The photo was taken in Ashburnham, Massachusetts on a lake in the fall. It was an early morning with a still wind. The reflection is self-explanatory except that it’s turned on its side. No, no Photoshop. It actually was the real deal. You don’t get this too often. But the story is of four couples, friends for many years (too many to say here) who would gather periodically to hangout and do whatever. In this case it was getting on a pontoon boat for a little early morning cruise. Sorry, if you don’t look your best early in the morning before coffee and tea. The guys were cooking breakfast.
We were on a five borough bike tour of New York City. There were thousands of riders strung out all over. As we rode along a road near La Guardia airport… I snapped this shot from the rear while riding… and was immediately admonished by my spouse (it’s not her!!). Well, if you wear worn out clothes in public, it’s fair game. No names, just places. It’s not a nice thing. It is in the category of street photography. There was no intent to offend. But a word to the wise, watch what you wear and where you wear it.
Here’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.
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.
I 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.”
I’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.
I have a bunch of non sequiturs. Actually I uploaded some shots from the Balud and they appear to be orphans at the moment. There always seem to be a few men bundling sticks cut precisely the same length. The bundles sell and I must remember to ask why they sell?Digital is a lot smarter than me. I shoot and the camera makes me look good. Mixed lighting and high contrast scene… no problem. It’s dates.This is as close as we came to actually buying anything. It was an old jewelry store, which is to say that the jewelry looked old. Nope, made in Pakistan, recently. Neither J nor David bought. Dave could have used something for his girlfriend….Shadows are a great subject. We’ve done some strange shapes. But the kids would have none of it as we walked at night. Patterns, I like patterns and especially when you have willing/unwilling subjects at hand.
I was wandering behind my kids as we walked through the Balad. It doesn’t embarrass them so much when I take photos from the hip. The kid with the hat carrying dried flowers was a natural subject. Before I could position myself for a shot, he stopped, posed, and nodded for me to take his picture. His companion stood shyly to the right. I beckoned him to join and took this image. Ordinarily I am aware of the background distractions. The guy standing behind was actually trying to position himself into the picture as well. The moment passed and the background fellow introduced himself and told me he was from Yemen. I smiled and hurried to catch my kids.
My daughter is self conscious when I do ‘street photography.’ I just shoot from the hip and get the street scene without posing any subjects. Here, the kids feel that if I should encounter any objections, it could go badly for me. Perhaps?
But on the same walk through Al Balad, I had three different sets of experiences to the opposite. People saw that I had a camera and just posed for me. The kids still think I shouldn’t invite trouble.
Parenthetically and off topic, I misspelled … as Balud. Because of this the Google search engine lists my misspelled posts in the top few finds on the first page. Wow! Who’d have thunk that a mistake would get yo to the toop of a search page?
It constantly amazes me how well the camera processor/sensor can analyze a scene and get a decent exposure. Basically I’m lazy. I don’t want to be twirling a lot of dials and adjusting shutter, ISO, and aperture. So the camera does the work and I compose and try to crop in camera as the image is taken. You could never do this with film. And you never had a chance to make instant corrections. Immediate feedback has made things so much easier. I will also admit that I am not shooting raw.
I’m saddled with slow shutter speed, image stabilization, high ISO, and a cropped image. You can see the movement blur. All in all I consider this a satisfactory grab shot. The beauty of auto focus is that you really do just point and shoot. In truth this is what I have come to know as street photography. I’d rather not tangle with folks who don’t want their picture taken. So I just shoot from the hip. This opens up a whole discussion on whether it is proper to just shoot like this. It is in fact permissible in a public space. My kids would rather that I didn’t do this and risk harm to myself. I’m just discrete and haven’t run into any problems so far. Hey, he was a cute kid.
There is a uniform dress code. Women must always wear an abaya in public. And that abaya shall be black. For the most part men wear white. For kids anything goes. All I keep thinking about is how Julia melted when she wore her abaya while visiting me in March. She literally melted inside the black (and she’s no witch). The weather is a lot better now. It’s almost pleasant in the evening. The downside is that the sunset is early and soon it will be dark at 5PM just like home.
