Wissam, who lives in Riyadh, had things to do and sent his associate to pick me up. Another Palestinian pharmacist met me outside and we were off to the Riyadh Military Hospital. Again, no parking.
The courtyard of the hospital was bustling. I was amazed to see people of all colors and ethnicities going into the hospital. The women were dressed in everything from African robes to Asian dresses, though they all had their heads covered (and some their faces). I figured that this hospital was likely a large training hospital for people across the Muslim world.
With much trepidation, I gave the security guard my passport in exchange for a temporary badge (he was not interested in my North Carolina drivers license). We walked the narrow, crowded corridors and found the office of the Chairman of Surgery, our destination. A sign on the door in English read “Meeting in Progress. Do not enter.” We went in anyway.
There, with his feet on his desk, junior faculty and residents nearby, and a cigarette in his mouth, was the Chief. We were warmly greeted and offered the residents’ seats. Noticing my quizzical look, he confessed that the sign was an attempt to keep the administration away so he could smoke in his office. It made me realize that the traits one needs to become a department chairman are the same everywhere in the world.
Thursday, January 26, 2012
Thursday, January 19, 2012
Visiting Surgeon in the Middle East: Part 4
Since we had some time before our flight to Riyadh. I, not wanting to spend much time in an airport given the day’s current events, suggested we get a Turkish coffee on the way. We went to a very stylish coffee bar that would not be out of place in New York, LA, or London and ordered. We had to order and pay immediately because the call to prayer (one of five daily) was about to sound and all businesses had to close. Our coffee and snacks came just as the call to prayer went out and we ate. We finished before the prayer was over and tried to leave quietly. But the doors were locked. All the employees had left to pray and we were alone and locked in the café. We went into the kitchen and found the cooks, interrupted their prayers, and were let out the back (where the nonmuslim employees were smoking cigarettes).
We got to the airport, checked in, and waited for our flight to Riyadh (my paranoia again surfacing and seeing conspiracies in my fellow travellers). After an uneventful flight, we landed in the middle of the Saudi desert in Riyadh. The terminal was beautiful, floor to ceiling marble and waterfalls. The first thing you notice when leaving the terminal, however, is that everything…I mean EVERYTHING, is covered with orange dust. The air tastes like dust. It’s everywhere.
I checked into the hotel and went to my room to get a few hours rest before going to work. Every TV station had news of bin Laden, and that made me nervous. I looked out my window to plot my escape and realized that, even though it was the second floor, my room was next to the roof of another building where people could easily get into my room. I did not sleep well that night, as I kept peering out the window to make sure no paramilitary terrorists were coming for me.
We got to the airport, checked in, and waited for our flight to Riyadh (my paranoia again surfacing and seeing conspiracies in my fellow travellers). After an uneventful flight, we landed in the middle of the Saudi desert in Riyadh. The terminal was beautiful, floor to ceiling marble and waterfalls. The first thing you notice when leaving the terminal, however, is that everything…I mean EVERYTHING, is covered with orange dust. The air tastes like dust. It’s everywhere.
I checked into the hotel and went to my room to get a few hours rest before going to work. Every TV station had news of bin Laden, and that made me nervous. I looked out my window to plot my escape and realized that, even though it was the second floor, my room was next to the roof of another building where people could easily get into my room. I did not sleep well that night, as I kept peering out the window to make sure no paramilitary terrorists were coming for me.
Thursday, January 5, 2012
Visiting Surgeon in the Middle East: Part 3
One of my over-riding philosophies in laparoscopic surgery is to use technology to make as few incisions and possible and, when necessary, make them as small as possible. This was not possible in Saudi Arabia. Their scopes were wide and lacked the HD I am used to. I operated with two very talented surgeons (one Saudi and one Sudanese). As a testament to the skills of my colleagues, we completed the case laparoscopically and the patient did very well. They showed me how to maximize the use of their instruments and I, in return, introduced them to some new techniques and instruments we use. I think we all came out of the case better surgeons with new skills.
The first case took a little longer than expected and we hurried to a private hospital for an afternoon case. What a difference! Though parking was still difficult and I had to walk a while in the Saudi heat in my dark wool suit, I was amazed at the luxury of the private hospital. The floors were immaculate white marble. The walls were freshly painted. The laparoscopic equipment was mounted on booms. Very modern. The case, another difficult rectal cancer, went well. The Saudi surgeon, like so many I know in the US, spent the entire case teasing the anesthesiologist, his partners, and the nurses. In an act of true hospitality, I think I was the only one spared. It was a lot of fun.
