Peru to Ecuador

As I said we had an awesome two days travelling to and from Machu Pichu but all good things have to come to an end and it was time to get to Ecuador for our medical mission.  This was to take two days.

Our flight was booked for 1250 so our driver had promised to come at 1100.  This gave us some time to sleep in, have a leisurely breakfast and even do a little half hearted shopping.   Our driver was late which was a little anxiety provoking, I should get over this, drivers are always late in developing and developed world.  We arrived at the airport and on checking in were told our flight was an hour late.  No problem, we were only flying to to Lima with no connecting flight.      We expected to have a few hours in the afternoon and evening to explore Lima which we had never visited.

Getting through security we entered the departures area which even by standards of the developing world was full and very busy.  There were no seats available and people were sitting and lying on the floor.  Our flight was not posted on the departures screen which was okay because there was only room for 4 flights and we were really early.  We had an indifferent coffee, and walked around the departures area in turn.  As time went by our flight was still not posted.  I went to a LAN employee and asked for an update and was told our flight was departing at 1350 as we had been told.  When it finally appeared on the board, it was now to leave at 1430.  About 5 minutes later, it disappeared from the board.  

It was pretty clear that something was wrong.  People were starting to yell; flights arrived, hardly anybody seemed to be boarding flights.  We went to the gate where our flight was supposed to leave before it disappeared from the screen  The screen was blank there but people were lining up.  I went up to the LAN employee at the gate and asked again for the status of out flight.  The man pointed out to the line and said stand in line there. 

About half an hour in line we started to board our plane.  Someone in line said that the pilots had been refusing to take off.  Some said it was a labour dispute, some said it was because of the weather.  Personally if my pilot thinks it is unsafe to fly, I will take his opinion over some MBA in head office and I also like my pilot to be happy.  I am kind of funny that way.  Anyway as we were boarding the plane, people not in line were yelling at the staff.  It appeared that our flight was going ahead while flights that were supposed to leave earlier were still waiting.  Not really fair but you have to look after ones self of course.  We eventually took off about an hour after we were originally supposed to land in Lima.  It was otherwise an uneventful flight.

A man from our tour company met us at the airport.  He had waited 3 hours for us so it was nice of him to hang around.  He half jokingly half serious told us we were going to have to leave a larger tip.  We had about a one hour car ride into LIma, the last bit driving along the Pacific Ocean.  The tour company had booked us a hotel 3 blocks from the beach.  This was too bad as we arrived around 1900 so really didn't get to enjoy it.  We just had a beer on the roof-top bar, ate dinner in the hotel restaurant and off to bed,

Our driver picked us up at 0850 the next morning and it was off to the airport through the morning rush hour traffic in Lima.  We got dropped off at the airport, negotiated a large line-up to  check in, got through security and to our gate.  Did I mention our plane was late?  Finally we took off for Quito.  I was able to shame the flight attendant to move me to an exit row.  After 2.5 hours we started descending to Quito but then suddenly started climbing very suddenly.  The flight attendant ran over anxiously to check if the exit row was unobstructed which was a little unnerving but we did land uneventfully.

This was our first visit to the new airport in Quito which was built outside of town.  No more descending perilously close to houses and apartments.  It is a very nice airport compared to the old one.  Even with our late flight we had a 4 hour stop-over.  The Quito airport has unfortunately been taken over by American restaurants so we had to eat at a "Fridays".   This is a pity because Ecuador has its own unique cuisine and frankly I can get quesadilas, ribs, burgers or wings in Canada.  We ran into some stragglers from our mission who were flying on another flight to Cuenca, the main group having flown earlier that day.  It was nice to catch up even though we have been meeting monthly for the last six months.

Our flight to Cuenca eventually took off.  The flight to Cuenca is a short flight where you are either taking off or landing.  On arrival our luggage was actually waiting for us.  We had planned on taking a taxi to the hotel.  Our hotel while not the Hilton or Marriott is a place where a lot of tourists stay so it was a little amazing that the first taxi driver didn't know where it was, even when we gave him the street it was on.  The second driver didn't either but with the help of an English speaking physician we met on the plane and a phone call to somebody, he figured out where it was.  Our taxi driver had the philosophy common to many taxi drivers in Ecuador which was that the only way to drive was to drive as fast as possible, maintaining the minimum distance between him and the car in front of him.  Plus my seat belt didn't work.  I haven't been so relieved to get out of a taxi, since the last time I took a taxi in Ecuador.  I paid the man $3 and  someone from the hotel got our bags.

