The bro code

Some eight years ago, just across our facade- Baghdad/Iraq

' If you ever come back here , I'll beat the $#%5 out of you ..you understand ' He shouted at the fourteen year old boy at the time ; Shoshta -that's how my brother likes to call him.

Of course , despite the fact that my father had literally chased Shosta with a brick that day and threw him out of the house (I can not recall another occasion when my old man was literally out of his mind apart from this one... because...drums please  Shoshta was a bad influence on my little brother !)  .
After few years however I think my dad had come to realise  who had been the bad influence on whom ! Looking back at it , its fairly apparent  who hid the hookah in my bro's closet and where all the naughty stuff   found in my brother's room came from .Shoshta!?

Despite all the trouble with the parents , Shoshta and le brother continued to be very good friends ..After all , they went to primary school together and well ...that's about it! Different high school ,different unis and now different jobs but you know what they say it is a true bromance ..not too easy for me to understand to be honest giving the fact they have got nothing in common apart from .. craziness maybe!


Yesterday ; with everyone in the car on the way to the restaurant to break the fast ... Amman/Jordan ; Over the phone with le brother

'Ramadan Kareem dear '
'so you did it ..you flew over to the parents .. '
'I did..now you tell me how are things in Baghdad ? how are you managing alone ? where are you breaking your fast ?'
'He's doing it the way you have been doing it when you were alone in London' said my uncle..Oh for god's sake , why did he have to speak now ..I can't even talk to my brother in peace.. 'can you not focus on driving uncle'...zero privacy at this place I m telling you ..

Laughters ..ok at this point I can't even hear my brother ..

'Sorry..did you say Shoshta ?! did you guys order anything ?'
'No he cooked for both of us ..four different dishes ..they were lovely .Well apart from the rice ..it tasted abit like Chinese rice ..he still blames it on the brand  '
'Who were you with ?'
'Ahmad had to leave ,so we broke the fast just the two of us'
Right ! how romantic ! plus I don't know who Ahmad was ....To be fair, I think I tend to do this as well.. throwing random names and being less cohesive when I tell a story.It didn't matter ..
Have you just heard what I heard! Shoshta was cooking in our kitchen and he was shouting over to me to say hi to the parents ..
The weird thing is, all my mom was concerned about was how he dared criticise her posh rice ...
Time can truly change some things !

When the heart starts failing

Do you know what it is like to have a zealous relationship with a rewarding lover?

I was just a raw teen full with optimism when we met. He took me under his aged arms for six years. I have to say our first six years were of late nights that were nothing but exciting. Granted there were some anxieties at first but he became the centre of my world .He was without doubt my first love.

Two more years passed by, when things started to crumble around me .When I couldn’t do anything about it, he was always there, satisfying me in different other ways. But truth to be said, I no longer found comfort in him. Even my parents who were initially uber excited , very proud about how well we were doing , they started to be a bit skeptical sometimes even synical of the way things  were heading.

He took a lot of my time, drained a lot of my energy. No matter how hard I tried, it was always a fight before letting me spend quality time with my family. He didn’t even bother to support me. Few words of his wisdom would have been enough but instead he engulfed all of mine.

I felt bitter, almost aggrieved by it. I decided that I didn’t have to put up with things the way there were. It was about time for a break. Who would know maybe for the best of everybody.

But like all true lovers, I couldn’t do it for long . Despite my resentment and the fears of going back to the hands-on life of medical wards and unsociable style of its shifts. I’m back. I have made a conscious decision to re-sparkle my relationship with clinical medicine. The truth is I never intended to leave .  For the past couple of years I’ve been a postgraduate student .Which is theoretically less demanding .Hmmm that’s a lie actually it is probably as demanding but far more flexible . I m trying to write up my thesis now… with virtually no time left .I was never good at multitasking.Add to it this growing  urge to leave everything behind and just bury my head in the sands .I was literally at some serious cross roads and was happy to finally decide on keeping it only to lose it a couple of days ago… which wouldn't be that bad (that's a lie :p)but I couldn't even look at a mirror (see here to know why) … 
I couldn't hit my one month target by the way I had to stop this cute challenge for various reasons. I know I promised to tell you all about it and few other things  but..but has it ever occurred to you ? You have a pen , your lucky pen , your favourite pen .. you open up your heart to it , share all your worries and your concerns together with all your goals and desires . And for some reason , you become less and less fond of it . At first you start leaving it at home together with your journal then you no longer wish to tell it as much as you used to and before you realise you forget all about its existence. 
But ,as good things always do, the idea of writing started haunting me again ..reminded me of all the satisfaction I get after pouring it all out of my chest. So I went back to my pen ... abit nervous , heart pounding , head full with stories I wanted to share with it ... I opened the box , got the pen out and  the very first thing that made sense to me was  feeling it's pulse..I tend to do that with every soul I care about  ..it's instinctive for me but cry-out-loud weird for everybody else ... Nothing would have prepared me for what I came to realise .. I couldn't feel a pulse , the ink has dried ...I haven't left it for too long I thought plus I had all the good reasons /excuses to tell my favourite old friend why I'd left for that long  .In the past few weeks I have successfully cried for England ..been homeless for a good week and dead worried about what's happening to family in Baghdad, I have starved a rabbit in the process  and got myself in all sorts of trouble . 
But guess what ; the pen didn’t say anything back ..I don't think it's dead rather I'm sure it doesn't care ..I left it long enough for the ink to dry ..I can no longer use it and that all it mattered . The truth is after what had happened I don't feel like writing in this diary anymore.

