If you drive out of Port Elizabeth in a northerly direction along Uitenhage road, after about 10 minutes you will arrive at an intersection where a right turn into Spondo street will take you to my place of work, Dora Nginza hospital in the township of Zwide in Ibhayi. At about 5.30am on last Sunday morning I was going along said road. I drove past Zwide however, continuing further away from PE. Past Kwamagxaki and Kwadesi, two townships that are served by my hospital. Motherwell township where a lot of our patients come from, is further eastward, away from the route I drove on this day…

I know these places by little more than their names and I have a vague notion of their geography around Dora hospital. When a patient has just arrived at the hospital they get their file at the clerk’s window. It comes with a fresh set of stickers with their personal information: name, date of birth, street address, telephone number, and lastly at the bottom of the sticker in bold capital letters the name of their township. That is where I know these names from. New Brighton is another one, closer to Port Elizabeth along that same Uitenhage road. I get my car washed in New Brighton every now and then… Approximately 80% of South Africans can only access public health care. That is to say the majority of South Africans cannot afford private health care. They have no choice but to go to a place like Baragwanath hospital in Soweto, Johannesburg (where I did my internship) or Dora Nginza hospital where I am currently almost at the end of my community service year. I vaguely remember being taught in family medicine back at medical school, that it is best if a medical doctor lives in the community that they serve. In South Africa bring a medical doctor means that one is relatively well off and most doctors, even those who come from townships do not reside in them. If one works in a peripheral public hospital most of the patients one sees come from the townships. We could get into a heavy analysis of the unfortunate lasting legacy of apartheid, the current gap between rich and poor, or the average South African’s struggle to access good health care but that is not what I want to do here (as juicy as that would be!). I was driving along Uitenhage road at that ungodly hour to get to my latest road race. And going along I got to thinking about these things, hence my musings. The absolute truth is I consider myself somewhat unqualified to comment on this subject in this forum. Asides from knowing that South Africa’s current problems are real and pointing them out, going any further than that at my amateurish level of knowledge of history and politics might not do justice to the real situation, the real problems, of the real people…

At a certain point along Uitenhage road there are no street lights. At that time of the morning this is a problem, especially when one doesn’t really know where one is going. So yes I got a little lost, just past the little town of Uitenhage, about 40 minutes away from PE, trying to find my way to Rosedale township, where we were running from. I got there, after only having to ask for directions once. Yes I had a GPS but you see Rosedale ‘Stadium’ isn’t actually on the system! I realised why when I eventually arrived there. It is really more of a sports complex-come-recreation center with a couple of soccer fields that double up as a cricket field, and a tennis court or two.

image Rosedale ‘Stadium’ image Woke-up-way-too-early/pre-race face

Not a lot of runners showed up, at just over one hundred it was a smaller crowd than I am used to seeing. The usual PE running crowd being quite conservative (another socio-political discussion we could get into but won’t) were not up for getting out to ‘rural’ Rosedale for a race. There were a few familiar faces though. Allister was there. I have mentioned him before, he runs for Charlo running club. He is at most races in the PE area. We exchanged a few friendly words. I knew a few other people, including funnily enough a couple of guys I had met on that disaster of a run the previous week, and also Bennie, who I haven’t seen for a while. He is super fit, forever alternating between mountain biking and running during the week.

I had a good hit out, 2hours 42mins over 30km is as good as I could have asked for, especially considering how I fared just one week previously over the same distance. The course had it’s fair share of hills again, but race-mode being what it is I was in an aggressive frame of mind, while at the same time trying to keep myself as relaxed as possible. I raced out at the beginning, my first few kilometres were at sub-5 minute pace but I didn’t feel strained. I finished the first 10km in approximately 48 minutes, faster than I would have wanted but I felt good. Got past 20km at 1 hour 48 minutes, 25km at 2 hours 11 minutes. The last 4 or 5km were quite hilly to end off. I put my head down and worked. I couldn’t resist the urge to beat myself on the chest once I crossed the finish line, even though my legs were feeling decidedly wobbly.

image We ran through the streets of Rosedale township. image We ran through Rosedale, and also past Uitenhage onto the road back towards PE. This photo and the one above it was taken on my drive back to Port Elizabeth. I showered and dressed.

There wasn’t as much as a hot dog stand in sight on the grounds around the Start/Finish area which I thought was pretty poor. After some chit chat with a couple of runners I drove off, stopped at a petrol station for a pie and a drink and then got onto the road back towards PE. Just before getting to PE I peeled off left onto Spondo street to Dora Nginza hospital. On weekends if none of the three doctors that work in my ward is on call then one of us has to go in. Inpatients have to be seen at least once on the Saturday or Sunday. This weekend happened to be my turn. I walked into the ward just after 11am.

No one wants to be at work on the weekend if you’re not on call (hec even if you are on call! 😓) so if one looks through a patient’s file and check for the doctor’s notes from the weekend ward round it is very likely that you would find a very hasty: Patient has no new complaints. On examination: Appears relatively well, Vitals (scribble blood pressure and pulse here). Assessment: Stable. Plan: Continue management. Seriously! 😌 I struggle with this, and as much as I too walk in thinking to “Lets get this over with quick so I can go home” I confess, I am incapable of any sort of efficiency. Left to my own devices I almost always do things the long way. So, as lame as my legs were feeling I saw every patient, checked blood results, and made notes that were far too thorough for a Sunday afternoon. Xolani, one of the other medical officers that works with me, during the week on seeing my notes chirped “You went a bit overboard there chap, eh?” 30 patients, and I left the ward about 4 hours after I had arrived. I will say though that the upside to that sort of a ‘work day’ is that one walks away with no lingering worries about something that may have been missed, and because of that I’ll happily be the last guy to leave the ward on most days.

