Thursday, October 29, 2009

New move

Hi all!

Just wanted to let you know now that I am no longer "behind the abaya", I have started a new blog called "Does this maple leaf get me a discount?? A retrospective roadmap of a Canadian girl's introspective journeys through geography, culture and life." You can find it at

I invite you all to come and continue sharing my adventures!


Thursday, June 18, 2009

masalaama and a story from the archives

My, how time passes.

I have no good excuse for neglecting to update my blog sooner, so I will not waste my time trying to make up something witty to make it seem more forgivable.

As it stands today, I have less than 2 weeks left in the Kingdom. My time here has been a completely life-altering experience. I have learned so much about myself, and about what is really important to me, and to how I perceive life in general. I have made some lifelong friendships while here, and I am going to miss all my new friends like crazy when I leave.
I have made it no secret that for me personally, the lifestyle here (e.g. poorly equipped stuffy gym, and hard-to-access alternate athletics) has been the epitome of incompatibility. However, it is through this discovery that I have become starkly aware of how much I was actually taking for granted back home.

I now look upon my life with a new appreciation of the abundance of valuable riches I have…friends and family who love me and whom I adore more and more every day…the right to speak out and a society that listens…freedom to hop on my bike and ride (almost) whenever and (almost) wherever I please…living in one of the most beautiful places in the world and being free to access all its elements at my leisure (and occasionally at my risk…!)…being able to walk to my favorite coffee shop, stand in the same line as the men, then sit on the open patio or stroll along the beach in the early morning sun and tranquility…(see above picture of an early spring morning on Spanish Banks)

Enough of the sappy stuff. I know you are really waiting for is a story, so I will oblige.

This is from a friend of mine, just before she left for Nepal a while back. I will call her Ms. X.

Ms X was putting together a little travel medical kit with all the things she may potentially need while trekking in the mountains – gauze, bandages, antiseptic, safety pins, etc. She also wanted to add a few medications such as some broad-spectrum antibiotics, some Tylenol, ibuprofen, and very importantly, some Immodium (anti-diarrheal). She couldn’t imagine anything worse than being 10 days into the mountains and suddenly struck by a case of thundering Montezuma’s Revenge…

Luckily for her, most medications (with the exception of narcotics…darn) are available over-the-counter in Riyadh. Thus, she cabbed over to the local pharmacy and gave the man behind the counter her list. When he came to the Immodium, he regretfully told her that they were all out. No problem – She took the other meds and asked her driver to take her to another pharmacy. Again, no stock. She was soon uttering alimentary-related swear words pertinent to the nature of her troubles. I should probably mention that this was the day before she was leaving for her trip. By the 5th pharmacy and an increasingly forbidding taxi fare, she reluctantly gave up her search. Deflated, Ms X returned home and resigned herself to the assumption that perhaps Immodium had been added to the long list of FDA carcinogens we were to avoid, and she should thus be thankful she was to have diarrhea instead of cancer.

As she sat on her couch sipping a coffee (and wishing, as she often had in the last year that it was something stronger), she started formulating a plan. An eleventh-hour act of desperation. She quietly put her morals on the shelf and strode over to the hospital’s family medicine clinic with renewed hope.

After an hour spent in the waiting room with a bratty little boy hacking all over her while his mother sat complacently watching, Ms X was called in to the examination room. The doctor sternly peered at her through his Armani glasses –

“What can I do for you today?”

MsX: “Doctor, I have diarrhea”.

MD: “ How long has this been happening for?”

MsX: “ Oh, it started a few days ago. I think maybe I just have a little stomach bug and need something to slow it down a bit…”

MD: “How bad is it? How many times a day?”

MsX: “Oh man, I feel like I have not left the bathroom for 2 days…I can’t even count how many times a day. Everything is just going right through me”.

MD: “Hm, I see. Well, I will write up a prescription for something that will slow it down a bit” (scribbles on his notepad) “ and while that is being prepared by the pharmacy, you can head down to the lab so we can collect a sample”.

MsX: (Oh…..NO!) “Um, actually doctor, I just went before I came, so I don’t think I will be able to provide you with anything right now…”

MD: “Well, with the frequency you have been going, I am sure you won’t have to wait too long before you will have no trouble providing us with one. Besides, according to protocol, this is a required step”. (turns to nurse) “could you please escort her to the lab?”