Hope you are  having a better day :)

Until next time-Maybe not ! , you keep smiling best friends !

not on this enrty apparently:P  I was literally homeless , and what do I do ? Chilling out in Westminster .Note to self ; bloody prioritise (I had a crappy week afterwards) lol

Letters from the front line

Hello there best friends ……

'Letters from the front line' will be  a series of entries to my random diary . Its basically about my very last holiday as a student in the UK - July-August - . Though it was relatively short but quite few interesting, exciting, distressing and crappy things happened. Not necessarily in that order. 

Here's a teaser of what had happened ;

• Hit by a London bus - ouch -
• Almost hit by a london bus -again!-(seriously whats wrong with them buses :P) if it wasn't for a law enforcement officer accidentally passing by  -How romantic ! -
• Impersonating Sherlock Holmes in one of the most mysterious Arabian -ISIS flavoured - nights in Baghdad 
• Blood pressure shoots up (for real) on any mentioning of rabbits .You'll know why !
• My story with A rabbit 
• A very special night in Baghdad - in a good way :)
• All about my ambitious to-do-list in Iraq 
• A couple of new friends  
• My visit to the doctors'
• My latest chick read
• Summer shopping ...anyone?
• A follow up on my Eid resolutions 

All that and more had happened in less than 10 days ! 

Stay tuned and until I see you next time you keep smiling ...

Eid Resolutions

If you know that Ramadan to me is what Christmas time is to most people here ,so you would probably understand why I have this annual ritual of creating a list of resolutions just as its about to end and with the beginning of Eid . It's practically like new year resolutions as I have never had actually given the new year thing any seriousness.

Ok enough talking ! There are so many on that list I thought I share a couple of them with you here :P

• I watched this video a while back ..And I have decided to give it a try .Almost a week down the line and I m telling you its amazing how being less clingy to my phone , has offered me so far ..Its magical ; smart phone out of your reach for few hours a day, you will be naturally more social   ..Yeah granted given the norms here I came across as a bit strange to a few but people generally appreciate it a lot. This is definitely staying on the list ..Enjoy trying it out ..

• No mirror challenge ; this one has to be the most difficult ;regardless of how down I think of therapists I decided to follow this advice as things hasn't been exactly quite orthodox for me lately !As this was the least  relaxing month I had since last Ramadan. I thought I might try this ! no kidding when faced with cross roads and asked to be more decisive about quite few things at once, I can't see how this can be within the comfort zone of anyone  .



My new make up kit ;yes its water! and some vegetable mask that I have to keep in the fridge!:@ 

Mirrors covered!

Anyways ; NO mirrors for a month .Ladies have you ever tried a no mirror make-up challenge! I m obsessed with mirrors and because I was so stressed and sick most of this month I truly think I look like 20 times my age ( not practically possible but you get my point ) with weird looking rashes and acne and stuff -not impressive- so no mirrors , no chemicals on my skin or in my body , organic all the way through for a month. Its been only 3 days since I started but It feels like ages ! It's ok when you're working but when you're out and about  man mirrors are everywhere ! I peeked through one quickly today o_O but I still think its doable and I m truly excited .I think its helping (maybe not!) I ll definitely keep you posted. 

no cheating


And until next time you keep smiling best friends .

The Last Lunch

Ramadan - Hospital Restaurant ;lunch time ; with le colleague

'I'm really sorry . I can come across as rude sometimes .I guess what I meant is simply that you have left your home country years ago and you are ..well you are basically an Italian now that was where you studied medicine and practised before coming here ..'

