Word and Image

Posts tagged “Jeddah

Happy Birthday

_DSC4310 copyBy agreement I refer to Jules by the nickname her friends use. Too many of her students stalked her name searching the web. She thought it was weird. I guess I agree. But here we are again, another birthday. She always had a celebration that began at the end of the school year with her classmates. This was well before August. Then, the excuse was everyone would be on summer vacation. Then, we were on vacation, the Tyler Place. This called for a second celebration, cake, party, the whole works. And then there was the extended family of cousins, and grandparents at home. _DSC4239 copyAnd on her actual birthday we had a family celebration. So it became a summer long party. For a kid who seemed deprived because of her August birthday, Jules would be about 100 by now if each party counted. And for the birthday wish, I wish her happiness. I think she is. Happy birthday kid._DSC4444 copy


Rays

IMG_7529Ghosts, gliding majestically along blithely oblivious to a couple of divers, Farid figured that if we were deep we might see them again. Typically he pointed too late for me to get an image of the first one that practically swam into my face. You can’t speak underwater so his strategy was lost as I followed him to 140 feet. We had just completed our rescue diver certification I was idly wondering if his brain was addled from the depth. Nitrogen narcosis is insidious. He pointed and even with max effort I was not going to get close to this trio. So the silhouette had to suffice until I get a better opportunity. Majestic.


Dominoes

IMG_0408Rain or shine – well it never rains…but the men’s dominos game goes on whether or not there’s a crowd. The guys are tolerant. People were crowded all about them snapping pictures. I mean the crowd was in their space! The game was on and no matter the crowd, it was proceeding. Just one table and one game…. The last time I saw this group, it was on an evening tour of the Balad. The tourists crowded and shot images. The men ignored them and played on.


Picnic in the Square

IMG_0401Plop! Yes bring a rug and plop down in any open space. No one seems shy about bringing along a rug and just claiming a spot in the middle of everything. I can’t say that it appears comfortable. Selfies in the background!? It’s midnight and joint is hoppin’! I’d ordinarily think a nice soft patch of grass would do. But there ‘s no grass in sight. Folks will set up in the most unlikely and most uncomfortable looking locations. And despite the hour, no one appears ready for bed.


Typical Drink Ramadan

IMG_0357My guide told me that there were typical drinks that were served at Ramadan. These things create the familiar memory of a holiday as eggnog would remind me of Christmas. The dark purple drink is served everywhere. The origin or berry is unclear to me. The taste is distinctive. The other drink is newer and is seen together. But it is the purple stuff….has an odd distinctive flavor. It is sweet without citrus tartness. Initially I did not like it but it becomes an acquired taste. It was new for me but is typically served where ever I go. Most vendors served it up from plain plastic containers. Here at least the display had some style and was worth sharing the image. Otherwise for the rest of the year I don’t see this drink.


Second Chances

IMG_0335More street photography – I got a second chance. Well okay. This time I wasn’t under pressure. If I got a shot or not, there was already one in my archive. So now the goal is to get a better one. Smile, get eye contact, and shoot.

Someone I know, knows all about second chances. This really isn’t. You have already seen two shots on a recent post. This time with nothing to lose, I relaxed, smiled at the kid, made eye contact,  and got him to engage with my camera. Instead of a distracted look, I got a smile. Like many of my street photography subjects, this kid will grow up. But for this instance I have preserved his youth forever.


Midnight at Balad

IMG_0411The last time I made the mistake of coming at 7PM. The action I spoke about starts after the last prayer. So this is the crowd milling about at midnight. This is a one-way thoroughfare. Are you kidding? Nope, it’s one way. I got caught about half way along and had to walk to the end twice. Pain! No one sleeps during Ramadan. They stay up until 4AM, then try to sleep all day to minimize the time of fasting and hunger. I’m saying that families and young kids are all up and active at this hour. If the routine change has affected me so, it must be hell on little kids. Once a year for 30 days…..


Typical for Ramadan

IMG_0328My guide told me that this is typical food served at Ramadan. It is liver she said. Diced liver and mixed vegetables are added to a hot grill. The savory smell beckons. It seems this is the specialty of the house and at every table multiple orders were being eagerly shared. No one seemed to mind me taking images, so I did.


