BEACH DAY

 

I have been in the city of Sligo since September 2025, and only last week I managed to go and check out the Strandhill beach. It was the perfect combination of me being on leave and in the mood, and the weather being agreeable. I got into the S2 bus and told the driver I was going to Strandhill for the first time, and he pointed out that the beach is on the last stop. It was a 30-minute bus ride. I enjoyed exploring the rest of the city. I was so excited to see the blue sea, the blue sky, and hear the sound of the waves. It was extremely serene. I sat on the nearest bench and enjoyed the scenery. I had packed a sandwich for breakfast, and having a meal with a view was very enjoyable. I took a walk down to the other side of the beach, passed the pebbles, and reached the sand. There was a surfing class in progress. It was quite cold and windy to even think about walking on the sand barefoot. The first thing that came to my mind was how my 3-year-old daughter would enjoy this beach day. 

She is a lovely child, and she has learnt to walk the streets at my pace and catch the public transport; she even has a sense of direction. For example, when we go towards the public library, she gets excited and runs ahead. We try to play inside the house, draw, and do various things, but somehow we end up spending hours in front of the screens. I try to organize outings for the weekends and spend quality time with my daughter. She enjoys playing with her doll, bunny, and other stuffed animals. She has a set of cups and plastic cupcakes where we have pretend tea parties. We enjoy drawing and painting. I can't wait for her to finally figure out how to colour objects individually. She goes crazy for the K-POP demons and sings and dances with them. Her speech has been a bit delayed, but she is slowly getting there. Only now she is making simple sentences such as I want to sleep, I want food, etc. Her favourite foods are toast with butter, chocolate of course, fruits, chicken, meat, fish, and chips. The other day, I made rice and tuna, and she completely omitted eating the rice and finished the tuna. 

She has coped very well with our immigration to Ireland. She finally started preschool in February 2026, after 5 months at home. She was not worried about getting in the transport lady’s car and going to her new school. She enjoys playing with other children. Even though she is a girl, she likes playing with cars and dinosaurs. When we moved to the new house with no bathtub, I was wondering how I could convince her to enjoy the shower. We succeeded with a bucket of foamy water and some toys, and she enjoyed playing in the shower. Potty training has not been consistent, and she still has a nappy on most days. But we have had successful days with the pants staying dry. 

Finally, on a sunny Sunday, we made our way to the beach. It was a pleasant bus ride. She understands the sea now and was even pointing out the baby sharks to mommy! We had lots of snacks while enjoying the view, plus feeding the birds and the seagulls. She would get very excited to see the dogs being walked, and would greet all of them. She did very well walking on the pebbles, and we found a lovely spot to play with the sand. I am looking forward to making more memories with my baby girl. 

LA LA LANAD

 

I have been on leave lately. I have enjoyed watching several movies, reading, creating art, doing crochet, and going for long walks when my little baby is in school. The other night, I opened Netflix, and I saw the movie La La Land come up. I am shocked to see that a decade has passed since it was released. It felt like yesterday. I cried a lot while watching that movie, shockingly more than while watching Hamnet. I know how passionate I felt when I first watched it in 2017. I was obsessed with the story, with the music, and all the dancing scenes. Playing that soundtrack in my car would really take me to La La Land while driving to work. I was passionate about life, about my work, and about the future. 

It was before the COVID pandemic, when life had different ways, and I  think most of us are not fully recovered from the pandemic trauma, and the post-pandemic price hikes and inflation. Before the pandemic, my plane tickets to home were booked 6 months in advance, and it was something to look forward to. I was constantly exploring new restaurants and places to eat out, shop, and meet people. My immigration to Ireland in 2025 is my first international travel since 2019. It does not count as a vacation; it was a painful immigration. I am the most minimal person right now when it comes to shopping. Buying clothes only when necessary, in solid and neutral colours. No more retail therapy, buying a leopard print blazer, and figuring out how to match it later! The last time I ate at a  sit-down restaurant was in February in Dublin when we went to get our resident cards. 