The first case took a little longer than expected and we hurried to a private hospital for an afternoon case. What a difference! Though parking was still difficult and I had to walk a while in the Saudi heat in my dark wool suit, I was amazed at the luxury of the private hospital. The floors were immaculate white marble. The walls were freshly painted. The laparoscopic equipment was mounted on booms. Very modern. The case, another difficult rectal cancer, went well. The Saudi surgeon, like so many I know in the US, spent the entire case teasing the anesthesiologist, his partners, and the nurses. In an act of true hospitality, I think I was the only one spared. It was a lot of fun.
Visiting Surgeon in the Middle East: Part 2
My alarm went off 5 hours later and I got ready for a long day in the OR. I turned on CNN as I dressed just as the news regarding Osama bin Laden broke. I have to admit, I had a momentary panic as Wolf Blitzer told me Osama was dead and, by the way, originally from the very city I found myself in…Jeddah, Saudi Arabia. My email alert immediately started going off as multiple alerts from the State Department to Americans travelling in the Middle East went out. They warned me to not go outside if possible. Then my mom called (how did she know already?). I looked out my window onto the Red Sea and did not see any crowds gathering or mass demonstrations. I called my new friend and host for the trip, Wissam, and asked what I should do. He reassured me that it would be fine, as the Saudis did not really consider him Saudi anymore. With his reassurance, we went off to the hospital to operate. I did, however, spend a lot of time looking over my shoulder and pretending I understood the Arabic people spoke around me.
The first hospital was the main public hospital in Jeddah. It was probably a training center for Muslims from all over the world as I saw people who looked Asian and Eastern European as well as Arab. We went into the locker room where an attendant from India gave us scrubs and shoes and put my bag into a locker. I was introduced to the OR staff and was taken to meet the head nurse.
The hospital was very clean but looked like almost any other 30-year-old public hospital in the world. The tile was worn, the walls had some scuffs, and finding a parking spot was nearly impossible (just like in the US). But the staff was kind and the patients grateful for the hard work of the surgeons and OR staff.
The patient was a man with a low rectal cancer. I don’t think the Saudi surgeons thought it could be done laparoscopically, but they wanted to see me try. I could tell they wanted to give me a difficult case and make me prove my mettle (this would be repeated in every hospital I visited). My first goal was avoid doing anything that would cause bleeding. Everyone was so incredibly hospitable and tried to get me all the instruments I use in the US. Unfortunately, they didn’t have many of the ones I use. The operating room was spacious and accommodated the surgical team and the several students and surgeons who were there to watch. Like most OR’s in hospitals built before the laparoscopic era, the equipment was placed in the room as if an afterthought (it was). The video monitors were small and gave a picture reminiscent of the TV pictures when we first got cable at my parents’ house in 1983.
The first hospital was the main public hospital in Jeddah. It was probably a training center for Muslims from all over the world as I saw people who looked Asian and Eastern European as well as Arab. We went into the locker room where an attendant from India gave us scrubs and shoes and put my bag into a locker. I was introduced to the OR staff and was taken to meet the head nurse.
The hospital was very clean but looked like almost any other 30-year-old public hospital in the world. The tile was worn, the walls had some scuffs, and finding a parking spot was nearly impossible (just like in the US). But the staff was kind and the patients grateful for the hard work of the surgeons and OR staff.
The patient was a man with a low rectal cancer. I don’t think the Saudi surgeons thought it could be done laparoscopically, but they wanted to see me try. I could tell they wanted to give me a difficult case and make me prove my mettle (this would be repeated in every hospital I visited). My first goal was avoid doing anything that would cause bleeding. Everyone was so incredibly hospitable and tried to get me all the instruments I use in the US. Unfortunately, they didn’t have many of the ones I use. The operating room was spacious and accommodated the surgical team and the several students and surgeons who were there to watch. Like most OR’s in hospitals built before the laparoscopic era, the equipment was placed in the room as if an afterthought (it was). The video monitors were small and gave a picture reminiscent of the TV pictures when we first got cable at my parents’ house in 1983.