I have to get a new wallet. Mine smells from all the perfume and cologne. It gets on the money and my wallet and even my scrubs have a scent. You pretty much have to wear something to cover the scent of wearing a black abaya or long sleeve thobe in 100 degree weather and no where to hide. I’d just like to have my wallet not be scented when I get back to NY. Most natives consider me barbaric for declining any supplemental scent.
It’s called technical diving. It’s what you do when you have been using a tank on your back for long and you want a different experience. Also it’s useful to swim in tight spots like a cave, which is the true purpose. For a few days I dove with a sidemount diver. And after all that time, I finally managed to get a good shot of Armand and his tank setup. We were headed into shore and I was trailing him. As I looked up the waves breaking above made the perfect frame and I got this image. At the time I realized how well matched we were. He had much more experience. But we were both photo enthusiasts and we could stay down more than an hour on a tank. He didn’t mind lingering over a subject to get more than one image. Yeah it was a lot of fun for those few days. I wouldn’t mind myself to dive alone and photograph at leisure. But it’s against the rules to dive without a buddy. So I don’t. And this makes everyone else, who knows how I feel about rules, happier.
I do admit to getting lost the other day. The water was murky. I estimate that visibility was 15 feet. It only took a few seconds of separation to make it hard to see my two buddies. We were at the midpoint turnaround time in the dive. I shot an image, looked up, and realized that my two buddies were not to be seen. No panic. I started back along the path we had come from. I figured it was time to turn around. I admit I was not panicked. I shot my images, watched my air, and arrived at the 3 minute decompression rope right as my buddies appeared from the murk. I promised not to get separated again. On the very next dive the inexperienced member of our group ran out of air and I was right there to share air and get him home to safety. Yes, yes… it’s important ‘never to leave your wingman.’ It also helps not to panic in the face of danger. This time my other buddy was lost in the murk and I waited till he surfaced and was safe.
I liked this image. As I shot it I knew it would be good. Sometimes (and I usually don’t) it’s good to look up. I’m usually getting an overexposed image. But here the silhouette is rather interesting.
There is a branch of diving called free diving. It means you use a mask and long stiff fins. You dive without a tank and go to some fairly deep depths. It’s sure different and not yet on my radar. Groups of free divers come to this resort and I am always fascinated watching them. Well, actually I see them walking around but have not seen them in the water until now. They always have a float and there is a rope with a weight hanging beneath so the divers can follow a line down. Otherwise I don’t know too much of the sport except what they describe on the ‘net. And no, it’s not that it costs nothing and is really free.
Right there! It says ‘Happy Thanksgiving – photobackstory.’ I am absent from Thanksgiving holiday in NY once again. Farid’s kids are off today. They go to the American International School. So naturally they have off for the holiday. He graciously suggested we have dinner. He was reminded of that quintessential menu item – “Gravy.” Well, that’s true but it does need a turkey to go with it. Where to eat? I started a web search for a restaurant in Jeddah where we could go. I’d also pay for dinner if I could get the bill first. Nonetheless, there are no viable suggestions. I tried the American junk food places – McD, Burger King, of course not; Fuddruckers, no way; Friday’s, Tuesday’s, not a thing on their website or anywhere else about Jeddah. No American chain hotels. To be honest until Farid suggested, I was just going to have a very quiet dinner out. I was going to drag my iPad along and read a digital book and look at the many photographs of the fishies I have shot. We’ll dive in the Red Sea tomorrow, of course.