I can feel how different I feel now compared to 10 years ago. I used to feel young and alive, with a world full of opportunities ahead of me. I used to be excited about life and the future. Little things used to inspire me. I feel so numb these days. I do everything as a sense of duty. Get up and go to work to pay the bills, clean the house, look after my baby, and check on my parents. Work has lost its spark! That training registrar's adrenaline rush to learn something new has been replaced with burnout and defensive medicine. My husband and I have been married for 6 years now. Those good old dating days when we used to drool over each other are gone. It is a sad reality for most marriages when we hardly plan to do anything together, or dress up and go on a date for a change. In the new country, we do not have a nanny or a babysitter, so it is quite impossible to have some time with just the two of us. I guess this is what a midlife crisis looks like. After decades of hard work and juggling. 

I was hoping that with immigration to Europe, working in a more systematic and organized health care system, I would be happier and have a more balanced life. I was hoping earning a decent salary in a strong currency would give more opportunities to travel. As I am writing this blog, the world is in the middle of an energy crisis with Iran, Israel, and the US in a state of war. Following social media and the war news has become extremely exhausting. Yesterday I came across a comic cartoon of Donald Trump on Instagram,  dressed as Moses with his stick opening the Strait of Hormuz! It is an uncertain time of history, with more price hikes on fuel, flights, and groceries. No travel plans for me this year, and only saving and survival so we can pay the bills and put food on the table. 

FLOORED

 If you are a woman and you have a pelvic floor, you need to read this book, written by a pelvic physiotherapist. I am a gynaecologist, and I have always undermined pelvic physiotherapy. After having my first child, my mom started babysitting for me. By the time my baby turned 2 years old, my mother’s stress incontinence had worsened from leaking a couple of drops to being wet most of the time. Having a chronic cough wasn't helping as well. I was hunting for a urogynaecologist in town to fix the problem. I felt responsible that lifting my little baby was a possible contributing factor. A colleague recommended a urologist. We had a consultation, he suggested we start with a cystoscopy and urodynamic studies. I found the urodynamic study very invasive, and it didn't add any new information. The urologist suggested a tape, and off my mom went for surgery. We did not send Mom for any pelvic floor physiotherapy. 

You don't have to be in your 50s or sixties to have pelvic floor problems. I had one vaginal delivery, and I know my ability to hold my pee and poo is not the same as my 20s. We underutilize pelvic physio in most aspects of women’s lives. Dr Sara points out how we get all the other organs regularly checked out, and we forget about the pelvic floor until there is a prolapse or a leakage. 

As Dr Sara educates us in her book, nearly one in three women suffer from pelvic floor disorders such as painful sex, prolapse, back pain, constipation, urinary leakage, and lack of orgasms. These conditions affect women’s self-esteem and their ability to exercise or have intimate relationships. Urinary leakage alone is costing women in the USA over 20 billion dollars per year, yet most of these treatments are temporarily successful and do not address the main underlying cause, which is pelvic floor dysfunction. 

There are multiple body stretches that are instructed in the book that help, relax the pelvic floor muscles. She explains the importance of pelvic physiotherapy during pregnancy to reduce pelvic girdle pain, and improve the strength of the pelvic muscles. She explained her own birth experience going smoothly, with an intact perineum. She explained that taking time and effort with the help of her partner to give her regular perineal massages. 

The book is written in a very easy-to-read style, with a friendly tone. It explains the anatomy and physiology of female pelvic organs in simple terms that people who are not medical professionals can understand better. There is a holistic approach into how the pelvic organs and the pelvic floor function, besides doing the Kegels, such as giving us hints as  how to efficiently empty our bowels and bladder without causing tension and ongoing dysfunction. 

Read it You have ever leaked while sneezing, feel "disconnected" from your core, are preparing for birth, or are navigating menopause. It is essentially the "owner’s manual" for the female body that most of us never received in school.