As the woman bearing a disquieting likeness to nurse Ratchet practically dragged her by her ear down the hallway, Ms X pondered the irony of standing metaphorically knee-deep in the same substance for which she had come to the clinic to “seek help”. Ms X noted the large black hair growing from the angry mole on nurse Ratchet’s chin as a small grey plastic container was shoved into her hand. She assumed the impatient flick of the woman’s wrist was the only invitation she was to receive to take a seat. She sighed with relief as the woman shot her one last imperious glance, then waddled out of room.

Ms X knew she had to act fast as the nurse would soon be back to collect said “sample”. The door at the back of the room stood slightly ajar, and she could see she the cold and menacing white porcelain waiting for her. She subconsciously patted her pocket and felt the reassuring crinkle of the prescription paper. Turning her back to it, she quickly glanced both ways down the empty hallway and stealthily made her way around the corner to the pharmacy. Like a heroin addict waiting in a dark, clammy back alley for delivery of her next fix, Ms X shiftily skulked in the corner of the waiting room. Her senses remained peeled for any sign of the hairy, hulking frame of the nurse who was sure to carry her by her toenails back to the lab, plunk her down on the toilet, and stand watch over her until she got her “sample”. Thankfully, the pharmacy remained deserted, and after being promptly handed her “illicit” Immodium by the sullen pharmacist eyeing her suspiciously through the glass, Ms X made a beeline to the exit and bolted home to safety.

With a flourish, she added the prized Immodium to her medical kit, and sat down to her lunch of whole-wheat toast and kidney bean soup.


It is unclear whether it was karma or luck that Ms X just so happened to need every last one of those Immodium capsules while struck with a volcanic gastric ailment 6 days into the Annapurna Circuit

Masalaama (goodbye)


PS - I am going to try and write one more entry for this blog when I get back to Vancouver. Following that, i will likely start another blog, as I will not longer be "behind the abaya...I will keep everyone posted. xo

Saturday, April 11, 2009

Namaste Nepal

Contrary to what may have become popular belief, I am still alive and well. I have been shamefully negligent of my blog the last couple of months, and I apologize.

The good news is that I have an official date for the end of my contract. Because I had a bit of vacation time left over, I was able to tack it on to the end of my stay. Thus, I will be working my very last shift on the 1st of July! Will likely be back in Vancouver the 2nd or 3rd. Be it heard that I have absolutely no intention whatsoever of partaking in any activities that could be described as “work-related” (unless it is the work my muscles are doing during my daily bike ride) until at least the end of August. I am looking forward to a fairly regular routine of cycling or hiking in the morning, lying on the beach in the afternoons, and drinking good red wine every night. Anyone who is willing and able to join in is more than welcome as long as you have no problem being subjected to a years worth of untold stories and typical Fiona-like over-analyses. As I have said many times before, there is nowhere in the world I would rather be than B.C in the summertime, and I am stoked to be able to live it without the constraints of a job, viewing it through a completely new lens following my travels, and having open/ample opportunity to re-experience everything I now realize I had been taking for granted before I left for Saudi.

As it so happens, I have just returned from an incredible month-long trip to Nepal. It has been my dream to see the Himalayas for the better part of the last 10 years, and I am happy to report that not even one of my lengthy list of accumulated expectations was in any way left dissatisfied. Nepal is stunning. It was a trip filled with adventures, misadventures, language blunders, and transcendental realizations, all of which I hope to share with you over the course of the next few weeks (provided I am a little more ambitious and motivated to write than I have been over the last 2 months!).

I touched down into Kathmandu on the 17th of March. It was smoggy, stinky, busy… and beautiful. The chaotic, colorful din was immediately healing after having spent the last 8 months in uber-conservative Riyadh.

The drive to the hostel was crazy. Nepali drivers make the Saudis look like prize Young Drivers of Canada students. Think “Twister”, but played with heavy machinery in fast-forward and without waiting your turn. The game-players include anything from the top-heavy colorfully decorated transport trucks belching enough CO2 to put B.C. emissions testers into cardiac arrest, to stuttering motorbikes threading their way through any small gap between obstacles, to gigantic horned buffalo wandering languidly through it all, blissfully unaware of the blaring horns as traffic swerves around them. I learned quickly that it was better to sit in the back and look out the side window as opposed to sitting sitting shotgun which was like being trapped in a surging “House of Horrors” roller coaster ride at Canada’s Wonderland (which I always rode with my eyes closed).

