. Maybe.

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I’m sure I don’t need to tell you about the devastating earthquakes which hit Nepal in April and May this year. And if you’ve read this blog before, you may be aware that I spent a month in Pokhara (Nepal’s 2nd city) working in the radiology department of the biggest hospital there in 2011.

So it may not surprise you to read that I’ve just got home from Kathmandu after going out as part of a disaster response team made up of radiographers, radiologists and a sonographer. The team was assembled by RAD-AID, an American organisation which sends teams out to developing or crisis-hit countries which require radiological assistance.

Other members of the team had arrived before me, and were there when the 2nd earthquake struck. They were unharmed although understandably shaken (yes, pun intended) but the radiology team at Tribhuvan University Teaching Hospital took care of them well.

I was packing my bag and booking a cab to the airport when I heard about the second quake. I continued anyway as I figured that help would be even more pertinent now.

My connecting flight from Doha to Kathmandu was cancelled but I was bumped to another 7 hours later so that was fine. While on the plane I got chatting to my neighbour who was a Nepalese ex-pat living in Philadelphia and working as a structural engineer. She had got on the first flight she could, leaving behind a young child and a worried husband. She said that she felt she had no choice but to return home to help, and she was incredibly grateful to all the foreigners coming along to assist in the recovery. Less than 24 hours later I had already come to the conclusion that her skills were much more needed than mine, but I’ll get to that later.

I arrived at the airport to scenes of chaos, but nothing too different from my last arrival there. Our flight had been in a holding pattern for over an hour due to tail wind, and this had obviously affected other flights too, but the chaos was typical Kathmandu.

The hotel was gorgeous and I felt awful. On the drive through the city I saw only a glimpse of the devastation, and the sprawl of tents in every open space. To be staying in relative luxury (a roof, a bed, running water) felt wrong. I was also pretty impressed it was still intact.

I serendipitously bumped into the rest of my team on the stairs a few hours after arriving, so introductions were made and stories shared. S, the Sonographer, was my room-mate and we got on well fairly quickly. Z, the CT tech, was the team lead, and it was apparent fairly soon that he was a bit out of his depth, and F, the Radiologist was pretty chilled out about the whole affair.

It turned out that they had spent the past couple of days in the company of a local radiographer, visiting radiology departments throughout the city. This rang alarm bells immediately. I was lead to believe that there was a desperate need for outside help, and that’s why we were there. Apparently this was the case in the immediate aftermath of the first quake, as the department suffered an increased workload as well as staff fatalities and departures. There was also a radiographer at a hospital in Jiri (one of the worst hit areas, about 6 hours east of KTM) who had contacted the team after the first quake but had fallen ominously silent after the second.

So on my first day we continued the team’s main activity of visiting hospitals, uninvited. I’ll cover the individual days and visits in separate blog posts as they were informative, if next to useless.

Before I had arrived, the team were staying in another hotel and had met some really interesting characters. There was Peter and his documentary crew, Eric and Wes, who were filming and photographing Peter’s activities to be screened at an upcoming fundraiser. Peter’s story is long and impressive. He’s married to an American who is fluent in Nepali and has summited Everest several times. They’ve also adopted 3 Sherpa girls, raising and educating them in a much more luxurious lifestyle than the one they were born into. He runs a foundation committed to educating Nepali girls and lifting them out of poverty. More on Peter and his endeavours later.

Another amazing person is the one who Peter’s foundation is named after, Tsering, who owns the two hotels the team stayed in. A beautiful, ageless Tibetan woman with the ability to just appear whenever we needed her, and at times when we didn’t realise we needed her. Like the evening S and I went for a walk in a storm (out of choice) but after a while our legs were tired and we were soaking wet, facing a steep walk uphill when Tsering appeared out of nowhere and gave us a lift back to the hotel.

Someone who I only met a couple of days ago, but had become a legend, was Jason, a kiwi helicopter pilot who does regular 2 month stints in Nepal rescuing people from Everest. He just happened to be there during the quake and his skills were immediately put to use, rescuing nearly 200 people in the first few days after avalanches destroyed Base Camp. When I finally met him he casually mentioned he was receiving a medal from the President for his services last year. Who knows what he’ll get for this year’s effort. He also had a documentary team from New Zealand following him round, which he was very blasé about.