Street Food

IMG_0325

This is a pocket food. It starts as a small ball of dough that like pizza is stretched to paper thinness. And then a filling is added. The package is folder and thrown on an oiled hot grill. Make it golden brown. It looked good. The picture says it far better than a description.IMG_0352


Seating For Seniors

IMG_0305This spot is designated seating for the elders of the village or neighborhood who would gather, sit, smoke, and discuss the news of the day. I asked and the pictures are of prominent members possibly deceased but who are still remembered. I asked and this man graciously let me take a few images. Jules would be proud that I asked.


Unstaged

IMG_0281Street photography – you shoot an image hoping to preserve spontaneity. It is an unguarded moment. I guess I’m better than I realize. I shot this. It is on my memory card. No one else used this camera other than me. The problem is that I don’t remember taking the image. It is in the middle of my Balad night series during Ramadan. So I am as surprised by the shot as anyone else. Does it still count if I don’t remember pressing the shutter release?


Face in the Window

IMG_0232This is sure to be a classic image for me. I was walking the old city Balad. The evening heat was still simmering. I was half melted. There in the window was a kid looking out at the passing crowds. As I snapped another woman commented it was a great shot. She did not copy me. And a moment later the kid was gone. I shoot multiples especially in poor light. Something is always wrong with focus or lighting. I have my favorite. It’s good to have a choice.IMG_0230


Hitchhiking – Cleaner

IMG_9730The small blue fish, a wrasse, represents a symbiotic relationship in the sea. They are the local car wash. Fish have no fingers to clean themselves. So the wrasse hang about. Some call their locations ‘cleaning stations.’ Bigger fish come along and the little guys do their task. I’ve seen them within the jaws of moray eels. Hmmm a tasty morsel, just swallow. But larger fish even seek out the wrasse. And there seems to be an unwritten agreement about not eating your cleaning service help. Do fish have ears? None that stick out. Because it is hard to clean behind your ears in the sea?IMG_9697


Ray

IMG_0076I was swimming along the reef with Farid. He wears glasses and has custom lenses in his dive mask. Maybe I should get some too. He always spots the good stuff first. He caught my attention and off I went in pursuit. I don’t know quite what is under the ray. A remora? We are deep. The floor here is about 120 feet. My gauge says we were as deep as 123 feet on this dive. So the colors are muted and the image is grainy. Fine. I was there, got an image, and we saw it.


Lunch Special

IMG_0125I am just realizing that the restaurants around here run lunch specials. Restaurants do this everywhere, I suppose. But bargains? This one was a pretty sweet deal. Zucchinni soup, pasta with bacon (it’s really beef), and a pounded tender chicken cutlet; the salad, bread, and soft drink are included. IMG_0127That’s my iPhone ebook reader in the background. Peaceful setup as anything…All this goes for the price of an entrée menu item. I’m trying to be good and not overdo this. IMG_0129I noticed the steak house has a lunch special too. And with Ramadan the Indian place will run an all you can eat buffet. So many restaurants, so little time. I’d mention the name but you probably won’t be dining in this restaurant.


Unintended, I’m Sure

IMG_6024Censorship is so wacky in this country, you have to shake your head in amazement sometimes. There are numerous instances. Just to refresh you, there is the blurring of faces in advertisements that stores show. You see a camp scene and six people gathered to model clothing and all the faces are blurred. They blur the monuments in the cemetery because of the crosses. I kid you not. This was a most puzzling scene in the movie Sherlock Holmes that I watched on the airplane. I am, by now, used to blurred spots where a bit of risqué cleavage (top button undone) might show. And often whole scenes are simply deleted leaving a gap in the plot that you would have to find imagination to fill.

So here is a billboard poster right on Thalia Street. It’s for yogurt. I get it even without benefit of translation. But if you look a different way, wouldn’t this be a fertility poster as well. Egg and well you guess….wait till someone else gets the same idea. Maybe it’s just me but now that you have a second look…? (If you’re extremely dim, the red berries are the cell nucleus.)


Looking Down

IMG_3480Here’s a party view I don’t often get to see. I was descending on the escalator overlooking Starbucks. A birthday party? Yes, I think so. Cellphone’s the recording device. I was to far away to hear any singing. Happy…happy.


