2009... same difference?

What did 2009 bring? Indulge me here, while I get a bit deep and philosophical... I have had some time for reflection whilst I've been home over the Christmas period. I've been able to catch up with old friends and family and for the first time in ages, check my head. The nice thing about coming home after being away for 4 months is the realisation that despite the fact that many things have changed, everything's still the same.

2009 was the year when I grabbed the bull by the horns, bit the bullet and faced all sorts of other metaphorical perils and hazards face on. 2009 was the year that I decided to fulfill a life career ambition of doing obstetrics and gynaecology in Africa. The decision to take a year out of program to work in Uganda is probably the biggest and most uncertain that I have ever made. Having never travelled on the African continent, I was charting unknown territory, on my own. It still scares me if I think about it for very long! Having thought about it a lot over the last few weeks I have come to the conclusion that it is the hardest thing I have ever done, the most frustrating thing I have ever done, the most acute learning curve I have tackled, at times fantastically rewarding and an experience that has taught me more about myself than anything else ever has. It has made me realise just how many people touch your life, in so many different ways. Mulago has challenged me in more ways than I thought possible. It has tested my resilience both as a doctor and a human being, and will almost certainly continue to do so for the next 7 and a bit months.

Lots of things happened in 2009; people got married and engaged, some had children, some are still waiting to hatch, a lot of people loved and a lot of people lost. And me? Well, I just plodded on, business as usual until August 13th. And then I stepped into the (metaphorical) abyss. I remember someone once read a verse out at a conference, referring to uncertainty, written by Guillaume Apollinaire. I distinctly remember it because I had a stinking hangover after an evening of wine tasting and subsequent shenanigans in Melbourne that resulted in my laptop drinking a glass of wine and ending up in hospital. The quote was ;

'Come to the edge, he said. They said: We are afraid. Come to the edge, he said. They came. He pushed them and they flew.'

That quote rang very true to me as the time came to leave for Kampala, and it was my pride that did the pushing, because when it actually came down to it, I didn't feel brave enough. Sometimes being proud and stubborn can be a good thing. I'm pleased I went to the edge, and I'm pleased I was pushed, although I'm not sure that I am flying with any grace or finesse just yet.

So what have I learned?

I've learned that one person doesn't change things, but that little by little you can begin to change the way people think, and changing the way people think changes the way things get done. Changing the way things get done maybe, possibly might change the world. A little bit.

I've learned that one pair of hands can only do one thing at a time.

I've learned how to reflect. Not in the way that our portfolios do, but in the way you sit on the theatre floor, head in hands, crushed because you couldn't get hold of any blood, and that a unit of blood might just have made the difference. And the way you change how you do things because this time you were just lucky, the way you learn from not having stuff that you take for granted to hand, or not having a team of 6 people working and focusing on one problem together.

I have learned the importance of having colleagues that will go the extra mile, but also the importance of acknowledging those colleagues, and appreciating them. When the propellor and the proverbial are having a meeting, it's a lonely place to be on your own. So to all of you who go the extra mile on a daily basis, thank you, you're stars, whether you're in Mulago, Liverpool Women's, Arrowe Park or Leighton - and not in any particular order. That extra mile might be running to Nakasero Hospital just to see if they've got another unit of blood at 4am, or making a shift of knackered people a tray of much needed tea, or being kind to someone when inside you're broken and you don't feel like it any more. But the little things sometimes make as much difference as the big things, so please keep doing them , they are appreciated.

I've learned that we probably don't need all those shiny silver things with obscure archaic names that look a bit scary that live on the section tray in theatre... but they're nice to have! Sometimes you don't even need a blade handle.

I've learned what all the fuss is about catgut... 'If only I had a length of catgut...'

I've learned that I am stronger than I think I am, and yet I am more sensitive than ever before.

I've learned that the things you think will get to you don't at the time, but come back and hit you when you're least expecting it.

I've learned that we should all talk less and do more. In the words of the late, great Elvis Presley, 'A little less conversation, a little more action please'.

I've learned lots of other things too, so many that I'd bore you. I'm the same as I was when I left, but I'm different too.

What else? I know that being able to write this blog keeps me afloat, being able to email people and vent has kept me sane, and the support that I have received from friends and family has been immense. I was overwhelmed by the number of people I saw over Christmas, braving the snow and ice, before and after nightshifts and long days, operations and the dreaded lergy to come and say hi. I guess you don't really appreciate what you have until you leave it behind. Thank you to each and every one of you that has listened, advised, encouraged and pushed me. You know who you are, and if I try to mention you all by name I'll miss people out.

So, now I'm back in Kampala, and it's a new year. My New Year's resolution? To appreciate what I have more, to appreciate the people I love more.