It was people like these who rescued my rescue mission.

I got frustrated pretty early on with the fruitless hospital tours, seeing fancy DR equipment, plenty of staff, and not many patients; as well as slightly put out (yet very hospitable) department managers, wondering quite what we were up to.

After all, what were we up to? A team of clinicians with skills but no equipment. Not even a portable ultrasound machine. I’d naïvely assumed that we’d have a portable DR X-ray machine and a couple of ultrasounds, but I was terribly wrong. That part of it was my fault, I had never been told that we would have some fancy bit of kit like the Xograph DRagon or whatever, but that was the problem- it was the things that I hadn’t been told.

Like, the fact that Z, our team leader had planned this trip (his first time leaving the USA) since last year, as a holiday / fact finding exercise for setting up long term fellowships at the teaching hospital and didn’t want to lose the money he’d spent on flights, so it was conveniently turned from an elective work placement into a disaster recovery mission when the earthquake struck. Yeah.

And the fact that our group hadn’t even been registered with the Ministry of Health (as is required, and only bloody polite, in these situations). This meant that not only were we unauthorised, but we were also excluded from info and meetings with other aid organisations which could have actually led to us providing help (although the bureaucracy of said meetings would have prevented us anyway). We gatecrashed those meetings when we found out the details, cos, y’know.

So I played along for a few days, and then S and I found other endeavours which were actually in need of outside assistance. The main one being an orphanage on the edge of the city which had become swamped with children from a city centre building which had been destroyed. This is where I met another inspirational person whose drive and determination was utterly incredible. Kalpana is a young woman who fell out of a tree as an infant (her earliest memories are of being in hospital, she doesn’t know how old she was) and broke her arm, so her parents abandoned her at the hospital. They abandoned her because she was literally “damaged goods” and would be of no use to them. She has had multiple surgeries to fix her arm, and yes, it has developed abnormally, but damn. Bearing in mind the things that she has achieved with one fully functioning arm, I’m intimidated to imagine what she’d have got up to with two!

Kalpana was resident at Balmandir Orphanage, and when she “aged out” she came back to work with the special needs children (she calls them her Tigers) as well as running an organisation called Creative Nepal, which aims to educate Nepali teenagers beyond basic level (one of them is a pharmacy student!) and empower them with skills that they can use to help others. Part of her education included a residential English course in London, and while she was there, she visited the coast for the first time, and went to the beach where I used to go when I bunked off school. Weird huh?

Kids in so called “developed countries” have it all on a plate and whine about hard work, when people like Kalpana and her housemates strive to improve their lives and those of others when they’d have every excuse to give up. I know, because I was one of those kids. I used to bunk off from my grammar school classes just because of bullying. It was easier to go sit on the beach.

So I spent most of my time at the orphanage because I felt like I could actually assist with looking after the children, rather than traipsing round local hospitals, getting interrogated by the staff.

Z guilt tripped me shortly after S left (her early departure was scheduled due to work commitments rather than frustration at the situation) and said “surely while you’re here you ought to do something vaguely radiological to justify the trip”. So I spent a morning shadowing radiographers at TUTH and wishing I was at the orphanage. Then at about 3pm I got a phone call from Kalpana saying that Upasana, a 9 year old with advanced Cerebral Palsy, had been admitted to hospital in respiratory distress. I took this as my cue to leave, and went with Kalpana to the hospital.

There was nothing I could have done as a radiographer at TUTH (their working practices are shocking, and their staffing is back to normal) but I was able to help with Upasana, if only for a short while.

While all this had been going on, tweets and Facebook messages were going up, detailing our rescue efforts. Incredibly misleading tweets and Facebook messages like the ones below:


Not a technologist, not doing anything radiological…


All that happened in this meeting was us displaying our ineptitude to a legitimate humanitarian aid group with amazing funding and infrastructure


This really annoyed me- this wasn’t anything to do with RAD-AID, this was Peter’s supply trip, S&I asked if we could tag along so we bought a load of sanitary supplies, hired a Jeep and joined the convoy to the village to hand them out. F was wearing scrubs. He shouldn’t have worn scrubs, because the villagers thought he was there to provide medical help and he couldn’t.