I spent the next 3 days sightseeing around Kathmandu with the 2 East Coast Canadian guys I met in the Doha airport who quickly became my close travel buddies. We spent the first night drinking really cheap, really good cold beer on the rooftop patio of the guys’ hotel which legend had it, was built by a Texas millionaire (though no one could tell us what his name was…).

In exploring the city, one of the aspects I was most struck by was the harmonious integration of the 2 powerful religions of Buddhism and Hinduism. The Hindus make up the largest portion of practiced religion in Nepal, followed by the Buddhists, an increasing number of Christians, and a relatively small number of Muslims. Large and internationally significant markers of the 2 largest religions mark every corner of daily life while traveling anywhere, urban or rural, in Nepal.

We visited “Swayambhunath” (affectionately known as the “Monkey Temple” as a result of all the little fuzzy characters draping themselves over it) which is a huge stupa (the word used for the large dome which is characteristic of Buddhist temples). The ancient temple itself is at the top of a huge set of stone stairs and overlooks the city from an elevation 200m higher than at its intricately decorated golden entry gate. Atop the dome were the painted “Eyes of Wisdom”, a sight often seen around Nepal. The eyes are bisected by a curly question mark-like nose, which is actually the Nepali character for the number “1”, and signifies the unity of all things, as well as the one path to enlightenment (through the Buddha’s teachings). The third eye represents the all-seeing eye of Buddha.

We also stopped by Pashupatinath, the most significant Hindu temple in Nepal. Here, we saw the riverside stone platforms where bodies are cremated and swept into the river in Hindu tradition. We also met some Sadhus – Hindu holy men who have devoted their lives to religious ascetism. The Sadhus are generally followers of the Gods Shiva or Vishnu, and pledge a life of frugality in dedication to their God. They have no material possessions, and eat only just enough to survive. They cover their bodies in holy ashes, and usually have more intricate tikkas painted in red and white on their foreheads (aside: the tikka is the Hindu symbol of blessing on the forehead – the “bindi”, the circular dot sticker is the more stylish version. The more common form in Nepal was the red or white powder applied in blessing each morning). The Sadhus we met were happy to offer a photo-op in exchange for a few rupees. As I handed over what I thought an adequate compensation to a holy man living a life of providence (a 20 rupee note), his ash-covered eyelashes flicked open incredulously, and in a thick Nepali accent, he intoned “small money!”. Flustered, I fumbled over an extra 20 rupees, which was self-righteously accepted with a slow nod of approval. I guess even Sadhus are experiencing the effects of global recession?

The 3rd day, I finally met Phul who was to be my (marvelous) guide for the trek in the Annapurna region of the Himalayas. I will stop here and save the start of the trekking adventure stories for next week!

One more thing I want to mention is the interesting phenomenon that occurred during my ride home from the airport in Riyadh. First I have to say that being in Nepal made me more homesick than ever for reasons not limited to being outdoors, increased freedom, and freely interacting with fellow Canadians (and others) of mixed genders. Ok ok, yes and relatively unrestrained access to good red wine (which of course I took advantage of as much as possible).

HOWEVER, this super weird thing happened while I was chatting in Arabic with my cab driver on the way home…I realized that everything felt kind of…familiar…and comfortable…It was so good to be able to communicate with the general population again (albeit on a basic level with my Arabic skills, but at least I can make sentences!). I don’t think I would have experienced this effect had I taken this vacation time to go home to Canada. It took traveling to another completely unfamiliar country with a totally unfamiliar language to realize, contrary to what I had thought when I left, that I HAVE actually assimilated quite comfortably into Saudi life. I was actually kind of happy to be back and to see and catch up with all the fantastic people I have met here. I also felt pretty good about the prospect of going back to work and blasting through these last 2.5 months on a much more positive note than the one I had been singing prior to my departure. Of course, that is not to say that I am not bursting in anticipation of returning to my beautiful country, I am just saying that it is funny how the removal and later re-insertion of one’s self from a particular situation which may have previously been viewed as undesirable can elicit a complete re-framing and refreshing new outlook.