Flat Bread

IMG_2991It’s made in fired ovens. David thinks that it’s two layers and the ‘puffy’ bread rises because of the construction of the dough. To me the dough looks like a single pancake. They make a lot of it. It’s the sliced bread of life here. IMG_2992It’s the Middle East equivalent of French bread served in NY. And then there’s the Tandoori oven. They slap pieces of dough against the sides and make another form of bread. When I attended a banquet at a home, there was a portable Tandoori available for on the spot baking. My assessment – it sure beats sliced white ‘Wonder Bread.’IMG_3001It looks like there’s something stuffed inside. Either way the food is good.IMG_2999Since we were in the outdoor kitchen, it afforded us a view to some pretty good cooking. IMG_3002


Ethics and Technology

IMG_3440“Hi doc, I’m Lea’s mom. Thank you so much. We’re at the airport…”

Shortly after I arrived in Jeddah I was faced with an extremely difficult medical case. By difficult I do not refer to the technical part of surgery. Right now great technology is a given in neurosurgery. But it is the ethical decision making that is involved in whether or not to recommend surgical care. A young 29 year old ICU nurse suffered a major stroke of the left brain hemisphere which is ordinarily a devastating brain injury. Recovery is poor and usually associated with major neurological impairment (speech and paralysis) and a good possibility to remain in a vegetative (unaware) state permanently. There was no family available for consent and her nursing colleagues became her health care proxies. In the glare of this discerning audience I would have to make some tough decisions and the outcome would affect my very reputation within the hospital medical community.

Many of my colleagues here in Jeddah have counseled me to be very conservative and not to take any medical risks. This has been a mantra for care since I have been here. It puzzles me because there are inherent risks in any neurosurgery decisions and the results are never guaranteed to go exactly as you plan. Balancing failure and success has never been more difficult than in the past two years. One thing that I have noted is that there is a definite tendency toward unrealistic expectation by patients/families that everything done must be successful.

Our young nurse had deteriorated neurologically and brain death seemed imminent. So a split second decision was made based on my gut feeling and medical experience; the plunge was made. We took her to surgery and in a series of operations proceeded to remove her skull bone, evacuate the blood clot, remove dead brain in order to preserve the brain that would survive, reconstruct her skull, and finally insert a ventricular shunt. I summarized about six months of hard care in that previous sentence. There were many times that I questioned myself as to whether it was the right decision that I made to try to save her life. My questions came because for many months she was completely neurologically severely impaired, unable to speak or care for herself. Mom arrived more than two months later. She had been unable to obtain a travel visa from the Saudi government.

The hospital and the nursing staff were wonderful in supporting a nursing colleague. And day by day my patient became more and more responsive to her environment.

I received this thank you text from her mom at the airport just before they departed for home in the Philippines. My patient, her daughter, was now communicating, not yet speaking, feeding herself, and walking with assistance. She needed help to take care of herself. Her mother was happy for her recovery. And knowing what I knew as she left for home I have no regret in pouring out a maximum effort to save her life despite the tremendous odds against even a fraction of the recovery she made so far. Some days it’s worth being able to think back that we did something that no one thought we could do.

No one likes an unhappy ending. Some years ago it was noted that movies with unhappy endings are not popular. Really, think about it. At the time, it was said to me, Robert Redford in “The Natural” hit a home run to win the game to end the movie. But in the book David Mamet wrote, the character strikes out to end the story.

I have experienced my share of unhappy endings. It can’t be helped. But there are those times when a decision and good skill will touch a life in ways that everything was worth all the hours and work you put into your profession.


Heartfelt Thanks

IMG_3493I had a patient come to the office this past January 11. She had had emergency surgery exactly one year before. That day she had been found at home collapsed and unconscious. A large intracranial hemorrhage was discovered and I soon had her in the operating room for emergency lifesaving surgery. As is usually the case we took her to the operating room in a rush as soon as I arrived in the ER. It really does work that way sometimes. The patient had a stormy post op course. She was paralyzed on one side and couldn’t speak or write for many months. Money was no object as she bounced around rehab programs even taking treatment in Paris. But as with most brain injuries, it is time that heals and I had repeatedly told the patient and her family that it would be a year until the outcome and recovery would become more clear to all. And so on what she refers to as her new “birthday” my patient arrived in the office with the deepest thanks. She brought me a letter of thanks, which she signed in front of me. Just writing was a big achievement. Her speech and strength had returned. She still had deficits but overall she was living life and appreciating her family. As I have often said, “It’s the smile of your thanks that makes all the work we do so rewarding.”