These “updates” really pissed me off, as it was yet more misinformation, attempting to legitimise our team’s presence in a disaster zone. About a week into the trip I was considering aborting early as I felt I was just wasting money by being there, and could potentially be a waste of resources if another quake hit and I needed help. Mid way through emailing the travel agent and feeling sorry for myself I got a message from Kalpana, nothing pertinent, just a “how’re you doing?” message. And I snapped out of it. From a selfish point of view I was really enjoying my time at the orphanage; the kids seemed to enjoy playing with me and I was able to be an extra pair of hands to feed the Tigers. So I stayed.

I barely saw the other RAD-AID guys, I occasionally bumped into them at breakfast, and one time I was returning from the orphanage just as they were leaving for dinner so I tagged along, but I wasn’t part of the team anymore.

And herein lies the problem- when I initially volunteered to go, I expected to pay for everything, naturally. Then I got an email saying that the Society of Radiographers (my Union and professional body) had agreed to fund it as part of their partnership with RAD-AID’s fellowship program. This was entirely without my input so I was quite pleasantly surprised, and somewhat relieved as I’ve moved house recently and my rent has significantly increased. And so my quandary: the intention of the trip justified SCOR funding (bear in mind the money they used comes from radiographers’ subscription fees) but the outcome certainly doesn’t. So what am I to do? I’ve paid for the hotel (which wasn’t a small amount) but do I offer to cover the flights as well? Bearing in mind I was mislead into travelling to Nepal to begin with.

But it was a life changing time, I fell head over heels in love, and have agreed to a life-long life-improving input into the lives of two very young girls (massive blog post to follow), and I met people who have completely changed my perspective on many things that I thought I had squared in my mind.

So there you are. Opinions are most welcome as I’m not entirely sure what mine is.

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Nighty Night

A recent article in the Independent caught my eye, as it was on the subject of healthcare workers and night shifts. I assumed that it would be about how difficult they can be and how they have a proven negative effect on the worker but I assumed incorrectly.

Instead it appeared to be quite a venomous piece on the audacity of hospital staff daring to have a twenty minute nap during a twelve hour night shift, and how some are even brazen enough to use hospital linen when they do so. There were frequent quotes from King’s College about how unacceptable this is, including this particular gem:

At King’s, emergency situations are now said to be more common than ever before, and staff have been told to be “alert and able to respond should these occur during their break time”.

To me this is an utterly disgraceful stance for a hospital to have; I don’t believe for a second that any healthcare professional would deliberately ignore a medical emergency, regardless of whether they’re currently on duty, on a break,  or even on holiday in a foreign country. A nurse I once worked with performed CPR on the first day of her honeymoon, before even reaching the hotel.  She could have carried on walking and enjoyed the first day of her holiday, but instead she spent it exhaustingly and ultimately fruitlessly trying to save a stranger’s life.
Most breaks in this context are unpaid, and a lot of the time they’re taken very late, if at all. It’s very common for junior doctors to work a 12+ hour shift overnight, covering an entire hospital, attending crash calls and sudden deteriorations, as well as monitoring patients who were already on their lists, without eating or drinking anything, and breaks can be as mythical as an early handover.

So KCH is expecting staff stay awake during breaks, but if this is so they can be around for emergencies, does it also mean they can’t leave the department? Can’t go to the vending machine (often the only source of nourishment out of hours) or outside away from the fluorescent lights? What about the staff who spend five minutes hiding in a store cupboard during their break because they don’t want their colleagues to see them crying about something they’re struggling with? Why not just force all staff to live on site so they can be nearby at all times, on duty or not?

My advice to healthcare staff working night shifts is this:
If you get the chance to take a break, then do it. Even if you don’t need to eat or sleep, just take the opportunity to get away from things, if only for a couple of minutes. Use your own judgement, and bear your own safety in mind,  as well as that of your patients’. Driving home? Don’t take the risk of ending up back in resus as a patient, it would be embarrassing at the very least. Gone 15 hours without water? That back pain you’re having could either be from muscle ache, or your kidneys shutting down. Dizzy? Lightheaded? I wonder what state your blood sugar is in.