The 2 pics at the top are guys cleaning the stupa at Swayambhunath, and 2 of the Sadhus at Pashupatinath.

Miss you all and can’t wait to see you again soon


Saturday, February 21, 2009

Article submitted to Pedal Magazine Feb 16 (may or may not be printed!)


“The first rule of riding in the desert is to make sure make sure you approach camels from behind. If they get freaked out, they start running, and God help you if you are caught in front of them – they go like the wind and plow into anything in their way”. Rodd Taylor, my friend and fellow Canadian expat was cruising beside me on his brand new Pinarello, the vibrant red/white/black paint job of the carbon frame a stark contrast to the harsh, dusty desert-scape that surrounded us.
I rolled warily past the hairy, hulking creature standing in the centre of the empty road we were riding along as it sized me up me from under its long, feathery eyelashes. I eyed it back doubtfully, thinking if this thing could run, there was still hope for Mama Cass to compete in high jump. Nevertheless, I rode the next 50m like Mario Cipollini in the final kilometer of a pack finish - muscles tensed and senses alert ready to stamp my pedals and sprint if this gangly long legged creature proved it could challenge the established laws of inertia…

When I first accepted my year-long nursing contract in Saudi Arabia, I resigned myself to the fact that any “cycling” would be a serious act of desperation as I would be resorting to the clunky, La-Z-Boy-like recumbent bike in the dark, stuffy basement gym of my all female housing complex. In a country where women are required to cover themselves from head to toe in an abaya (a long black loosely fitting garment) every time they step out the front door, my life as an elite cyclist was no doubt going to slip into the distant past.

Luckily, I was wrong.

Soon after my arrival, I heard about the Riyadh Wheelers - a bike club based out of Riyadh, run by several dedicated expat cycling enthusiasts. A mere 3 weeks into my stay, following a few emails and a visit from one of the women in the club who had heard there was a new cyclist in town, I had a brand new bike on the way from Bahrain, and a number of new friends eager to help me get back on the road.

The Riyadh Wheelers are a 70+ member Middle Eastern establishment – a 25-year legacy of enthusiastic cyclists of varying experience and ability. With representation from the Philippines, UK, Switzerland, Sweden, New Zealand, Australia, Ireland, Scotland, France, Germany, South Africa, Syria, Denmark, Austria, Canada, USA, and Saudi Arabia, the pack is enough to make the European pro Tour look ethnically drab. The club is as rich in its range of athletic abilities as it is in its cultural representation. There are Ironman triathletes, members of the Saudi Junior National Team, an ex-European pro, as well as a number of “weekend warriors” who come out to happily ride a few laps before dipping into the coffee and cookies offered at every race, and taking to the sidelines to cheer on the leaders.

The race season runs from September to April so as to avoid the unfathomable peak summer temperatures, which often reach 48C in July and August. The races take place in various sparsely inhabited locations on the outskirts of Riyadh, and range from short 10-mile time trials, to true tests of attrition such as the new 160km road race slotted for March of this year.

The most notable aspect that makes racing in Saudi so unique, is the influence of the culture. For example, the holy month of Ramadan is one of the keystones of the Islamic religion, during which time Muslims engage in a daily dawn to dusk fast. The purpose of the month long custom is religious cleansing, sacrifice, and to learn self-restraint and humility. Our first race, which happened to be a 10-mile time trial, fell within the month of Ramadan. One of the top finishers was a Saudi man, who, determined not to lose any points for the season, came out despite his fast. The man not only finished in 4th place out of 60, but did so with no water or food to fuel him. For those of you thinking this is no great feat for a 10 mile TT, it must be further considered that upon finishing his race at around 9am in the steadily rising 40C+ heat, he still had almost 12 hrs left before he could re-hydrate or even think about nibbling a Power Bar. This gave me a whole new perspective on what devotion and commitment meant, both religiously and athletically…move over Lance!