MENOPAUSE MISUNDERSTOOD

 

I have moved to a first-world country now, and I see a totally different demographic of patients with new problems. Women are well educated and way more fit and active in their fifties than women in third-world countries. I came across a woman in her sixties who is still working in a law firm with a demanding job, and she was experiencing a bit of brain fog; her GP put her on HRT to improve her memory. What is the first thing that comes to our mind, in elderly women with memory loss, perhaps this could be the beginning of dementia, or the normal forgetfulness with aging. She presented to us with unscheduled vaginal bleeding and decided to stop her HRT. Her hysteroscopy, dilatation, and curettage showed uterine atrophy and no hyperplasia. She claimed the HRT did not make a difference

The most shocking thing I witnessed was a patient in her forties, who presented to the gynae clinic with an extensive psychiatric history of bipolar disease, with extensive medical treatment, previous admissions to psychiatric ward and even a session of Electroconvulsive therapy (ECT).  she was in her fourties, still menstruating, and was asking if going on HRT will improve her psychiatric condition! She was hoping she could even try to reduce or stop her psychiatric treatment. I reassured her that she has to continue her treatment with her psychiatrist. She is menstruating and not menopausal yet, and the real indication for HRT is severe hot flashes that decrease the quality of life and sleep, etc. I explored some of the side effects and the contraindications, such as a history of thromboembolic disease, stroke, ischemic heart disease, or estrogen-dependent malignancies. 

We have had an ambulatory gyneacology unit in the department since 2024. The referrals to the department are mainly women with heavy menstrual bleeding or post menopausal bleeding. Other services, such as coil insertion, are also offered. Patients have analgesia, and in cases of post menopausal bleeding or unscheduled bleeding on HRT, women are triaged to attend within 2 weeks. When women start HRT, and they experience some vaginal bleeding, we usually still classify them as post menopausal bleeding. The biggest worry in this situation is endometrial hyperplasia or malignancy. One of the non-invasive tools for this is a transvaginal ultrasound to assess the endometrial thickness. The British Menopause Society indicated that the endometrial thickness varies in women on HRT, with the higher ET limit of 7mm in women on a sequential regimen and 4 mm in women on a continuous regimen being accepted. If the endometrial thickness is increased or difficult to visualize, an urgent hysteroscopy and endometrial sampling are mandatory. 

Most clinicians offering HRT understand the importance of progestogens along with estrogen in women with a uterus. The challenge is calculating the optimal dose of an oral or vaginal progestin and ensuring patients adhere to it. 

Women with unscheduled bleeding with HRT with these major risk factors for endometrial carcinoma should be prioritized for hysteroscopy and endometrial sampling. These include: A BMI more than 40, lynch syndrome, being on HRT for more than five years, and inadequate use of progesterone. Minor risks for endometrial cancer are Diabetes, a BMI of 30-39, and a history of polycystic ovaries. 

Mirena coil is a good option to ensure a good endometrial progesterone supply without systemic side effects. We need to ensure the Mirena coil is in the correct position; if it is more than 2cm from the fundus of the uterus, it will not be protecting the endometrium. 

Using oral HRT preparations or Mirena coil as the progesterone component ensures more amenorrhea and less unscheduled vaginal bleeding. Using the fixed oral combined estrogen and progesterone ensures adequate dosing. We need to ensure our patients are up to date with their cervical smears, and if there is evidence of vaginal atrophy, to supply them with topical estrogen. 

APPRECIATION

 

I am under a lot of pressure at work, and it is affecting my mental health. It is the 8th of March, and the weather is still as frosty and cold as January, crushing my expectations that spring is near. I have downgraded my winter clothes to lighter jackets with no gloves, and I am not able to cope with the cold weather when I go out in the mornings. My baby girl started school in the middle of February, and I am having a terrible case of the flu again, after recovering from a chronic cough that lasted three months. On top of the new and difficult work environment, absenteeism has been prominent during the time colleagues were writing the Royal College exams. Not to mention the world leaders have decided to start a new war and bomb each other. With the instability in the Gulf countries, the fuel and grocery prices will go up. Here I am trying to be positive about life. and make a list of the things I am grateful for. 

I am grateful I actually have a job right now. This is the job I got so excited about last year may when I had the interview and broke the news to my parents, and started applying for a work permit, visa, and getting tickets for Ireland.  We are back to basics. We are grateful to have a job and a stable income to put food on the table. The demographic of patients has changed here; they are well taken care of, and I find it very rewarding compared to South Africa, where every day we had to save patients from critical conditions such as severe cardio-respiratory distress, sepsis, or haemorrhage. 