The key message from this is to look after yourself, because you’re no good to your patients if you’re suffering. How you do this is up to you. Some people like a proper sleep if they can get it, others prefer a short catnap instead.

The Royal College of Physicians put out their own guidance for surviving night shifts, and I found it really useful, but when you’re first starting out it can be a case of trial and error.

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Cherry Black BSc (Hons)

We’ve been living in London for a month now, and we’re fairly settled; the move itself was tough but fairly smooth overall. There were only a few fatalities, caused when a box containing crockery and a glass chopping board landed on my dad’s steel toe capped boot; RIP Matt’s favourite mug. The flat is nice (not sure it’s worth the money, but is anything in London?) and the area is very leafy with great transport connections. I still can’t believe that I can hop on a bus just up the road which takes me past the Houses of Parliament, Trafalgar Square, and Hamleys, for £1.35! Assuming it doesn’t break down or inexplicably change its destination, of course… Another massive perk to our new home is that we actually have our own outdoor space, something I could never afford in Portsmouth. The novelty of sitting outside with a cup of tea and the Kindle won’t wear off any time soon. I just wish summer would arrive.

You may have noticed that I have changed the subheading on my blog from “student radiographer” to “unemployed radiographer”. This is because I have now finished my course and registered with the Health Professions Council! I have yet to find employment though, not for lack of trying; I’ve been dutifully applying for every post advertised within 20 miles but to no avail.

At the beginning of the week I was in Manchester for the UK Radiological Congress. The primary reason I went was because some of the lectures looked really interesting, but it’s also a useful event to make friends at (and this was my last year when I could get the discounted student rate). I got chatting with a veterinary radiographer who works at a really innovative practice near Guildford; when I was younger I always wanted to be a vet but wasn’t clever (or hard working) enough, so this is a field I am hugely interested in. I also attended some really interesting lectures on post mortem and battlefield imaging, quite morbid but really informative and I learnt a lot from the speakers.

So it’s been a fun-packed month, I’ve moved house, gained a BSc, rubbed shoulders with eminent radiologists, registered with the HPC, and can now officially call myself a Radiographer. A job would be lovely though.

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It’s incredible how one’s current situation can affect even the laws of physics. To paraphrase the famous quote:
“A two hour lecture can feel like a week, yet the week before one’s dissertation deadline feels like two hours. That’s relativity!”

It’s been a shitty couple of weeks; a fortnight ago I had a dental appointment to do the prep for a crown fitting, but the prep work aggravated an infection in the tooth that was otherwise dormant. I’ve spent the last week or so in agony, with the painkillers only taking effect for an hour or so each time. It was so bad last night I went to A&E to beg for something stronger to knock me out. It worked, and I had the best night’s sleep in about a week.

Also, Dusty, AKA Schnauzersaurus Rex, AKA Puppula, AKA Fluffy, AKA D-Dog, AKA Schnaut, has declined somewhat recently.

She’s 14 and 10 months old, which is apparently pretty good, but it doesn’t make the current situation any easier to handle. On Friday afternoon, shortly before I hop on a flight up to Manchester for QEDCon, the vet’s coming round to put her to sleep. While I 100% agree that it’s the best decision- her quality of life has decreased in recent months- that doesn’t make saying goodbye any easier. She’s been around longer than Daisy, in fact I distinctly remember her sticking her head in the bucket containing Daisy’s placenta at the birth. Gross. So after saying goodbye to one of my oldest friends, I’ll be shooting off to a weekend-long social event. Apologies if I’m a miserable bitch.

Also, this week I finally finished off my dissertation.

It was essentially written by Monday morning, but I was lucky enough to have it proof read by lots of people so I spent yesterday and this morning making adjustments and re-reading, and this afternoon I had it printed and bound, ready to hand in tomorrow. Following this, I have three weeks of academic time, five weeks of placement… and then it’s all over. Hopefully.


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Home Sweet Home?

The second leg of the flight was interesting. I had a seat in the row directly behind first class so the leg room was vastly improved, and there was no one in the seat next to me… until the child belonging to the family across the aisle decided to sit there and continually bash into me and generally be really bloody annoying. No sleep for me then.