The Inca Real our home for the week.

It was a relief to finally get to the Inca Real where I have stayed 7 years in a row.  The staff even knew our names and we got checked in quickly.  We exchanged pleasantries with the people who had arrived earlier.  I had resolved in the Quito airport that as soon as I got to the hotel I was hitting the sack but we ended up talking,laughing and drinking until 2300 when we finally hit the sack in our usual room.

Sacred valley and Machu Pichu

At about 0800 our guide Timas and our driver met us at our hotel to drive to Agua Callientes via the sacred valley.  We packed just enought clothes for overnight in our bags and headed out.  Our driver headed out thru the narrow and steep streets of Cusco until we left town and got on to the highway.

After an hour or so we pulled up at a craft area where we got out.  The people at this craft area put on a demonstration of dying, spinining and weaving alpaca and wool.  Somebody brought over a class of coca tea and we watched the demonstration.  After of course we had to buy some stuff and then we headed out.   

About 5 minutes later we stopped again and got out of the car.  With our guide we walked through the streets which had crafts for sale.  We arrived at a church which our guide pointed out was built on the foundation of an Inca wall.  We kept on going, rounded a corner and came upon this.

Walking on a little further we can upon these terraces with this spectacular backdrop.  At the bottom of the ravine according to our guide was the Inca trail.

We drove on stopping to view this:

The sacred valley is at the bottom.

We then drove to Moray below.  This is not the work of aliens.  Essentially these are sinkholes due to tectonic activity and the Incas terraced them.  The purpose of these terraces was agriculural experimentation as each terrace represents a separate microclimate.

We then went on to this impressive Inca site.  We climbed up the terraces and walked around coming down by a different route.  

 The town is overlooked by an Inca man.

After spending about 2 hours at this site it was off to catch the train to Agua Callientes.

 

The train ran along a raging river quite often right above it.  It was possible to see Inca terraces along the side of the river.  The scenery was impressive but at the same scary.  We rode gradually downhill and the vegetation gradually changed to jungle.  An hour and a half later we pulled into Agua Callientes and got off the trail.  We walked through a gaunlet of vendors before getting to our hotel.  

Agua Callientes sits at the foot of the mountain that is Machu Pichu.  It is an impressive setting with steep mountains rising up on all sides and the raging river running through it.  It is a mixture of a tourist town and a boomtown with many buildings half built.  One expects to run into Indiana Jones or a James Bond villian.  

Our guide met us at 0800 the next morning and we got into a long line-up for the bus to Machu Pichu. It took us about 30 minutes to get to the front of the line.  

 It was raining moderately hard.  We got seats at the front of the bus.  This was a mixed blessing.  We did get excellent views as our bus navigated the switchbacks, however we got to see how close our bus was to the end of the road and how steep the drop was below us.   Many switchbacks later our bus driver stopped, turned the bus and started backing up the mountain.  Great, I thought, he is going to show us how good a driver he is by driving the rest of the way in reverse,   He was only parking however.  The road had been blocked earlier by a rock slide and we had to get off the bus, climb some stairs and get on another bus, arriving shortly at the entrance to Machu Pichu.  

We negotiated the entrance relatively fast and this is what we saw right away,

I had expected Machu Pichu to be impressive but had no idea how impressive even in the early morning rain and mist.  Aside from the terracing and buildings the natural surroundings were sherely awe inspiring.   It is hard to think of a place where man made and natural features are juxtaposed so intimately.  

It was raining moderately hard in the early morning.

As our guide walked us through the ruins the weather improved and we were  soon able to see the surrounding mountains.  Below is the temple of the sun.

We had tickets to climb Warnu Pichu the steep peak below but declined in view of the rain and the narrow stairs.  Later we climbed up the Sun Gate trail and were able to see this vista below us.  