I cannot put a price on the feeling of safety we have staying in Ireland. There is no constant fear of an armed robbery, hijacking, or a gun attack. I often walk to work while on a video call with my mother.  In other countries, phones go missing in public. I remember when I worked in one of the government hospitals in Johannesburg, there was an incident in ED where one of the patients started assaulting a male nurse, and another patient pulled out a gun, to defend the nurse! I love my morning and evening walks to work,  thanks to a safe community. 

We appreciate the change of seasons, and we are eagerly waiting for the beautiful spring and summer to arrive. Hoping to spend more time in nature with friends and Aryana. Most of my career and study difficulties have occurred in winter. I remember when I was in university back home, I had not submitted my research proposal, and I was in crisis before the start of the internship. I was very stressed out, while mom and Cyrus were in South Africa, every morning before going to the university, I would have an episode of crying at the breakfast table. 

I love seafood, and Ireland is a country where we can get a good supply of fish and prawns. I am in love with Salmon. My favourite meal of the week is baked salmon fillets in the oven with a healthy side of vegetables. My daughter is also a great fan of seafood and prawns. I am planning to cook more sophisticated dishes on weekends when I  have time, it is more fun and rewarding than eating out. 

I am happy that my little girl is going to day care. It was weighing on my heart all these months she was at home. hopefully the school will help her pick up more skills and learn to be more vocal. Immigration is hard, but we are slowly settling in and getting used to our new environment. I enjoy the slower pace of life in our small city. There is no hectic traffic or morning rush to day care. My husband and the transport lady take care of the day care drop off and pick up while I focus on getting to work. 

THE MONTH OF LOVE

 January has been a difficult month for me. My in-laws, who paid us a visit during Christmas, left on the 6th. I was suddenly put on back-to-back night shifts, under supervision, and heavily criticised and broken at the end of the month. I had a week of annual leave, and we attended the immigration office and came back empty-handed and irritated. We tried to make a vacation out of the Dublin trip and booked a fancy hotel, but it didn’t turn out as we had expected. I was hoping to go and visit a Persian restaurant and eat kebabs, flat bread, and Persian tea, but the visit was cancelled due to poor mood and bad weather. Work has been draining me, adjusting to the new demographic of patients, the new system, and constantly being supervised and on edge is a recipe for burnout. The negative political news from back home was the cherry on top to make this cold and dark January more and more miserable. The last blow to my mental health was my Cuban friend doctor showing up for her job in ED, after long research and chats with me since last year, and abruptly leaving after three weeks of work. I can not believe the stress I went through to find her an accommodation and help her out. 

February is the month of love and Valentine's Day. The second of February 2020 was our engagement anniversary. It was a beautiful day, and a complete surprise when he gave me the ring while I was on labour ward duty on a Sunday. We were truly in love, and what pushed him to propose was losing his aunt at the end of January. It was the year of Covid-19 pandemic, and there was no room for fussing and throwing big engagement parties. Social media makes things easy; you post a picture and a caption, and all your friends and family will know that you are engaged. We had a small court wedding and dinner later in September. Once you are in a committed relationship and have a child, things change from date night and excitement to duty. just making it from day to day. There is love everywhere, every day. The romantic love, the love of parents, and the most special thing is friendships. Our friends do not love us because they are related to us, like our parents and siblings; they are there because they want to be with us. I feel that is a genuine love. 

We had some good family time on Valentine’s weekend, with my girl and daddy. I met another South African doctor from ED for a long-awaited coffee break. It was my first time meeting someone for coffee in Ireland, and I was very excited; I felt like I was going on a first date! She was lovely, and we both knew why we left South Africa, due to its poor health infrastructure and poor job opportunities.  We knew that settling in Ireland had not been easy, leaving our family and friends behind, and adjusting to a new country is a huge challenge. There is always room to find love in a foreign land, to give love and kindness, and feel connected. This is how I felt when I met my Lebanese and Serbian friends in South Africa, and we connected instantly. This is what the world needs right now: for the people to come together regardless of their race and colour, and it was beautiful to watch Bad Bunny perform in the NFL halftime show, and remind us of all the countries there in the American continent, encourage love and togetherness. 

