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Tuesday, March 23, 2010

Context, embarrassment and practise

Our new ECG machine arrived today and we decided to have a little play with it down stairs in the resus room, that was all fine til it came to actually trying the bugger out; Pommery not his real name) refused to be experimented on and Rubster and PiggyP (not their real names either) were not volunteering so in the end, for want of a gentleman, I said that I would do it. I'm very much a believer in being prepared and, knowing how easy it is for things to go drastically awry in this place, I thought we'd best try it out. I got up on to the couch and they attached the rather fetish looking leads around my ankles and wrists, the boys were all looking slightly sheepish... Next up were the chest leads, Rubster asked me if I could identify my fourth intercostal space, whilst trying to feel for something without looking - it was like I was suddenly something very strange in their midst. Next came the sticky suction cups - not exactly the most elegant (or indeed up to date) of devices, these little cups are filled with aqueous gel before being suctioned onto the skin, Rubster was still not looking where he was putting the things and looked like he was in a state of apoplectic embarrassment, he'd told me he couldn't apply the suckers properly unless I was " further exposed" and almost withered with embarrassment as I whipped off my under things and said "Well then, you best get on with it then". Even then he was fumbling somewhat as the six chest leads were applied in a very unusual fashion - I think he was afraid to touch me as the leads where nowhere near my costal margin and pretty much right across the left side of my chest - I'm not sure whether Rubster was just confused of paralysed with horror at a topless collegue. He couldn't get way quick enough to start the damned machine - the trace was twitching around all over the place as the left lateral lead kept popping itself off and needing to be reapplied.... My ECG reading, needless to say, was grossly abnormal - apparently I had atrial fibrillation! - I thought this was a summary lesson as to why it is best to apply the chest leads properly first time around and not go all coy and school boy. To set this all in context these guys are experienced paramedics, people who've worked on the roads in South Africa and Australia and in war zones in Iraq and Afghanistan - They've seen the worst of days - plenty of claret on the road and possibly up the walls - so why the confusion I wondered? Ladies - if you want to bring an empire down, forget the guns, apparently all you need to do is corner your male work mates and show them a slip of lace... They'll be quivering wrecks before you know it.

It was just then that I understood the powerful psychological weapon of having a petite woman torturer when trying to bust a detainee - I'm told that a bloke can withstand a bitter beating and remain mentally intact when faced by a man but that the absolute loss of power and hope that goes with being interrogated by a woman holding all the power is just too much and they crack.

Later, I head for Karte se - it's the usual scenario - I am with Mazar our driver and we are chatting about stuff - I've a map to guide us but still we are not sure - it's usual here to get close and then to ring your host and get their Afghan guard to describe how to go the last part of the way to the house - nothing is marked here so you could be driving round many a street looking and looking, houses are all behind walls or high metal fences so you can't really peer into windows either. This evening was a novel one as we got as far as Pol e Sarc, a couple of calls later and we were really none the wiser - I am tired so I leave it all to Mazar and am amused when the guard turns up on his bicyle to guide us in - it turns out that we are still quite some way away from the house and it's a comical scene with our bicyle lead escort, a skinny Afghan on the de rigeur bike, wobbling his way through the heavy traffic to guide us in. one and a half hours late; I finally make it to dinner :)

Dinner is with a lovely family from the US who have two kids in school here. The house is full of toys and they even have a really cool McDonald's Happy Meal star wars toy of Wicket the Ewok. there are a number of families who have chosen to bring their kids with them and there are a couple of expat schools here in Kabul for the kids to go to. Some people might consider it a little crazy to bring the kids out here but from what I can see the kids I've met have amazing parents, dedicated and committed to stay for the long term, would not consider it to be right for the family to be apart. The kids are wise and adventurous, speak several languages and, as only children can do, broker a street diplomacy, live and see the real life of the inhabitants playing football in the street hanging out with their Afghan friends.

Later on the way home, Mazar knowing how much I like dogs, slows down whenever we are passing some of the street dogs who stray along on the roads at night - there are plenty of them and it's a slow drive home.

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