Then about halfway into the flight some crazy drunk lady decided to go on a loud racist rant-fest. She started shouting about how she wanted a Business Class upgrade and was declined even though there were empty seats “because Qatar Airways don’t want white people in Business Class!” which I found hilarious as when I walked through there earlier there were loads of white people enjoying their overpriced seats. So her tirade went on for about half an hour by which time everyone around me was muttering words to the effect of “shut up” as it had gotten rather tedious.

Then, when we eventually landed at Heathrow, none of us could leave for about 20 minutes while armed police boarded the plane to deal with the (now rather quite calm) situation.

When we were allowed off the plane, there was then the tense 15 minute wait at the luggage carousel, and then I met Matt at the arrivals gate.

After a long drive home (the A3 was closed so we ended up going round in circles trying to follow the diversion) we got back at about midnight.

So here’s the emo bit: after an awesome month, it’s actually been a bit depressing being back in Portsmouth. The mundanity of shopping in ASDA is tenfold now, and I just want to go back to Pokhara as soon as possible.

I miss Nepal.



Sat in Doha airport having found the wifi and the power outlets, but I made the mistake of putting my power cables in my checked baggage.
iPhone – 47%, laptop – 66%
I do however have my Kindle but I can’t read when it’s noisy (and boy is it noisy here) so I might go to the prayer room and worship at the altar of Carl Sagan if I’m allowed.

On a side note some crazy Italian-sounding lady is lurking next to me asking for technical support… seriously, it’s a free wifi hotspot, if you can’t figure out how to use it, it’s probably for the best.

So I got about 2 hours sleep last night, partly due to getting back to the hotel so late and partly due to the loudest monsoon rain so far. So I’m knackered. I left the hotel at 6am, at the same time as Daniel, an Icelandic guy who was staying at the one next door. He was going to the bus station to hop on the Greenline to Pokhara which is on the way to the airport so we shared a cab as it was pissing it down and there was only one in sight. I was a tad jealous, and told him so, and he was relieved to hear that Pokhara is nothing like Kathmandu. It took a fair bit of will power (and admittedly some common sense) to stay in the cab and go to the airport rather than following him to Pokhara.

The airport was chaotic, which I had anticipated, but not to the degree that I experienced this morning. I dashed out of the taxi, through the monsoon to the departures area, where there’s basically a load of different entrances depending on what airline you’re flying with, although they all open into the same check-in hall. All the doors were closed when I arrived, as was the airport. This remained the case for an hour, which was fun, and then they opened the door next to the one I was meant to go through, so I thought “bugger it” and went in anyway. It’s not exactly a finely tuned system at Kathmandu Airport, I wasn’t going to mess up their perfect check-in process.

Another slight issue was my lack of boarding pass having checked in online and being minus a printer, but apparently waving a British passport around does the trick, which was good. I will be very surprised if my baggage is waiting for me in Heathrow, however, as they didn’t stick the tag on properly and I watched it fall off the baggage carousel when it got to the airside of the conveyour belt. Ah well, nuttin I can do.

In the airport, I bumped into Corey, an American guy who we kept meeting at Busy Bees, and the last time I saw him he couldn’t afford his bar tab, so Kat kindly bailed him out by giving her phone as a deposit. I frantically texted her to ask if she ever got her money back, but by the time she replied he was already airborne. It’s weird that I keep meeting Pokhara people in Kathmandu, that’s the third time it’s happened.

Anyway, eventually the airport opened properly, flights resumed, and mine was only running an hour late so it wasn’t too bad. Except yet again some asshole had nicked my seat, but as I wasn’t running late this time, I decided to make an issue of it. Turns out he was meant to be in the seat next to mine, but had decided to take the window seat instead so the steward bumped him across. This meant I had to sit next to him for 5 hours, which was unpleasant as he was borderline obese, rather sweaty, and refused to turn his mobile phone off until the steward threatened to kick him off the plane.

I managed about an hour’s sleep I think, but the seats weren’t far enough apart to accomodate my femurs so I was hunched at a very awkward angle. Moan moan moan… bitch bitch bitch. Can you tell I’m tired?

Yeah, so Doha is not my kinda place. The airport stinks of money and so do the people in it. I’ve not dared to find out how much a cup of tea would be, but if it’s what I expect then I’ll improvise. I have some tea bags in my hand luggage, so all I need is a mug, some hot water, and some milk. Oh, and a spoon.