KINDNESS IN HEALTHCARE

 I recently attended a very informative webinar by the Royal College of Ireland regarding “Kindness” in health care. It is a topic that is often not talked about or pointed out in medical school, and we only come across it when we interact with patients or our colleagues. Kindness is different from being nice; it is a necessary skill that we need to understand and cultivate every day. Esther Perel often talks about such skills as if they are muscles that need to be trained. 

I believe the first step to being kind to others is to be kind to ourselves. Try to enhance our self-care, and try to recharge our batteries from the struggles of day-to-day hustle. We do not want the empathy tank to run out while we try to give to others. It starts with basics, like good sleep, and some good body movements. I try to do as little as 5 minutes of squats or stretches in the kitchen while I am cleaning up. I know that sometimes the dirty laundry can wait to be hung or folded if I have had a busy day; this is a way for a working mom to be kind to herself. I try to set boundaries with friends and family, and say no if I am busy, to give myself more time to recharge. My favourite thing that keeps me going every day is sipping on my cup of black tea with no sugar while I take a small break. It takes me back to the good old days when I used to sit by grandma, drink tea, and watch the world burn down on the news. I enjoy going on walks, but it is more limited with my toddler.

One of the speakers on the webinar had a very interesting point. As doctors in medical school, we are trained to probe the signs and symptoms, run some tests, come up with a diagnosis and treatment, and feel good that we fixed the problem. There are times when, as a gynaecologist I am consulting a patient, and I know that I do not have much to offer, but just the gesture of listening to the patient attentively, allowing them to talk and not cut them off can go a long way. Learning to be a good listener is not an easy job when all we want to do is to interrupt the patients and tell them about the latest treatment options or clinical trials. Other aspects of being kind are having good follow-up plans, if we have booked an imaging or a test, to make sure it goes smoothly and does not get cancelled. 

Getting negative feedback from patients is not easy. I have had a few complaints from my consultants, which were feedback from my outpatient consultations, and one from the labour ward management. These are not big litigation cases when a patient was injured, or there was a very poor outcome. These were simply times when the patients felt unhappy with my behaviour. There is always room for more kindness, empathy, and attentiveness. In the webinar, we were introduced to a lot of books and reading material to help us cultivate kindness towards others. My senior consultants have been relatively good to me, and I thank them for their kind guidance. 

EARLY PREGNANCY

It is an absolute culture shock to relocate from Africa to a first-world country. After all these years of training, working, and saving lives, the first thing I hear is that only formal, departmental scans are accepted, and I do not have permission to scan because I have not been trained in the Irish system. We used to cover gynae unit calls as a registrar, and we would review up to 50 women with early pregnancy, with either vaginal bleeding or abdominal pain. In that busy setting, we would detect up to 5 ruptured ectopics, which we were managing laparoscopically if the patients were heamodynamically stable. Unstable ruptured ectopic cases, or unstable or septic incomplete miscarriage cases, would be taken to the theatre immediately, usually after the blood products are available. Most patients do well with IV fluids and blood transfusions. Still, some may require prolonged ventilation. The cases of missed miscarriage, or first-trimester miscarriage, will mostly be managed by Manual Vacuum Aspiration, which is done under anesthesia by the interns, in the MVA room with simple analgesia such as IMI diclofenac or pethidine. 

Women who have a viable intrauterine pregnancy are told to go to their local clinics to book their pregnancy and to take supplemental folic acid. 

In Ireland, women present to the ED with early pregnancy complaints, and then they are assessed in the gynecological assessment room, which gives us good privacy. If the patient is hemodynamically stable, they are booked for a formal departmental scan as soon as possible, if the point-of-care BHCG levels are more than 2000. The ultrasound department tries to accommodate these patients in the morning, and has the pregnancy growth scans later during the day. It will not be pleasant for these women to clash with heavily pregnant women and feel traumatized by their pregnancy loss. 

Women with a viable intrauterine pregnancy get assessed regarding risk of preeclampsia according to the checklist with moderate and major risk factors, and are started on Aspirin and counseled. Women with missed miscarriage or an incomplete miscarriage are counseled regarding their preferred mode of management, which can be conservative, medical, or surgical management. 