 

The Sun gate was about and hour out and 30 minutes back. The Inca trail arrives at Machu Pichu at the Sun gate so maybe one year we will walk thru it.  

Our guide had left us so we walked down to the bus, making not to sit at the front and 30 minutes later we were in Agua Callientes where we went for pizza and Mary had an Inca Cola,

An hour or so of shopping near the train station and we boarded our train with our guide.  To distract us the railway put on a fashion show of alpaca goods and Mary bought even more alpaca.   We didn't take the train all the way to Cusco but got off at the first station where we had caught the train and our driver was waiting for us and we had a 1.5 hour drive back to Cusco where we checked back into our hotel.  

We were pretty worn out, we had had two pretty amazing days.  A light supper, a couple of glasses of wine and off to bed.

Peru

Our trip to Peru started as most long trips start with a way too early wake up.  At least this year we were spared having to wrestle two hockey bags full of medical equipment and instead just had too roller suitcases and backpacks as carry on.  Our taxi arrived on time and we were at the airport over 2 hours early where a moderate sized line-up had already formed.  Pretty soon we were checked in and with our Nexus cards US customs was a relative breeze.  The agent almost smiled this time.

We (I) ate a large greasy breakfast near our gate washed down with copious amounts of coffee and took our first dose of acetazolamide.  We would be heading to 13,000 feet pretty much our first day in Peru and it was time to start peeing out that bicarb.  Eventually we boarded our plane.  We had paid extra for exit row seats so had lots of leg room which enabled us to alternately sleep and read during the 3.5 hour flight to Houston.

On arrival to the George Bush airport we headed straight to Pappadou's for a little seafood and of course a beer.

That killed an hour or so of our layover so we walked around, Mary bought a watch, I bought a cap and soon we were able to board our plane for the long flight to Lima.  

Thanks to United's incomprehensible zone booking system we got to board last.  As I mentioned I paid extra for extra leg room but by the time I had got to my seat the adjacent seat was occupied by an ancient haridan
with elbows like Gordie Howe who had already taken over 2/3 of my seat as well.  This lead to 6 hours of trying to push her out of my space and being pushed back.  I tried to sleep but every time I drifted off to sleep I got an elbow to my shoulder or the drinks cart came by and knocked my other elbow.  

We eventually landed in Peru, breezed through customs, (Canada should send their agents down to train there) and after waiting a long time for our luggage we walked across the street to our airport hotel which had been booked for us.  It was now close to midnight local time.  We even turned down the welcome drink the hotel offered us and headed straight to bed.  Oh did I mention we were supposed to check in for our flight to Cusco at 0730 the next morning.  It is amazing how sitting on your ass for 10 hours tires you out and we slept like logs.  

We were up at 0630 the next morning got our bags packed (well really we hadn't unpacked them) and got down to the buffet breakfast.  Like most airport hotels there was a polyglot of different nationalities; we saw many tour groups and wondered if we were going to be joining them.  We then grabbed our bags, rolled across to the airport and checked in.   Like most airports in South America it was a hive of activity but we were able to get checked in and through security relatively quickly which of course meant all the more time sitting at the gate before lining up to get on a bus to our plane and boarding. 

It was a short flight to Cusco, a little cloudy but with some mountain views.  We had our first glass of Inca Cola which tastes more like Cream Soda than cola.  Eventually our plane cork-screwed down into the Cusco airport and we deplaned.  Now came the moment of truth, were we going to get the dreaded altitude sickness.  I was expecting to gasp for air as I walked off the plane but was pleasantly surprised.   

We picked up our luggage and met the lady from the tour company who was waiting for us and we got into a van to drive to our hotel.  Pleasantly we found that we had a private tour and that there was just the two of us, a guide and a driver.  Not that we are anti-social,  we have met a lot of nice people in tour groups; we have also met some real disruptive types.    The lady from the tour company told us that we would be taking it easy that day.  She cautioned us to take it easy, drink lots of water and to avoid red meat.  She also encouraged us to drink Coca tea which she told us would be freely available in our hotel.   Sure enough after checking in and getting oriented about our trip, the manager took us to the lounge where this bowl of coca leaves:

was waiting next to a container of hot water.  He placed a fistful of leaves into a small paper coffee cup, let it steep and handed it to us and we drank it.  I wasn't sure what to expect but I didn't get any urges to disco dance, play in the NBA or be mayor of Toronto.  