As Rodd and I rode on, I thought about the contrast between our chosen route today (which was to be our next race venue) and the environment I had left behind that morning. It had been only one hour since I had hastily buttoned my abaya over my obnoxiously colorful lycra, thrown a flowered silk scarf around my neck, and walked my bike to the heavily guarded front gate of the hospital compound where I was to be picked up. I took in the details of our current surroundings - the promise of brand new luxury suburban dwellings in this abandoned subdivision was feebly stated in the miles of new, paved roads laid several years before, but now eerily empty without the hustle and bustle of any further active construction. The unattended, dehydrated palm trees lining the house-less streets drooped in the arid heat like the tails of giant prawns. To me, however, it was beautiful: Here, I could be abaya-free, and we could safely ride in our colorful lycra kits without challenging any gender laws, or offending the bulk of the ultra-conservative Saudi culture.

For the most part, the only real hazards of desert cycling include roads being blocked by packs of camels herded by Bedouin (often nomadic desert-dwelling Arabs), the scattered rock-hard piles of camel dung the packs leave behind, and the occasional pack of wild, howling saluki dogs. Special care does have to be taken in slightly more populated areas as road rules generally seem to be optional in Saudi – the speeds and the daringness of the drivers here is enough to make the notoriously famed German Autoban look like a scene from “Driving Miss Daisy”. Until you have actually seen a car full of shebabs (young men) rowdily try to pass your taxi on the inside of a single lane right turn, you cannot appreciate just how important it is, cultural customs aside, to be in an area away from traffic.

As it is illegal for women to drive in Saudi, and that a ride alone, even in the quiet desert would be seriously putting an uncovered female at risk if discovered by the wrong parties, I am consequently nowhere near the strict 6-day a week training regime I followed while living at home in Vancouver. For the most part, my riding now consists of the bi-weekly Wheelers races. On the days where desperation sets in and withdrawal becomes overpowering, I have however been known to call up my favorite taxi driver who takes my bike and I out into the desert, then follows behind me for 50km while I ride, grinning from ear to ear, and completely thrilled with my 2 hrs of “accompanied freedom”.

Now, 6.5 months into my contract, and an active member of the Riyadh cycling community, I am happy to say that though I miss being able to step out the door and ride the North Shore or climb Cypress Mountain whenever it strikes me, I am grateful that I have not had to abstain completely from my favorite sport. Not only this, but I feel honored to have had the chance to be a part of a community which is every bit as friendly and supportive as the cycling scene back home in British Columbia.

Wheelers website:

Tuesday, February 3, 2009

A day out in old Riyadh

A couple of weeks ago, on a rare shared day off, my good friend Emily and I decided that we were going to visit the National Museum in Riyadh (Em and I work on different teams and thus normally have completely opposite schedules).
We set out early as we had heard that the exhibits are extensive enough to warrant several hours time to wander through and absorb the contents. Areas of interest include Arabian Kingdoms, Jahiliyyah (translation “period of ignorance”, referring to time before Islam), The Prophet’s Mission, Islam and the Arabian Peninsula, 1st and 2nd Saudi States, Unification, Hajj, and the 2 Holy Mosques. We were looking forward to a very educational day!

We wandered through the museum grounds – mazes of tall palm groves, intricately designed ceramic mosaic pathways and fountains of bubbling water. This little oasis was sheltered from the street din by tall modern structures making up the different buildings of the museum. We entered through the heavy glass doors into a rather starkly empty but bright high-ceilinged lobby and made our way towards the entry kiosk on the far side of the room. We felt a slight, nagging sense of vulnerability as our footsteps echoed and we did our best to avoid the dark leering eyes of the armed guards lining the perimeter. We approached the counter, and were quickly sung the theme tune of our Saudi endeavor to date: “It’s men’s day today. Women and families can come tomorrow night.” Darn my XX chromosome.

Not to be discouraged on our day off, we decided to go abaya shopping at Dirah (the ladies’ sook). Em’s abaya had 3 broken clasps and was starting to look more like a showgirl evening gown - her jeaned legs were scandalously revealed with each step through what was now a hip high slit up the front! Haram! Now, one may think that the purchase of a long black drape is a pretty straightforward business, but let me tell you – the purchase of an abaya is as personal as the interior decorating of a new downtown condo. Different lengths, widths, straight sleeves, princess sleeves, not to mention enough variations of intricate sparkly bling to appeal to the tastes of any woman. When you consider that this is the only garment through which you will be able to express any sort of individuality when out in public, getting something that reflects your personality and tastes becomes paramount.