Evacuation of the uterus is done under anesthesia in the theatre by the consultants. Patients come on the day of the procedure, and are discharged on the same day to save bed space in the hospital and control the costs. There might be one ERPC done per week, and in the span of three months that I have spent here, I have seen 3 stable ruptured ectopics managed laparoscopically and 2 managed medically. All women with suspected pregnancy of unknown location or suspected early pregnancy are handed over meticulously, every day at the huddle meeting, so no cases are missed. 

The fascinating fetus is growing in a little gestational sac. This was me scanning myself after 3 months of amenorrhea, it was such a joy to see a fetus with a heart beat.

THE HOLIDAYS

 

life is an amazing journey, and time gives us a different perspective. It is fascinating when I look back and see that I started my blog in 2024, and I am still going.

I enjoy putting my ideas in writing, and various ideas about medicine and everyday life keep coming every day. Today is the first of January, and we are halfway through the holiday season.

It is a time of year that sometimes gives me a sense of FOMO (fear of missing out). The presence of social media makes things a bit worse.

I was born and raised in a Middle Eastern country. We do not do things like Santa, Christmas, easter, or even the tooth fairy!

there is no way that Middle Eastern parents11 would buy a gift for their kids, and give the credits to some fictional character!

But living abroad, and knowing the majority of people are celebrating Christmas, like setting up a tree, getting each other gifts, and having fancy Christmas food makes me feel empty,

because I am not doing any of it, and don't feel fully festive. 

There was a phase in my life when I was obsessed with my next holiday destination, and it would deplete my bank account because I couldn't afford any of them.

Today I am grateful that I can afford food and pay my bills, even though I am not on a tropical or exotic island resort right now.

Another category of people spend this time either on a fancy tropical island in the Caribbean or a ski resort. However, most people are currently battling with the economy.  

My in-laws visited us on the 22nd of December, and it has been quite nice to have them around. The city of Sligo is relatively small, and I am not very familiar with most of the interesting sites at the moment.

I have been asking around, trying to figure things out. The most popular places are at the beach, such as Ross’s Point or Strandhill.

We don't have a car, but it is nice to drive to different places and have fancy walks and hikes near the Benbulben mountain.

This one is probably not an option for me, who is on baby duty on weekends. I always pass the Glasshouse hotel in the city, and it looks very fancy, and I wish to dine in it on one of the weekends that I am out with the family.

My in-laws eat strictly halal food, so this is not an option for them either. Ireland has very wet and unpredictable weather, and does not have outdoor cafes like Italy or France.

People prefer to go to the warm and cozy bars and drink. I am not much of a drinker, so this would not suit me either. 

Sligo library is a nice and tranquil place that I visit on my free weekends, and it has a vibrant environment for my 3-year-old daughter to interact with the other kids, draw, and browse the vast collection of children’s books. 

one of my best moments of the holidays was taking long walks in the mornings, knowing my mother-in-law is home watching my child until I come home.

I had heard from one of the taxi drivers that there is a lake near where we stay, so on Saturday morning, after the Christmas holidays, I wandered and found this beautiful lake near the Hazelwood forest.

I watched the sunrise and felt very relaxed, spending time in nature. 

I am grateful for the holidays with family, and for another year. hoping for a year full of health and abundance for my family and me.

We don't need expensive gifts or fancy holidays to be happy. I am more mature and grounded these days, and it's funny that we now clean the house to the music we used to dance to in a club. 

THREE MONTHS INTO OUR IMMIGRATION JOURNEY

 

It is time for some reflection on our immigration journey. I had friends and family asking me how I felt about  Ireland within weeks of our relocation. I was still overwhelmed with the trying phase, so I had no time to think or feel anything. I was trying to figure out the new house, work, and grocery stores. At first impression, the very clean hospital environment was very pleasant. The city felt safe and clean everywhere.  Seeing a government hospital with good infrastructure was new to me. For example, you wash your hands, and there is a paper towel to dry. You attempt to take a blood sample, and there are adequate gloves, sharps containers, and other required equipment. I hated it when I had to do bloods, and I would end up running around with a syringe, trying to find a sharps container. in general, work was not overwhelming in terms of the number of patients, but it was overwhelming in terms of admin, logistics, and adjusting to a new system. I was feeling very stupid at times, not knowing the names of the medications or the various protocols. it still seems a bit overwhelming at times. 