Cusco which the Lonely Planet describes as a tourist trap is full of a wide variety of visitors ranging from back packers to elder hostlers.  Not sure where we fit it.  It is a Spanish colonial town, a lot like Cuenca but more developed for tourists.  The coca tea gave us energy and we walked up towards the main square.  As we approached it we started coming across boutiques selling beautiful alpaca clothing, much finer (and more expensive) than we were accustomed to seeing in Ecuador.  Between shops street hawkers flogged their wares.  The main square is quite large with churches on two sides and stores and restaurants occupying the remainder of the perimeter.  

Starbucks has arrived in the high Andes but most of the restaurants are authentic.  A little hungry and just wanting to sit down, we accepted the entreaties of a man on the street to eat at his restaurant where we both had a ceviche of the local trout which was very good.  As well we were able to sit on a small balcony overlooking the square.  

More shops, trying on sweaters and back to the hotel where I had the massage I had booked earlier.  Later in the evening we walked to the restaurant that the tour guide had recommended.  We took her advice not to eat red meet but compromised by having a bottle of Chilean wine with it. After that a walk  home and off to bed where we had a good sleep in the thin air.  

We got up around 0700 and ate the buffet breakfast in the dining room.  At 0900 our tour guide  arrived and we went on a short walk to Santo Domingo church.  This church was built on the site of a large Inca temple and the Spaniards simply plastered the wall and built their church around it.  An earthquake in the 1960s revealed the original Inca structures which were then excavated and restored. The Incas built their structures with large blocks which were cut accurately enough to fit together without plaster and were able to withstand earthquakes.




After exploring the ruins and the church with our guide, our driver picked us up and we headed through the narrow busy streets eventually climbing up high above the city where there were more Inca ruins.  

This huge site originally a temple to the Milky Way is still only partially excavated.   These photos really do not do it justice.


 Our local guide Dimas.  We have been lucky in our travels to have lots of good guides and he was one of the best.

Leaving this site we drove higher up to what was originally an Inca way station.

We also explored one more set of ruins dedicated to worship of the Puma before returning to Cusco where we toured the cathedral and said goodbye to our guide for the day.  

We ate lunch at a restaurant suggested by our guide.  He told us it would be possible to eat Cuy (guinea pig) however they require advance nice so I had duck and Mary had a quinoa tabouli.  I also sampled an excellent (dark) local beer.  

Then it was more shopping.  We first visited a market much like the ones we knew in Ecuador.  

It was there that I met this character.

I thought about bringing one home as a trophy for Surgeon of the Year but I suspect our customs would confiscate it. 

We next went to a more upscale store and each bought a nice Alpaca sweater.  Then back to our hotel  but not before Mary met these people.

Our adventure continues tomorrow as we visit the Sacred Valley and then on to Machu Pichu.

2013 MS Bike Tour

After surviving the 2012 MS Bike Tour, Mary and I, curiously, were looking forward to another crack at it. This year we were joined by colleagues from the Misericordia Department of Anaesthesiology including Danny Chen, Will Flexer, John Soong and his wife Bernadette. Ignoring more disgusting names we called ourselves "Asleep at the Wheels".

I went to my massive email contact list and spammed everybody I knew (or didn't know) and some people actually pledged money. The other team members did their own fundraising and eventually we were able to raise about $8600 for MS. Thanks to everybody who contributed.

Because of the late winter, I wasn't able to get out on my road bike as much as I would have liked and got in one MS Bike Tour sponsored training ride and a few short rides on my own. Nowhere near the 90 or so km I was going to have to do each day.

On Tuesday Mary and I headed out to the MS Bike Tour office in far east Edmonton to pick up ours and everybody elses race kits. We also got to pick up the jersey I got for raising >$1000 (thanks again to everybody who donated). Mary got to pick up her special red jersey for riding with MS. This is jersey that nobody should have to wear but one that can be worn with pride. Many thanks to the volunteers at registration who really had a lot to do but handled it with incredible grace.