Wish me luck.

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Last Night in KTM

Today was my last full day and night in Nepal and it could have been better! But it could have been worse.

It rained all day, so I tried to get around and see a bit of Kathmandu, I even downloaded a walking tour onto my iPhone but I couldn’t really walk around with my phone in my hand as it would have drowned. So I walked down to Durbar Square to see the temples and places like Freak Street, but there were military folk everywhere and I really don’t like how they stand with their fingers on the trigger while they’re milling about so I had a quick nose around and then wandered elsewhere. It wasn’t very easy to get around though as the streets are so narrow and everyone’s got umbrellas, and occasionally a rickshaw or motorbike will squeeze through so making progress is difficult. I gave up and headed back to Thamel where at least the streets are slightly more negotiable (omg I miss Pokhara so much) and picked up a few souveniers for next to nothing, as the shops weren’t selling at all today. I bought a silk dress for NR800 when the guy originally wanted NR2800 so it just shows how much profit they normally make!

So I mooched around for a bit, somewhat annoyed that I couldn’t see the city, and ended up at a hairdressers for no apparent reason. Got a haircut for NR275 but gave the change from a 500 note as a tip to the hairdresser as she did such a good job (I think so anyway). So that’s a cut and blow dry for less than a fiver.

Then I went over to the Last Resort office to collect my DVD from yesterday’s jump. The guy at the shop was the same one who harnessed me up on the bridge; he had a wicked sense of humour up there and it was still in action back on the ground, so that was cool. Then I went over to a restaurant for dinner as I had somehow managed to miss lunch. During dinner, Chloe, one of the girls who was at the Last Resort yesterday came over and joined me, and the evening picked up from there. We finished dinner and headed upstairs to Tom and Jerry’s-
holy shit there was just the loudest bang and a flash, and then the power went… eek! Anyway…
ahem. So we went to the bar and chatted for a while about all sorts, although a major theme was Auroville, a very new age concept for a sustainable community. Look it up, it seems incredible but a tad cultish, if you know what I mean. Plus there’s some controversy about paedophilia which is never a good sign.

Anyway we chatted for a while and then a Nepali guy (whose name I can’t remember) came over, I chatted to him before leaving for the Last Resort, and he wished me luck and told me if he didn’t see me back in the bar on Thursday then it means I fell to my death in the Bhote Kosi. So he and his mates came over and sat with us and we talked about all sorts of things until a vague kind of argument broke out between the guy and Chloe about trekking knowledge. I stayed out of it but it was all fairly good humoured anyway.

We all chatted until after midnight when we all got kicked out, so I ran back to the hotel in the rain, where I’m now writing this post. I ought to get to bed as I have to be up in 4 hours for my flight…

Good night!

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36 Hours in Kathmandu

The journey back from the Last Resort was interesting. At points I thought that we were going to have to get out and walk, but the bus clambered over landslide after landslide, until eventually the driver noticed a problem with the rear wheels when we stopped at a roadside cafe halfway through the journey. I honestly didn’t notice and I was sat over the rear axle, but that might have something to do with the general state of the bus.

So we then transferred onto another bus for the remainder of the journey, and by this point it was dark and we were so high up the mountain that we were driving through thick cloudy fog which was so bad that you couldn’t see more than a metre or so in front of the windscreen. I’m assuming that the driver knew the road quite well as we didn’t plunge off the windy mountain road to our death, but there were some close calls with pedestrians, motorbikes, cars with faulty headlights.

We got back to Kathmandu and I remembered I didn’t have a hotel booked (well I did, but there was no way I was paying $30 a night again) so I asked one of the girls on the bus if she knew of anywhere cheap and cheerful. She showed me the way to where she was staying, a hotel on the outskirts of Thamel (the main touristy district of KTM) and they had a room available for less than £10 for 2 nights so I took it. It’s not great, I’ll admit, but it has a bed and a bathroom with a working shower so I will not complain.

I’ve just checked in online for my flight home, meaning that in 36 hours I’ll be leaving this stunning country, so I expect it’ll be yet another emotional journey. Especially if someone nicks my window seat again.

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