After a short recovery period post gasping laughter following the discovery of a sparkly horse head design (reminiscent of the ubiquitous tourist souvenir t-shirts in Canada with the painted wolf heads and “Vancouver”, or “Prince Edward Island” in cursive writing…), Ems found one that was meant for her. Following a 15min wait while the original muumuu abaya was
whisked off to an unknown location and tailored to fit Em’s tall, slim figure, we set off on foot, looking for our next adventure.

We walked 30 mins in a random direction away from Dirah, rounded the next corner, and stopped in awe…there ahead of us, as far as the eye could see was a wide street swarming with hundreds of men wearing every variation of traditional Saudi dress imaginable. Many were walking hand-in-hand in a show of typical Arabic male companionship, and the steady din of day-to-day greetings and business dealings added color, warmth and character to the otherwise dingy, run-down setting. The dusty street was lined with crumbling buildings wielding colorful shops ranging from butchers, to bakeries, to leather shoe shops, to random household goods. This was Batha - we had heard about it – a sort of traditional commercial market centre in the old area of Riyadh. We glanced at each other and smiled, knowing we were going to keep walking. We pulled our scarves up over our heads so as to be as discreet as possible and smiled at the futility of the gesture – 2 sub-6ft tall Western women walking down the sidewalk of a busy traditional Saudi market centre…maybe we can blend in? Ha.

We gleefully haggled with street vendors (and still got ripped off), warily eyed the dried blood splashed up the alleyways outside the butcher shops, and deeply inhaled the rich Middle Eastern aromas of various tiny restaurants wedged in between the commercial stores. We stopped and bought flat bread (for 1 riyal!) from a baker whose display consisted simply of 2 worn, rickety wooden trays. The huge clay ovens behind him were encased in white tile, and 2 large round holes yawned open to reveal the coals next to which our bread was tossed in to bake. A steady stream of regular customers exchanged typical loud Arabic male pleasantries with the baker as the bags of pizza-like bread were bought up as fast as they came out of the oven.

Next, we visited a small leather shop with rows and rows of Saudi-style sandals lining the walls. A small, smiling, white bearded “baba” was sitting cross-legged on a dusty prayer mat, sewing a pair of tall leather boots. After the typical “where are you from” conversation, I had an apparent willing escort back to Canada…my Arabic speaking friends can correct me if I am wrong, but I don’t think there is any other way to interpret “enti/ana rooh sawa sawa Canada? Canada kwayes!” – “you and I will go to Canada together. Canada is great!”. Sometimes being able to claim ignorance is the best way out…and that is exactly what I did to escape that one! “Malesh, ana mafe malum Arabi, baba” – “sorry Baba, I don’t speak Arabic”.

After 45mins or so of walking, we gradually neared the end of the market district. We started to notice that there were an increasing number of “shebabs” (young men) passing by in the opposite direction. Most of them had several textbooks wrapped in colorful prayer rugs, and we figured that we were near a school that had just gotten out for the day. The novelty of this intimate look into the day-to-day routine of these young boys was quickly lost as our presence was suddenly realized: The tendrils of unease quickly crept up and prickled the backs of our necks as several cars circled around us, and “I LOVE AMERICA” (Em is Irish, and for those of you who don’t know, I am Canadian) was yelled from boys hanging out car windows. The boys passing us on foot had just begun taking notice and slowing down when we decided that this was a great time to end our little adventure and hopped quickly into one of Riyadh’s many cabs to make our getaway.

All in all, despite the disappointment of missing out on the museum, it was a fantastic day. We finally felt as though we had gotten a glimpse of the “real” Riyadh, and had the chance to venture into an area not seen by many Westerners.



Monday, January 12, 2009

Language is Power II (but know your limits!)

Last week I talked about language, and how making the effort to use it can create bonds and help to seal off deeply running cultural fissures. I find that for the most part, my faltering Arabic is met with endearment, and, as I said in my last post, provides much needed comedic relief within a mostly sober environment. Often, words are used that I know aren’t exactly right in a particular context, however the patients are usually…well…patient, and their forbearing is generally rewarded with better understanding of their care (after they think about it for a second!).