Visiting Surgeon in the Middle East: Part 1
It wasn’t until at about 39,000 feet over North Africa that the thought finally came to me. “What on earth am I doing going to Saudi Arabia?” I was invited to be a Visiting Professor in Jeddah and Riyadh, Saudi Arabia followed by stops in Kuwait and Lebanon. My purpose was to teach surgeons there about advanced laparoscopic techniques for colorectal cases. As a surgeon and compulsive traveller, how could I refuse?
I landed at the airport in Jeddah and found the driver sent by the hotel to pick me up. With my worries of terrorism starting to crescendo, I was relieved to meet my driver, a middle aged man from the Philippines. He uneventfully drove through the ferocious rush hour traffic and dropped me off at the hotel. I called my host and we decided to meet for dinner shortly. He had a restaurant in mind where we would meet up with the Surgeons I would be operating with in the morning.
We met in the lobby and promptly got into a car with 2 other men. After introductions, I realized I just got into a car, heading north out of the city of Jeddah into the desert along the Red Sea, with essentially strangers (pharmacists) from Lebanon, Syria, and Palestine. At that point, the only thing that could have been worse in my mind was if I was in Pakistan.
After a short time in the car, I quickly realized my fears were unjust and that the men in the car with me were young professionals (like me) with families and small children (like me). They had left their homelands in search of better prospects in Saudi Arabia.
We got out of the car and I could immediately smell the salty sea air. The restaurant, as opposed to Western restaurants, had no large single dining room. Rather, there was an area outside with TV’s and rugs and multiple private rooms. The outside area reminded me of a drive-in movie where people could sit, eat, and watch TV under the stars. All were occupied by men who came in from the desert to dine. They prefer dining outside.
Before going to our private room, we ventured across the parking lot to the store where the fish were kept on ice. Row after row of fish just caught from the Red Sea were waiting to be chosen and cooked. We asked the cook to pick the best, freshest fish and shrimp and bring them to our room. As we waited for the food, our room slowly filled with local surgeons. Most wore the traditional Arab clothes and desert headdress. Water pipes were placed around the room and we all shared. I was concerned we would have little in common and the conversation would be labored. Those fears were quickly extinguished (again) as a very lively discussion about surgical technique started. Just as I was interested about how they practiced our science and art, they wanted to know how we did things in the US. We traded stories and pearls of wisdom learned over long careers, ate a fabulous meal, and finished the evening with Saudi coffee (coffee infused with cardamom). The meal ended with an invitation to go with them to operate in a clinic they are opening in Khartoum, Sudan.
I landed at the airport in Jeddah and found the driver sent by the hotel to pick me up. With my worries of terrorism starting to crescendo, I was relieved to meet my driver, a middle aged man from the Philippines. He uneventfully drove through the ferocious rush hour traffic and dropped me off at the hotel. I called my host and we decided to meet for dinner shortly. He had a restaurant in mind where we would meet up with the Surgeons I would be operating with in the morning.
We met in the lobby and promptly got into a car with 2 other men. After introductions, I realized I just got into a car, heading north out of the city of Jeddah into the desert along the Red Sea, with essentially strangers (pharmacists) from Lebanon, Syria, and Palestine. At that point, the only thing that could have been worse in my mind was if I was in Pakistan.
After a short time in the car, I quickly realized my fears were unjust and that the men in the car with me were young professionals (like me) with families and small children (like me). They had left their homelands in search of better prospects in Saudi Arabia.
We got out of the car and I could immediately smell the salty sea air. The restaurant, as opposed to Western restaurants, had no large single dining room. Rather, there was an area outside with TV’s and rugs and multiple private rooms. The outside area reminded me of a drive-in movie where people could sit, eat, and watch TV under the stars. All were occupied by men who came in from the desert to dine. They prefer dining outside.
Before going to our private room, we ventured across the parking lot to the store where the fish were kept on ice. Row after row of fish just caught from the Red Sea were waiting to be chosen and cooked. We asked the cook to pick the best, freshest fish and shrimp and bring them to our room. As we waited for the food, our room slowly filled with local surgeons. Most wore the traditional Arab clothes and desert headdress. Water pipes were placed around the room and we all shared. I was concerned we would have little in common and the conversation would be labored. Those fears were quickly extinguished (again) as a very lively discussion about surgical technique started. Just as I was interested about how they practiced our science and art, they wanted to know how we did things in the US. We traded stories and pearls of wisdom learned over long careers, ate a fabulous meal, and finished the evening with Saudi coffee (coffee infused with cardamom). The meal ended with an invitation to go with them to operate in a clinic they are opening in Khartoum, Sudan.
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