Out of office

Photo of the week.  Poison dart frog. Highly toxic. Do not handle. 

Highlight of the week: Rain. Our garden’s browns turn green

Lowlight of the week: Rain. Our bikes stay dry. The bike shed door firmly closed.

Maximum temperature: 15 degrees Celsius

Rainfall: Generous

Back in the day: my index finger forcefully shared the momentous news with the world. Ginny is out of office. A flourish. The keyboard almost crumpled, as I insisted that I would not be available for a whole fortnight. My holidays were my happy places. Stepping stones meticulously placed throughout the year. Each booked well in advance, to ensure that my sanity could be preserved. I always had at least one holiday up my sleeve. Often 3. The out of office message was a firm boundary. A declaration.

Fast forward 5 years. The out of office message plays to an empty English theatre. My boundaries are vague. We are, to an extent, always available to our Zambian patients and juniors. Offering open access to our patients with high blood pressure and diabetes. Available 24/7 to our front-line clinicians in Zambia with their conundrums and queries. Our departure from South Luangwa last October was heralded by some observant colleagues. Enjoy your holiday they smiled. We shall. Our reflex response. Out of Africa we step away from one role. But being Into Africa, our other roles follow us. Pied Piper of Hamelin-style. So much for holidays.

Since leaving South Luangwa in October, 8 months have passed. Our holiday is almost over now. Term time looms. I dig out my school uniform. Write shopping lists. Sharpen my pencils. Polish my shoes. But am I really ready? My mind plays tricks on me. Last minute ab dabs. I find myself down rabbit holes. What ifs. My mindset will have to change. As I prepare to commit to 4 months of hard labour, there is still time to reflect on our pseudo-downtime. Has the last 8 months been fruitful? How should we build on the foundations of our previous 3 tours of duty?

We had bold plans for our holiday:

• To tick all the boxes to keep our GMC registration ticking along.
• To spill the beans on the story of us setting up a blood pressure and diabetes clinic and running an occupational screening programme. Learned medical journals will eat this up.
• To keep our middle aged bones moving. Former Valley docs Karen and Alan are responsible for us signing up to a Costa Rican boot camp.
• Catch up with friends and family. Aiming to keep the down out of down-time.

Lists written. Priorities made. Rejuvenated. Inspired. Primed.

Let’s make a bash at defining a holiday. What words might help us? Should we include the word travel? Or recreation? Leisure? Rest? The word work seems to be the antithesis. That might spoil the fun. But we can’t expect 8 months to be solid fun. So perhaps, there could be a balance here? A time when work is part of the fun. Could that be a retirement Nirvana?

My out of office note was a handy boundary. A symbol of closure and a symbol of opening. I tied up loose ends. Locked down the house. Zipped up the bags. Headed to the airport, or squeezed into our campervan Rubus. The firm tap on the keyboard. The clicks of doors closing and opening. Tap. Click. We’re off. Off work. Off, up and away.

What should we expect of retirement? A long holiday? Time out, being put to pasture? A chance to fulfil our bucket lists? Or a time to let others fill our shoes, whilst we fill our boots?

I’ll admit I’m struggling to define the words holiday and retirement. For now, let’s agree that this 8 months is our off season. And during our off season we have taken 2 holidays. Each of these holidays have been pierced by work, either invited or not.

Tax is another word that challenges me. Our work in South Luangwa certainly taxes me. My brain is constantly challenged. Forced to solve new riddles and to make ends meet. I like that our off season usually offers me time to repay these taxes. To recharge my over-taxed mind. But these two holidays have also offered two medical challenges. And we will admit to being flummoxed on both occasions. Orthopaedics is not my strong suit. Nor Keith’s. Please forgive our cack-handed care.

The pain experienced by our unwitting patients seemed dramatic. Could they be footballers rather than rugby players? Rolling around in agony at the slightest of contacts. We employed time as our main diagnostic tool. Magic sponges deployed to distract and disarm. One patient got back on his bike and then canoed to cross the rest of the continent. One gamely continued in his cheer-leader role to complete the murder mystery, with his leg hanging off. Both soldiered on, whilst our X-ray vision failed them.

Patient one discovered a chip off his olecranon process, soon after aircraft wheels contacted tarmac in Manchester. Real X-rays beat my piercing eyes, hands down. There is nothing humorous about a broken humerus. Patient two was even more of a challenge. Ubers seemed in short supply that night in Mallorca. And potential drivers were too woozy to drive. Our delay, although helpful diagnostically, attracted comments from wily Spanish medics. A hairline tibial fracture barely visible using radioactive beams. Legless without the benefit of gin. Both patients proved to be rugby players after all.

At home our medical work has ploughed on. Keith gets twice weekly updates from the blood pressure and diabetes clinic in Kakumbi. His phone goes crazy on Tuesday and Thursday afternoons. WhatsApp messages ping in, as he is sent measurements and prescriptions. His spreadsheet of data is in full-bloom. Over 500 people in our polytunnel of care. Taking medications that work. Blood pressures hitting their marks. Sugar levels more level. Lifestyles chosen with style.

Our bold plans deliver. We shoot. We score. So, stop the presses: two academic articles are about to make headlines. We're just waiting for the ink to dry... and for the carrier pigeons to catch their breath. None of this would be possible without your generous support. Strokes prevented. Lives saved. Soon, we’ll share our success stories and bring to life the detail behind Kakumbi’s newest clinic and the work-placed health support that we have been providing.

To bring balance to our blog - and to give a more rounded perspective - it’s only fair that I try out some health services for myself. And I have to say that our very own NHS has truly impressed. Less than three months ago, I had not one, but two, Morton’s neuromas chopped out of my feet. A two-for-one deal, you might say. I got lucky and had NHS care in a private hospital. My first experience of turning left in the NHS. No long waits. Initial assessment to definitive treatment in less than 3 months. A private room. 5 star service. The recovery was tricky. Probably as hard for me as it was for Keith. Two weeks of enforced sitting around. Then another 4 weeks of gentle rehab. No cooking. No shopping. No cleaning. No bike rides. No walks. No pickleball. No gardening. All during the driest, warmest, spring in a long time. This enabled other projects to be completed. A photobook about the building of Kwetu. Scientific papers written and edited. TV watched. Box sets binged. But the bottom line. The end result: my Morton’s neuromas are history. Morton-less I am so much happier. My feet are now happy feet.

We spend some of our last few days of freedom up North. In Scotland. With friends from the States. The United States of A merry chaos at present. We all seek order to settle our turbulent worlds. Summer seemed like a safe bet in Scotland. Craving blue skies, just before the midges wake up. We had dreams of long sunny days. Walks. Whisky tasting. Music. But the wacky Scottish weather had other ideas. Erratic conditions. Wind. Snow. Minus five Celsius at night. But in Scotland there are no real weather surprises. A year of seasons in one day the norm. We relish the cold. Wrap up in layers. Have fires at night. And savour the contrasts. Box it up. And remember it with gusto. Because it will be the last time we feel cold, or see rain, for four months. The Loch Tay hotbox allows us to dip into Loch Tay repeatedly using a homeostatic process to normalise our body temperatures away from the ambient of the sauna and steam. Acclimatisation our aspiration. Otherwise, our bodies will be in for shock therapy in two weeks’ time.

So our off season is due to become on season. Our off heat is due to go on heat. So to speak. And we fly back to the best office in the world. Our out of office is due to turn off.

Siblings in full bloom

Taking the plunge