I still like to be fairly certain of the meaning of the word I am using before trying it out on a patient - thanks once again to my Arabic speaking friends whom are constantly being forced to listen and give feedback as I try and twist my tongue and my throat around the unfamiliar sounds and syllables.

HOWEVER. I am also aware that in certain situations, it is not appropriate to have any ambiguity around what is being said. In some instances (usually those which are more emotionally charged), the necessary explanation or command of the language goes far beyond what I am capable of. I have also learned that sometimes, just staying quiet completely and doing your job quickly and expertly speaks louder and more articulately than the most intelligent and thought provoking exchange in any language...

A story to share:

This story is about a nurse (RN) and a doctor (MD) whose identities will remain anonymous (though I am sure many of you will have your suspicions after reading the story).

A patient on a particular hospital word is slotted for a bone marrow biopsy. Any of you who have ever experienced (either receiving, observing, or assisting with) a bone marrow biopsy know well that “barbaric” is a gross understatement in describing the procedure: The patient lies in a semi prone position while the doctor drives a needle (see above picture) roughly the width of a chopstick and the length of your hand from wrist to tip of your middle finger through layers of dermis and muscle, and into the pelvis. The intention is to collect a corkscrew-like sample of bone marrow to analyze for blood cancer (as blood cancers are characterized and can occur at any stage of cell maturation, samples must be obtained not only from the peripheral blood, but also from the early-stage undifferentiated stem cells). I say “with the intention of” because often, it takes more than one trip boring through the fleshy tunnel, and pulling it out to check if the sample attempt was successful. This procedure is done under local anesthetic (a needle as long as your middle finger is driven into the flesh and alternatively eased forward and backwards to ensure that an adequately wide area has been “frozen”). The patient gets some pre-medications for pain and for anxiety, but I liken this to offering someone a Tylenol and a pull of Mary-J before looping the noose around their necks in a lynching ceremony. Get the point? It sucks.

Anyway, this patient has a history of chronic pain and depression, and was particularly anxious and teary prior to and during the procedure. RN had pulled up a chair beside her bed, and was holding both her hands, speaking in her best soothing voice, and trying her best to pass on strength and will to the distraught woman. The woman is crying out in pain as the needle is driven into her pelvis.

The doctor is an incredibly smart man, meticulously conscious of minute details “behind the scenes”, however his bedside manner would no doubt turn Florence Nightengale to the sauce. He is not a native Arabic speaker, but seems to truly believe that knowing how to say “is there pain here”, “you are not feeling pain”, and what is the problem?” in Arabic is an acceptable range of vernacular to competently perform this procedure. As these questions were being delivered in his signature manner with a harsh accusatory “HUH?!” after every question, RNs jaw clenched tighter and tighter as her patient’s cries grew louder. The third “THERE IS NO PAIN, WHAT IS THE PROBLEM, HUH?!” was cut short by an urgent, even statement by RN “With all due respect doctor, I think the crying and the yelling is fairly indicative of the pain, and the problem is that she has an 8 inch needle the size of a pencil stuck into her pelvis…can we just get this over with as quick as possible please?”.

Well, the room was suddenly silent except for the whimpered Koran verses escaping the pursed lips of the young woman. You could have cut the tension with surgery shears. RN calmly met MD’s patronizing stare despite the creeping fingers of crimson slowly making their way up her neck in her signature blush. Just when RN was certain MD was going to stalk out of the room leaving the biopsy needle protruding out of the patient’s pelvis like a Saudi oil rig, MD broke the gaze muttering something about protocol, and the remainder of the procedure was slightly tense, but thankfully quick, quiet, and relatively uneventful.

My point here is that though it is important to know the language, it is also just as important to know your limitations, and to be honest about the range of your abilities both with yourself and others.



Monday, January 5, 2009

Language is Power

Language is power. Power to learn, grow, understand, and expand personal, professional, cultural, and geographical boundaries.