'Don't worry I'm only joking ...you're right .I am an Italian .. I'm just saying what had been told to you is not exactly true .'

'But things can change in twenty years,don't you think ? '

'Not that. Christians are the same everywhere...I went to a Catholic high school there and ..'

 Oh dear not another Carl story ! 'Oh really , so were all my aunts not there obviously ..back in Baghdad' I didn't want to argue further .I thought I've already done enough in terms of limiting my chances of getting a good reference from him .So I decided to shut up .
On a separate note, It was very entertaining watching Carl  talk about his teen years. His eyes lit up when he started telling stories about his school .He reminded me abit of my father . Anyways ,few minutes later , I just couldn't curb what was going in my head anymore. But to be honest looking back at that afternoon I probably shouldn't have gone further. It was not the most appropriate discussion for the hospital canteen . But I did !

'So you're telling me that no Christian; absolutely no one, is still doing this back home now or in the past?  '

He stared at me ..looked slightly unsure of what to say next ,maybe a bit confused , possibly surprised I couldn't really decrypt his face ...and just when he was about to say something , I saw (something) from a distance..
Oh what the h#^$?!..I really wanted to hear what Carl had to say 'this time!' .

'Hello hello hello .. ' here he came , the bundle of joy ; Sham , with his fish&chips+CURRY  lunch tray ( yes people you read it right !) I have nothing against him but he tends to appear when he's least wanted.
He put his tray down , grabbed a chair from the table next to ours and sat down.

'Heys, lunch time! ...you know coming down the restaurant when one's fasting isn't  the most brilliant idea'   better be nice I thought plus it's Ramadan spirit !

'Oh you're fasting .Why are you down here then?'  That's Sham for you ! I didn't say that of course  'Well Carl was telling me all about FIFA ,Germany , Argentina and why his team's left the world cup so early ' I said
'Nigeria ?' he inquired
'Cameroon ; alright listen I know you're not fasting but me and my friends  are breaking the fast in Clay Oven tomorrow night would you like to come ?'
'I'm on call '
'Great ' shoot..I said it out loud  !
'I can't believe you said that '
neither was I gosh!
' Carl you have to come '
'I will '
'see you then '
'D remember it's like the world cup'
Because we'd chatted quite a bit .I had no idea what Carl  was referring to by that but yea what the heck ' Sure '

What happened next ?! well, I was too sick to go out that night and I still don't know what Carl wanted to say on that day. I totally believe that Sham has jinxed it all . Hope he won't be reading this !

Happy Eid to all who's celebrating it ! May this earth be guided to be more humane , peaceful and loving . And until next time, you keep smiling best friends :)

6 key steps for your MRCP PACES success

So I sat PACES (the rather nerve racking practical examination of the examination for Membership of the Royal College of Physicians) earlier this month(2014).With it out of the way , I have finished all the MRCP parts in 10 months and no I'm not that smart but I know quite few doctors who worked much harder than me in their preparation but didn't necessarily clear their MRCP as quickly as they planned.I think the main key is to be PACES-focused(rather than I want to know it all -focused! ) in your revision. For this I made a few notes on my experiences with this nasty exam, I thought I would put them up here in case they were of use to anyone.

A word of caution: these steps solely reflect my experiences and might not necessarily apply to you , it's maybe an idea to read through them and take what you think is useful and leave the rest .. you can always comment below to add what you think might benefit others ..so shall we start ...

Step 1 - Start NOW 

Just because you haven't cleared the other parts ,it doesn't mean you can't start preparing for PACES now . Get a paces book ; Cases for paces and Oxford pocketbook for paces would be perfect for the wards . You know that patient with PSM on CCU that you heard about from the CCU cover ; finish up your break five minutes earlier and go and examine them and present them to a colleague if possible (even if you're planning to take the exam next year) .I tried to learn/refresh (a) paces skill everyday .  

Step 2 - Identify your improvement points 

Get the PACES mark-sheets for different stations (from the MRCP UK website) and familiarise yourself with them early on .Now is not the time for Harrison's and Davidson's.You want a clear and focused study plan for the exam .Identify the points that still need improving in you and tackle them accordingly . You might think that you're slick enough in your examination skills but you kinda need a bit more in your clinical Judgment or the differential diagnosis and so forth.

As for me being an international medical graduate , I was told early on that my main focus should be working on my communication skills and history taking as stations and managing patients concerns and welfare as well as my presentation skills .I started working on those when I was still preparing for my part one.The key is to know that people do fail even in history taking be prepared for all the stations .

Step 3 - Don't prepare for PACES alone !