 


What Are The Odds

IMG_3009I’m not famous. I’m not a celebrity. Really! But it always seems that I run into people who know me in the places that I visit. Jeddah has 3 million people give or take. And when the kids were here, we were cooling our heels waiting for a table at the Palm Garden. Just as a table opened up, I had my camera up and taking a picture. As you can see, a fellow diver greeted me with open arms as he recognized me behind the camera. Coincidence, yes, but not isolated because in this same 10 day period David saw me greeted by a patient I had operated upon in another restaurant far away from this site. This woman graciously invited him to her daughter’s engagement party so he could taste a different aspect of Jeddah. It certainly remains interesting who you meet and who knows you while you try to remain anonymous.


PF Chang

IMG_3431David said don’t do it. He said it’s a chain and it’s not too good, too formula…. He’s eaten in a lot of places by now, so he’s more sophisiticated in his taste and evaluation. Unlike Ajii which both of my kids approved, PF Chang was a place to avoid according to both children. With a lack of choices I found myself drawn to try it. All local reviews were positive and everyone raved about the dynamite shrimp. Now I have found out that the entire six restaurants at this site are owned by a single company group. So far it’s been very successful with no parking and lines everywhere. I’m not impressed that cheesecake costs $8 (33SAR). A burger at Shake Shack is only $8. But my eye was on PF Chang. The singles section is like an afterthought. The space is small and cramped. Service is very attentive. They do a little show to mix some dipping sauce tableside. The food – dynamite shrimp is the local NY version of deep fried shrimp covered in a mayonnaise sauce. It’s pretty funky in NY and so what else can you say. It is a recipe that was made on the spot in NY with ingredients at hand in a combination of ingredients put together from a bad dream. Not bad…. Just not worth mentioning again. Dynamite – it’s in the hot cloying sauce. Anywhere else and without the sauce, this is tempura shrimp.IMG_3418

Chicken lettuce wrap has the standard iceberg lettuce – ice cold – to wrap around diced chicken and deep fried crispy rice noodles. Decent. IMG_3424The shrimp dumplings were covered by steamed wonton skins and were largely tasteless, hence the dipping sauces. IMG_3427There was green apple soda, way too sweet, but with a crunch green apple slice. I’ve not made another foray to try the mains yet. But so far David and his sister were right.IMG_3417


Jet Lag

IMG_2698Yes, it is possible to be asleep on your feet. Actually there was a time when I was an assistant surgeon (residency) and it would happen regularly. Up all night long, then leaning in able to see the operating field with only one eye open (and the other closed) as the surgeon worked. Before you knew it I would be bumping his headlight as I dozed. When I finished my training he said to my wife/significant other then, “Great guy, I just don’t know how he ever managed to learn any surgery.” (I just didn’t sleep when it wasn’t boring.)IMG_2697Well, I told you that J had been through multiple time zones from LA to NY to Jeddah. David and I had no mercy. So it was no surprise to have her sleeping during our self-portrait. Not just eyes blinking, no no no, it was a full blown drowse. She’s a good sport about it and we even went to dinner afterward. We just didn’t keep her up later.


Amara, Missing Shots

IMG_2445I bet you wondered when I spoke about Amara (lukewarm) if I had left out the pictures of the restaurant because it wasn’t the greatest. Nope, just a senior moment. IMG_2739David was the one to find it. He pushed me on a quest to find roadside sculpture. And with a family (J, daughter) we could eat upstairs!IMG_2723Yeah, it’s a lot different view. If you are single you eat somewhere else. IMG_2724Same food, just different view. As a single, I read. I’ve got a library on my iTouch. Reading ain’t conversation. But a good page turner  is a distraction. Yay for ebooks.


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