I am realizing this more and more every day. I know now that language is the link between truly understanding a culture and simply accepting (or rejecting) a culture based on your own (possibly incorrect) interpretations. I am quickly learning that one cannot truly state understanding of a culture simply by living in it for an extended period of time. In this case, opinions of what one may observe are based solely on whatever frame of reference our own cultures have instilled on us as we have grown up. To truly grasp the intricacies, history and breadth of a culture, we have to be able to ask our own questions, and we need to hear the answers based on the response of one who answers from the heart and soul of the culture in which we are but humble visitors. The language connection is much more profound than simple verbal communication, though dialogue is undeniably an important component.

Language in the nursing world is critical:

In terms of the more obvious gains, the more Arabic I learn, the better I can care for my patient in terms of assessment, explaining medications, procedures, etc. Another crucial component of care for me is psychosocial considerations which includes but is not limited to, being able to chat and bond with my patient, as well as being able to joke around a bit when appropriate.

On the next level, speaking even a bit of Arabic, shows an effort is being made on the part of the nurse, and this generally serves to gain a moderate amount of extra respect from the patient. Respect generally leads to compliance, something which is often difficult to attain in my work. The respect earned is amplified if one can actually put a few sentences together. If interest is made clear, many patients will willingly teach the eager learner (a.k.a. me) new words on a daily basis. This in turn takes language still to the next level as the teaching and learning serves to greatly strengthen the therapeutic bond between nurse and patient (= greater compliance! Hamdullallah! See below for translation…)…not to mention, the pronunciation attempts often provide comic relief for both.

As a general rule, trust is directly proportional to the breadth of the vocabulary built up. As knowledge grows, the nurse can better explain medications and procedures, and the patient feels the nurse truly understands voiced concerns, and can thus ask questions about their care and treatment. As the tables are turned in terms of language anywhere outside of the hospital, I can strongly attest to the loss of control and humbling resignation when one cannot voice a concern or ask a simple question to get what one needs. The benefit to gain honourable mention with mastery of this level of language is the power to negotiate and compromise…a skill which is incredibly important working as a nurse in Saudi culture!

The last level, and one which I am only just starting to understand and graze the edges of, is the deeper understanding gained of the culture as a whole based on the actual use of words and structure of the language itself. For example, there are many expressions used which involve reference to Allah (God):

- “Hamdullallah” (thanks be to God) is used generally after anything positive e.g. in response to “how are you?”, “the procedure is over”, “did you sleep well last night?”, etc. The word is often accompanied by a finger pointing up, and a quick glance to the heavens…

- “as-salamu-aleikum/wa-aleikum as-salam” (peace be upon you/and upon you peace) is the standard greeting and reply in Arabic. It is EXTREMELY important to reply to this greeting in the proper way

- “inshaallah” (with God’s will) almost ubiquitously accompanies any (positive) action one is hoping or intending to happen in the future, e.g. “inshaallah I will be there at 8pm”. It can sometimes be frustrating at first as an outsider as realizes that God’s will often pushes that meeting back to 9pm or later…however, after a bit of time here, one inadvertently starts using the expression just as freely, and accepting that God’s will sometimes has its own schedule…

- “wallah” is an expression for which I have not quite figured out an exact translation yet, as there seem to be many. It seems to be most often used as “well then!”, “oh my God!”, or “no way!” though I am sure many of my Saudi friends are cringing at these Canadian interpretations of mine!

- “mash’allah” is also another one I have not yet deduced a proper translation for…this one is sort of like “wallah”, but more of an endearing expression which is frequently used after gaining knowledge of a new piece of positive information pertaining most often to a person e.g. following “my sister is getting married” ( ;) ), or “I was accepted into university” (inshaallah!)

Once one is able to recognize just how often these expressions are used as well as the contexts in which they are spoken, one begins to realize just how seamlessly intertwined Allah is in the everyday life of a Saudi National.

I would like to take this opportunity to thank all my Arabic-speaking friends who put up with my constant barrage of “how do I say this in Arabic? What does this mean?”. Shukkran jazeelan koolo intum. Inshallah ana kalam Arabi alatool gabel shugulee hina kalass sabaa shahar!

I have a story to share with you about knowing the limits of your knowledge (or lack thereof) of a language, but as it is too long to tack on to this post, I will leave you on the edges of your seats until next week!



PS - The Arabic script above means "Allah".