There! Right there on my search page screen capture. It’s even on the first page! There’s a reference to my blog post last Thanksgiving. It’s irrelevant to my search. But the tags and key words put me on the first page of the search engine. That is too cool! It also means there is no where you can hide. (Note to myself: “self, don’t put anything into your blog that you would be embarrassed if your mother should read it.”) … which means that no one will be seeing anything about the inside workings of the world of neurosurgery anytime soon. It would prove way too politically incorrect. I have no particular desire to be the nail that gets hammered. Happy Thanksgiving again to one and all for whom this is a significant day (which excludes most of the rest of the world). …For the historical record, I had dinner with Farid and Silva, and the kids. They both (the kids) passed out by the end of dinner. We ate after 9PM in an Italian restaurant. It was quite a find. I have been up and down this boulevard countless times and never looked up to see a restaurant on the 4th floor with an outdoor balcony (smoking). The menu had hamburger, and spring rolls. I had veal scaloppine – after all it’s Italian. It was breaded, deep fried, and very tender. It wasn’t Turkey (Friday’s or Chinese), but it was very flavorful and enjoyable. I fought once again but lost out in paying. It wasn’t family; it was close friends and that’s a wonderful thing too.
This restaurant would otherwise be the equivalent of a Brazilian churrascaria. Basically it’s the same setup – salad followed by grilled meat carved from the skewer at the table. You eat till you drop. Our nurses eat like birds so that the consumption of large quantities of meat is lost on them. I had a great time. It was a meal sponsored by one of the drug companies – a touchy subject these days. And the representative was stuck in traffic so she arrived for dessert. Me, I was just along for the ride. I was told to show up and I did. One thing that our nurses enjoy is taking group pictures. So we did.
While Farid and his wife were away, their kids were with Grandma. As an act of good will I took the kids to the amusement park. They have a setup in many of the big malls here. This mall actually had an ice skating rink. Nicholas was excited to skate until we got on line and then he claimed he didn’t want to do it. No amount of cajoling could get him to put on a pair of skates. He’d been skating before but I think he just got a little nervous and scared. Ok. But which rides did the kids want to do. Kelly is younger by about two years. The rides she liked (merry go round) were too young for Nicholas and he told me so. I got Kelly on some rides too young for her but she was fine. Kelly made me ride on one with her that left me queasy and dizzy. Oh great! Then I made Nicholas go on a ride with Kelly that tilted, swayed and swung. He didn’t like it but he put up with it. Ah! It’s so touching to see kids grow up and outgrow things in such a hurry.This ride is a bit childish, but it was no problem.
I was driving Farid’s car for a few days while he was away. My nurses have been pretty wonderful in making life a bit easier. So I took them on a field trip as a way of thanking them. Jen runs my clinic. The other Jen is my OR nurse. They are both left handed like me. Anna joined Jen and is not left handed. We went over to the Corniche (beach) and caught the sunset – not too spectacular this particular night. Then we ate in a Chinese restaurant. Hey! I gave them a choice and this is where we ended up. Finally there was a late night shuffle through the Balud – the old city. We ended in a Body Shop – just like the USA – where I stood outside (family only- female). What I did not know was that it is illegal to be out with a woman not your relative. Come to think of it I have been single with other families. But anyway, I read somewhere that it is forbidden to be out with single women, morality and all that. So here I was with three (women) and in trouble again without realizing it.
This reminds me of another way to get into trouble around here. English is really a second language for everyone else. Most of the MD’s are Arabic speaking. Our nurses are mostly Filipino except for batch of new Chinese nurses recruited by the last nursing administrator. One day it was dim in the OR. One of the spotlights we use had a missing bulb. I asked for a candle. (It’s a joke!) Usually the nurses ignore me. Once in a while they pause and actually look to see if I’m serious. I never get a candle. (To be honest I’m old and I need more light to see. – Another joke.) On this particular day the new Chinese nurse took exception to my request for a candle. What did I say? She just stopped talking to me. No, I don’t speak Chinese. What?! Well she told Jen, my regular nurse, I had just insulted/embarrassed her asking for a condom. Huh!?!? It doesn’t sound the same and in the context of the OR I suppose a condom or a candle were both strange requests. I don’t know what to do. They did not fix the lights in any case. Honest! I didn’t make this up and I certainly didn’t intend to insult anyone. At the end of the evening out, the ladies bought bananas – 3kg for 10 SAR about $2.50 – that’s cheap.
