London to Kabul under someone else's fragrant steam

I look for a way to imagine what else I might be doing right now but it actually feels like I'm right here in the moment, carried by the current, slightly to the left of centre, faster flowing water and I'm with it; on the surface at the moment but only just, got to watch my footing, by breathing by brush strokes, I'm here but really, not really. That's how it feels to be flying back to Kabul with about $100 dollars in one pocket and a couple of the proverbial beans in the other. I've got a stack of bills arriving at the end of each month and only a whisper of a plan. I'm going back to Afghanistan but maybe I should stay in England, get a regular doctor's job and nine to five some sensible money. Instead I am dealing with the unusual sensation - reliant on others as never before - of even more elevated risk. I might come home with my tail between my legs but I might just come home in glory and it's that thought of achieving what I set out to do versus never knowing if I could that makes me stay, sitting in the aeroplane seat, facing forward and urging it to go faster.

All of it; I wished for it and then it happened: PM, and him being delightful, the trek, the opportunity to just to sit still with my film material for more than 10 minutes at a time. But I feel nervous that I don't have a title outside of the the one that I give myself. I have to provide my own justification and this is hard, probably one of the hardest things a person can have to do; it's just you and what you think of yourself, and what you say about yourself, and what you can be motivated and daring enough to do when you get up each morning. But I have hope, I have leads and I have the will and the energy. The trek scares the living daylights out of me right now, what if I'm not good enough? Expedition medicine yes , in theory, in some strange ways it's the game I've been playing all my life in various ways. But mother and child care; lets just say there'll be a whole lot of internet knowledge refreshment going on over the next four weeks. That said, it's not like we can perform major operations, so what's left: basic resus, analgesia, antibiotics, antifungals, de worming, nutrition. The suggestion of referral to a bigger centre, may be to Kabul, but probably only the slightest of chances that a person will make the journey from the Nuristani mountains to Kabul for medical treatment.

As I sit and observe those around me I try to still by fears of the as yet unknown and allow myself to be thrilled, as I usually am, at the unfolding adventure. It's a strange process of transition, like one is emerging from a glut of wealth and excess to a much leaner, clearer existence. Today, it feels like that; in four weeks time though I will be dirty and tired of stinking drains and wishing for Starbucks and Zara and Topshop.

In Dubai I stay at La Bustan Rotana, a hotel near to the airport, a pretty good choice as it has a pool, reasonable size, enough to do mini lengths, and opens at 6.30am. Would go there again and ++ close to the airport. It was only later that I found out about the hotel that is actually inside the airport - this one you can pay for by the hour which sounds really dodgy but is actually brilliant for those middle of the night London-Dubai-Kabul transfers.

I feel bad about not knowing what the exchange rate to Dirhams is so not sure if a 5 Dirham tip is enough or not. I apologise to the porter and then wonder why I feel so bad, why I am apologising; I'm the one who at 3 O'clock in the morning handed her last $100 dollars over as a deposit on the minibar (did they think I would drink it dry? At Dubai prices a $100 would probably get me a cup of orange juice and half a mouldy Toblerone!). In a place where wealth is everything I was only obtaining small solace in my 'freelance' and 'charity worker' status. I wished that I had a sign that said ' my religion forbids me to use credit cards', instead of the fact that all of my cc's are maxed out and just spit forlornly back out of the money machines, lonely and unaccompanied by even the smallest denomination of currency. I feel strangely detached, like a homeless person, outside the system. "Cash only? Sorry madam, you must be a bit strange, only children pay in cash". I was right back at the shop counter, counting the silvers and coppers over for something trivial, stacks of two pence pieces, some tens and then the shiny, beautiful hexagonal twenty pence pieces - five make a pound - always my favourite.

In my hotel room at 4am, I drink (free) water and eat expensive (not free) wasabi peanuts. I open the jar and then wonder why I bothered, I wasn't really what I was looking for but I eat them anyway - such is the persuasive power of the minibar. In the bathroom I play the usual hotel game of guess how not to scald yourself in the shower (a friend had a rather unfortunate accident with the hot and cold taps on a bidet and, with this in mind, I am always careful not to assume foreign plumbing will be straight forward. In fact, the bathroom sink has a curious arrangement, two identical gold plated taps either side but possibly one is temp, the other off and on but but they seem to switch over as I play with them; hot-cold, on-off, perhaps this vice versa arrangement is the height of Emirati sanitary-ware sophistication, but it's all very confusing, or perhaps, its just 4am in the morning and I should be asleep. I shower with caution and a plastic shower cap on and go to bed. Can't sleep immediately, bloody sods law! Fitful but nice, clean, white sheets; won't be having any of those for a while. Eventually I drift off.