That was Sunday. The week seems to have flown by. I was on call on Thursday and the other days have consisted of 5am wake-ups to study before work, a short hill sprints session on Tuesday, a 8km time trial at Charlo running club on Wednesday, a hard 20km run Friday evening and trying to squeeze in as much studying otherwise and in between everything else. There is one week to go before the Two Oceans Ultramarathon in Cape Town. There, now I’ve said it! It seems to take away from the surreal quality of this significant running event. There is also the very real possibility of my giving the FCP part 1 exams a real crack in the not too distant future. “If I feel ready…” as I’ve been saying for what feels like the longest time. This would be the first concrete step towards becoming a specialist in internal medicine. I first thought about it in late 2013 during the last few months of my internship. I was tired and drained, on autopilot dragging my feet through orthopaedics, one of my last couple of rotations. I need a goal, I thought… And here we are about one year and a half later. Studying on and off in between life, love, running and everything else has been as difficult as most other doctors told me it would be but also easier than I expected. Motivation being what it is… The sheer volume of everything that has to be grasped though is such that even when one has done a lot of work one always feels like a lot more could have been done. I ask myself (more often than I care to admit) How are you left with so much still to cover when you’ve spent so much time at it…? The scary part is that once this is done, if it goes well it’ll just mean more studying. The specialist physician who runs my ward has been a medical doctor for over 20 years, and he still reads every night. Such discipline. Imagine knowing all that stuff. I wanna be like him when I grow up! 🙄

A good day at the office

Aside

Not enough in the legs

I just got back to the flat in Port Elizabeth Central after a 30km run out in Seaview with Robyn, who I work with at the hospital and a few others from her running club Charlo. It was supposed to be 30km, but I only managed 28km. We went out quite fast I felt, for a long run, doing about 5 and half minutes per kilometer for the first 15km. The second half of the route was quite hilly, and I did a lot of walking. I just didn’t have the juice in my legs today, struggling from about 21km onwards. The last bit was a winding gentle uphill that went on for about 4km, which isn’t far by anyone’s standards (I don’t think) least of all a runner (I think I can call myself that 😌) but my state of mind at that point, having been running for over 2 hours with the sun bearing down almost directly at us (so it felt like) was not conducive to any sort of gritty put-your-head-down-and-work-it strategy that one would normally employ at that stage, in desparation. It had been dark cool and quite foggy at 6am when we’d started earlier…

The previous day I ran a 10km road race at Lake Farm, not far from Seaview. I did it in 48mins which isn’t too bad. I have definitely run faster 10km races before but this too was quite a hilly bugger.

 

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As you can probably tell hills are a problem for me. In road running, as in life though having to go uphill every now and then is inevitable. It’s all about one’s approach isn’t it? It makes sense that if you just put your head down and give it a good hard go you’ll get over it (the hill that is) faster. It’ll hurt (like a female dog!) obviously, but you’ll definitely be stronger for having gotten through it, as in life. All of this is very easily said, of course and I sound like I know what I’m talking about but that is so far from the truth that it is actually depressing and somewhat soul-destroying (if you will allow me a little hyperbolizing 😋) In real life (or do I mean in a road race?) when I see a hill coming up I put my head down sure, but when I get to the hill a mental switch goes off and no matter how good I’m feeling or how hard I’ve been pushing I then proceed to put one leg in front of the other with the sole intent (it seems) to survive the hill rather than own it as my above described bravado would suggest. This makes for a slower pace, more akin to the resigned shuffle I have spoken about before.

 

Seaview is absolutely beautiful and even after almost a year here in PE, and getting out there every other weekend I still can’t get over that. The greens, browns and greys that make up the surrounding scenery are so vivid it is almost surreal. The never ending road on a long run though is somewhat less awe-inspiring methinks :-/ “Some people are lucky enough to actually live out here!” I often exclaim to myself. So if anything when one of the other Charlo club guys picked me up in his car at the 28km mark I was miserable because of how I felt physically and because I didn’t finish the planned distance but I was inspired (sort of) by the surroundings.

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I spent the last 30 minutes of the run fantasizing about buying a Vitamin Water after the run at the petrol station not far from the start/finish point. But when we finally got there (by car and not on tired but triumphant legs as initially planned) I bought the sweetest coldest drink I could see in the fridge, a Fanta! Not exactly the drink of champions but there you are. This along with the biggest bottle of ice cold water on sale and a chocolate, also the biggest one I could find. There are no rules and there is no conscience (at least not one I’m willing to acknowledge, guilty or otherwise) when you’ve been running for 3 hours!

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For a humorous,  if somewhat elitist attempt at a runner's definition of 'tired' check out http://caitchock.com/distance-runners-and-a-skewed-tired-scale/

For a humorous, if somewhat elitist attempt at a runner’s definition of ‘tired’ check out http://caitchock.com/distance-runners-and-a-skewed-tired-scale/

 

The author of The Oatmeal, a blog I read sometimes (theoatmeal.com/blog) is a keen runner. In an old post he talked about getting home after a great race and wanting to tip over the fridge and devour everything that fell out. I can certainly identify with that urge. When I got back a little while ago I had half a pizza left over from yesterday and having composed this latest post, the plan right now is to have a wee sleep before hitting the books for a couple of hours. I have to go in to work later, I am on call at the hospital tonight.

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