For PACES you need feedback , apart from the differential diagnoses and theoretical knowledge which you have already covered in part 1 and 2 . You do need some form of feedback to make sure your examination and presentation skills  are as good as good can be .If you can't find anyone , present in front of a camera then replay it and watch yourself .. try to identify ways to make your presentations better.

I didn't prepare with anyone who was planning to sit the exam as I was doing a full time academic placement at the time which meant that non of my colleagues were preparing for it . 

But lots of colleagues have actually helped me prepare in so many ways .Examinations ,history taking scenarios , ethical scenarios and the hours I spent whining about it to them (literally hours) . I have been helped a lot by quite few colleagues at Ealing hospital especially in the last few days before the exam when my nerves started to get the best out of me.I would rather not mention names as surely I won't be able to cover them all here! I don't want to forget my sister here - a final year medical student , the poor thing was my slave .She did countless history and communication scenarios with me (whilst fasting) bless her . 

Step 4 - Take a PACES prep course 

Now some people might think its a waste of money as attending your local teaching, group preparations and good PACES books should suffice but I did go to courses and I think they help .

Well , maybe I'm wrong .In fact according to study published rather recently , there isn't any significant difference between people who attend commercial courses and those who don't in terms of pass rate but here you go . I went to PASSPACES   I think it helped me a lot . I also went to EALING PACES  -you get a discount if you're staff- and both are well established , both are good .It's worth mentioning that I was broke afterwards (for a while) ! just plan your budget alright !Don't say I didn't warn you 

Step 5 - Invest in PACES BOOKS

Not your money but rather your time ! you can get most of them as a pdf copies ( comment below if you would like me to email  any copy-righted material , I don't think I can upload them here! ) or borrow from your hospital library .

here is what I relied on ;

Pastest website ; not exactly a book but it has quite useful tips and videos 

Podcast of common cases  presentations ; a colleague emailed it to me  it was really useful

Ryder book for history and communication stations 

Clinical medicine for MRCP PACES vol 1 for the clinical stations 

Step 6 - Meditate !

You come that far through the blog ;congratulations ! Seriously ..try to relax or at least look relaxed in front of the examiners,stethoscope off your neck ,hands behind your back when presenting ! Its easier said than done though . 

I was absolutely horrendous when I started preparing for it and I m still not the best person to give advice about it .But I was advised to Google mindfulness and practice it , I prayed as well and listened to some final pep talk from friends which did help me a lot . surround your self with some positive energy (don't ask me how !). 

I hope those steps are useful and if you are sitting the exam anytime soon, Good Luck!

and as always best friends until next time , you keep smiling !

Say Cheeeese !

'Stop it..' 

'Take your hands off your face ..'

'leave me alone I don't want any photos  ..'

This is an all too familiar conversation that I had with anyone who tried having my photographs taken! Its been like this for as long as I can remember ..In fact if it wasn't compulsory at the time , I wouldn't even have any school photos...

My relationship with cameras hadn't been always that bad.I was the first born to my family and the very first grand child .That could probably explain the tens of albums my family still keeps of me... a lot of baby photos (A LOT) ...I mean when you think about it for a bit ; at a time when there were only those Kodak cameras where you actually have to collect the films , process the photos then print them out .It feels like a dinosaur's tale now but that's what used to happen,seems like a lot of hard work to me! Man, they were keen!

Some of those photos were actually very cute ,some were a bit embarrassing ..One thing for sure; more photos were taken of me as a toddler than through my teenage and adult years combined !

  

I barely had any photos when I was growing up..I really can't remember when it started but at some point,I couldn't look through my pics and absolutely hated the way I look in them.... I still think that I'm not photogenic  but I'm slightly more comfortable with the idea of being in a photo ..Not really that's a lie !

 No seriously , only few years back was when I started to 'voluntarily' appear in photos ..I realised that I was probably asking my brain to remember too much ,unaided!I can totally rely on my memory when it comes to the vibe of places and people but I don't think its fair to hold it accountable to disrupting facts,actual moments , all the faces and the places I didn't want to forget.Its just the way it registers stuff !

Growing up in a city like Baghdad had forced me experience losses of people I care about too early , in utterly unexpected ways . I found out that my iconic memory won't be good enough to remember them for life. I know this will sound very weird but nowadays to resist my first reaction of saying no to a group photo I always ask myself 'Could it be the last time I'm gonna see them?' if the answer is yes even remotely (and it will be if you or them were living in Baghdad) then I gather my energy and smile for the camera :) ..but if there is a even a tiny chance that I'm seeing  you tomorrow then...forget it ..leave me at peace :P  

you keep smiling best friends !