 I find the Irish homes relatively older, with very old furniture. I sometimes feel sad to have changed from being a homeowner to renting, with nothing much in my control. I often feel envious of my friends who are more settled in their lives, living in their own home, focusing on renovations and home decor. I often fight the urge to spend money and buy extra things in every house we move in, knowing that in the Irish health care system, there will be a lot of changes. Somehow, finding accommodation and the housing crisis in Ireland gives me a lot of anxiety. 

Public transport has been a challenge since we moved to Ireland. After moving to a house that was a walking distance of the hospital, I have been saving a lot of money and time. I have more peace of mind, not having to make sure I won't miss a bus, or taxi, or worrying over the cost of transport every month. 

I have more peace of mind these days. Instead of sitting in SA traffic for up to 4 hours a day, I have more time in the mornings to read or study. Weekends can get a bit boring or lonely. I try to go out of the house with my toddler, I try to read books and watch movies to kill the weekend, since I no longer have a social life, or dont have a lot of shifts like before.  I do panic sometimes because it is only my husband and me to mind the child, so often if he is late or busy, I wonder if I will make it to work without someone to watch the child. He loves his weekends because he is not on baby duty and has the freedom to go out, meet people, or have a drink. We live in a small city, and besides several local pubs, we don't have a wide range of restaurants compared to Johannesburg. 

I am hopeful for the future. Hoping to travel more, learn, and enjoy life. I know my career development is lagging with me being a trainee again, but there is always room for development. I miss my house, my parents and brother,  my car, my kind work colleagues,  and vibrant Johannesburg with all the places to go, especially the Virgin Active gym and the child-friendly restaurants. I am hoping for a better future for my daughter, but sometimes I ask myself, is it really worth it? Maybe South Africa was more fun for her, or is all this worth it with her not growing up near her grandparents! Only time will tell. 

2025 REFLECTIONS

 

It has been a very busy year! Starting in South Africa and ending in Sligo city in Ireland is not easy, along with my husband and a three-year-old girl. I want to reflect on the activities of this year, going through every month. I find writing very therapeutic. It's like having a debrief session with a therapist. Looking at the past events, appreciating the good moments, and learning from the mistakes. 

January: I remember dropping my toddler off at a creche on the 4th of January. They gave me a starter pack with some chocolate and tissue, knowing how anxious I would be. For a good three weeks, we had tears in the morning and afternoon. I would catch Aryana playing along with the other kids in the playground, and as soon as she saw me, she would run and cry. She settled in well. I received my registration with the Irish Medical Council that month. I attended a Robbie Williams concert on the 26th of January, and it was really fun, but it made me realize that both Robbie and I are aging.  

February: We started the month attending a very nice 35th birthday party and my colleagues' baby shower. I remember February was a very hot and humid month in SA. Work got slightly busier as two of our consultants went on maternity leave. I was thrown into a very busy obstetric unit, with a hectic clinic. There were days when child pick up wasn’t possible, and I would stress to make it on time to the creche. Mom had a small gynecological operation, and I accompanied her to it. All the back and forth was very stressful, and it was during my annual leave, which did not feel like leave at all. I managed to attend the SAMS conference as well. 

March: This is a time of the year when I feel very sentimental. The Persian New Year happens at the same time as spring. That is the time of the year that I miss home, Grandma, and spring, which none of them occur in Sub-Saharan Africa. We had a brief celebration with my husband in the Turkish restaurant. We celebrated the end of the fasting month with my in-laws. 

April: It was a relatively uneventful month. I stopped working on the weekends and started having a bit more free time. Most of the evening activities, like dinner dates, gym or paddle, were not possible with baby creche pick up, so I started going to the Gym mid-week before work and on the weekends, and would visit my best friend for brunch on the weekend at least once a month. 

May: I had an interview for a job at Sligo University Hospital, and I got the job. Things became very stressful. There was tons of admin that needed to be done. Paperwork with the medical workforce, work permit applications, and ACLS, BLS, and other mandatory online courses needed to be done. On the 31st of May, we attended a fun birthday party in a little gallery. All the guests participated in creating a Johannesburg skyline painting. It is hanging on the wall here in Ireland, and has a very special place in my heart. 