I was fortunately invited to attend a Saudi banquet in honor of two physician administrators one coming and the other going. Here are some observations. The invitation was for evening dinner. This means come over after the last prayer – about 9PM. You sit in areas cooled by outdoor fans.
Once you are seated there’s not too much movement and social mingling. No women – not even the female medical colleagues. And if there were women, they would have to mingle in a separate area. The pool setting with seating all around. And it was hot so you needed the fans.
You sit and talk with the fellow next to you and you’re out of luck if it’s someone who’s not conversational. This polite conversation goes on for about 2½ hours. Everyone who arrives after you comes around and shakes hands and then drifts off to sit in an empty spot. I suppose the next time I will know this and pick my partner a bit more carefully. And I think that I will make it a point to move around anyway. Little cans of soda and a bottle of water at each place setting. There were a few cans of diet Coke. No alcohol allowed.
Dinner was buffet style but we changed seats to a formal table setting. Everyone ate quickly like they were famished. I certainly was hungry since I didn’t know dinner would be served at nearly midnight. After 30 minutes everyone started to say goodbye and quickly departed. I am told this is the style. So my observations are based on this experience and the questions I asked afterwards.The buffet line loaded with too many interesting choices.
….of course I ate too much.
The other event I shot recently was the karate class demonstration. It’s in a fluorescent lit space. There’s no room to maneuver. Getting an angle of view and shooting the action is a challenge. I suppose video would demonstrate the skills better. But as time has gone by, I find that I look at my still images. I have many hours of video of the kids but hardly ever pull it out. Action… you have to anticipate. I’m using direct flash so there are shadows. I don’t know the routine so to catch a kick in midair is tough. And how do you catch the grace of the kata and the tension of the exercise routine?
All of the sudden I have become an unofficial photographer for local events. There aren’t too many and I’ll return to fish soon…. David, one of the managers of the Purchasing Dept organized a Fitness Competition. For the first time I got to see how the other half lives. We have a couple of fitness groups that run at different times and I guess they have become competitive. My group is very strenuous but does not emphasize weight lifting. However, there are some hard core ‘lifters around. Three teams gathered poolside and competed in several two-man team events. I’m working with a DSLR and in-camera flash. The flash recycles slowly so motor drive is not in play. You simply have to get the ‘moment.’ And then there’s the angle. Shirt off… because there was a swimming portion of the meet and everything was timed. So I got low… angled and I popped the flash. It’s not flattering but it captured the essence of competitive testosterone.
This year will be the first Village parade I have missed since leaving NY. Last year was canceled because of Hurricane Sandy. There are a lot of participants and the avenue is lined 10 deep from Spring St to 23rd St. It’s a wild and crazy night. This couple got married right before the parade and like Cinderella rode a coach up the parade route.
Just like those buddy movies, David and Michael remain best friends to this day. They met in grammar school and have stayed steadfast ever since. This was one of the autumn trips we took to Bear Mountain. They were just a couple of buddies having a quiet walk in the woods. To complete the circle, David called me this past autumn for directions to the lake. He and Mike, with Sarah and Josh, were planning to hike in the autumn around the lake again. It’s pretty special to have that memory carrying forward.
As I have mentioned, Julia was born on August 1. The poor kid was deprived of having a school year birthday party. So she had a party before the school year ended, a party for the immediate family, a party with the extended family, and often a party of her friends during the summer vacation… all so she wouldn’t feel left out… It was Julia’s birthday and we had arranged for a party in the Hamptons where we had rented Margaret’s place that summer.. Her friends and her brother just fell into place for me to get this shot. No posing. I was just there. Sorry, I don’t know who was far left but second in… Julia, Alexandra, Ben, David, Chessie… endless summer day without a care.