June: I had annual leave and yet, there was no fun activity, only running to Home Affairs to get Aryana’s Passport and renew my husband’s, and then another trip to my home country embassy to renew my own passport, which was no fun. We were invited to a very big birthday party for my colleague’s daughter. It was full of fancy food and drinks for adults, and games and activities for the kids. We really enjoyed it. Israel made an attack on my home country, and my dad’s flight back to SA was cancelled. I was very concerned. With my immigration plans coming closer, I needed him back in SA to take care of things and help my brother take care of Mom. 

July: The craziness of June continued into July. I had to attend ACLS and BLS the whole weekend, and it was freezing cold in that venue. I was trying to publish a peer-reviewed case report that had a special place in my heart. Some days I had to wake up at 4 AM to work on the peer review corrections and make the journal article ready for publication. I was enjoying work as I was working in a gynaecology unit which was less busy, and I would make sure my trainees got their hands onto something, and learn how to operate.  Dad arrived in SA on the 13th of July. It was a relief to have him back safely. I attended one of my friend's Book launches, and I was very proud. 

August: We were getting very anxious with the visa department. I was already on the Ireland work group chat, and I needed to break the news to my South African colleagues and start serving notice. My article was published in the Cureus Journal on the 8th! I got my Visa on the 13th of August and told my Boss I am leaving at the end of the month. Luckily, one of our colleagues was back from maternity leave, so it wasn't a terrible blow for the department. Little did I know that resigning from a permanent government post has its hectic admin. From the police affidavit to retrieving the pension fund, etc. On top of that, immigration was more than real. We had to get our tickets, sell everything and pack the rest, and go. I had a beautiful farewell party with my colleagues and they gave me an SA rugby T-shirt. My in-laws threw a fancy farewell and birthday party and spoiled me with gifts.

September: I turned forty on the first of September. My best friend took me on a spa trip to Mount Grace, and we really enjoyed ourselves. It was a very thoughtful gift. knowing I probably can not take goodies anymore in my heavy luggage. Packing for an air travel is very stressful, making sure the bags are not overweight, etc. We flew to Ireland on 08/09/2025. We arrived on the 9th in Dublin; drove to Sligo on the 10th. I was at work on the 11th! I remember taking a cold shower because the heating system in the new house was not working. I attended occupational health and did my blood tests. I went to the hospital and signed my papers, got my staff card to access the critical wards. The biggest struggle was commuting from Tubbercury to the city. I was often late for work and would get home around 8pm. Most of September was a blur. For the first two weeks, I could not touch patients until I was cleared by occupational health. The biggest pain was opening a bank account and making sure the first salary kicked in before our South African savings ran out. 

October: We slowly started settling; there was still endless administrative work. I quickly discovered the public libraries near me and enjoyed their vast collections of kids' and adult books. One of the first things was applying for a PPS number for hubby and child, mandatory training, learning the admin parts of work, and opening a Revenue account for Tax returns. We came to the conclusion that the long commute is not working; I was spending up to 700 euros per month to make it to work and back. We started house hunting again. My first night shift was on the 21 October. 

November: We moved into a new house on Friday, the 30th of November. All the unpacking was done, and I was on call on Sunday. As I was recovering from everything, they told me I had to prepare for the section statistic meeting, which was crazy stressful. I started not getting good vibes from work. I started feeling that they are pushing me away and they assume that I am not competent. I clearly did not leave a good first impression. 

December: Here we are getting closer to the Christmas festivities, which are beautiful. I really do not understand the concept of telling kids the gifts they are getting are from Santa and the tooth fairy. I was raised in the Middle East. If my parents got me a gift, they would make it clear that they were not some imaginary fictional character. all the Christmas decorations are expensive and once packed take up a lot of space, and with the Irish life of moving around, I am drifting towards being minimal. The demographics and the workload of Ireland is much lighter than SA. The hospital where I work is not very busy, but the level of supervision and micromanagement becomes a bit crippling and ruins one's confidence and independence. I tried counselling a difficult patient while the unit consultant was on annual leave. She made a fuss, and it escalated and led to a huge departmental issue. I now look at the difficult patients, and tell them that they need to speak to the consultant. I do not get involved. One more dramatic incident and the department will be on fire.  I have given up the ego and humbled myself to fit into the new system again.