I also picked up the bicycle shorts that I got for raising >$2000 (thanks again). I have up to this time spared that world from the sight of me in Spandex and on receiving the XXL shorts held them up and thought, "I'm going to fit into these?"

The evening before the ride we met at Violinos for a pre race carb load. The food and the company were great and we had a lot of laughs before going home to rest.

This year knowing how slow it is getting organized I had vowed not get up to early but to relax and get there just in time. That didn't stop me from getting up at 0530 so I did some stretches, made some coffee, shoe-horned myself into the bike shorts and got on my jersey. I also smeared diclofenac gel over all the places I knew were going to get sore. Then we loaded our bikes on the car had headed out to the start at Ritchie Brothers in Nisku. We were at the exit at about 0630 but everybody else had the same idea as us and it was after 0700 before we got parked. We figured out how to put all the numbers and wristbands in the right place and pushed out bikes towards the start where we met the rest of our team.

It was a sunny day, still at little chilly in the morning with a wind coming from the northwest that promised to blow us to Camrose. Gradually the ride started as the riders pulled out in groups of 100.

Our team at the start.

We pedaled through the industrial areas and Nisku before turning west for 10 km and then south. As we got farther from the start the riders thinned out. Bernadette, John's wife who had apparently been training flew off ahead and we didn't see her until the finish. The rest of us headed on at our own pace, meeting up at checkpoint and the lunch stop. With a strong tail, I was able to get some impressive speeds giving me a false impression of my prowess as a cyclist. Eventually Mary took off on her own. Eventually I rolled into Camrose where Mary and Bernadette were waiting and the other men rolled in shortly after. After dropping our bags off it was time for some liquid refreshment in the beer garden.

Okay, I'm not sure why the photo of Danny and Will is upside down. I blame Windows 8.

While we were well fed along the way, Fat Franks just happened to be there and when Will offered to buy me a smokie, how could I turn it down. Beer was provided by Alley Kat which is a good thing because when you ride 90 or so km, Molsons or Labatts is not going to do it. Alley Kat had a grapefruit beer which wasn't all that bad.

Feeling just a little happy, we picked up our luggage and got on the Shuttle to the Travellers Inn, our home for the night. I will not comment further on my choice of motels except to say that there were no cigarette burns or mysterious stains on the bedspread. By the time we got showered and changed it was time to head back for the 1000 Club reception followed by dinner where we re-joined our team.

There were fewer speeches by politicians this year and the rest of evening speeches were uplifting and inspiring. We didn't stay for the band but headed home to get a good night's sleep for the next day.

We woke up the next morning at about 0600 and looked out the weekend and saw the flags flapping. Getting dressed and outside, waiting for the shuttle, it was pretty clear that the wind was definitely not blowing in the right direction. Back at the arena we all ate a huge breakfast, picked up our bikes and got back on the road. The sky was initially blue but quickly turned into a dull grey with threatening black clouds to the west. The wind came from the northwest meaning we rode into it whether we were going north or west. No speed records today.

We all rode on doggedly from checkpoint to checkpoint at our own speed. Mary soon left us, we all rode on meeting occasionally at checkpoints and at the lunch stop at Hay Lakes. The rain held off as we continued on north and west into the wind. Soon we were at the second last checkpoint followed by a hill of despair just before the last checkpoint 14 km from the finish. From there after a few km north, we turned west up a gentle uphill towards Nisku. From 10 km on there were signs every km, reminding us how near (or far) we were to the finish. After entering the Nisku industrial park it was 2 km to the finish and finally through the finish where we all crossed the finish line to applause, bell ringing and clapping. Mary was there waiting for me.

Will and Danny had to head off but John, Bernadette, Mary and I had a hamburger at the finish before heading home.

All in all another great experience and it was really nice to ride with a team this year.

As I had said before, the MS Bike Tour is a really class organization and I can't say enough about the volunteers who kept us happy and comfortable over the weekend.

Ecuador Mission, the rest of the week Part 1

It is now Saturday afternoon almost evening and the work portion of our Ecuador trip is more or less over and I can reflect on how the week went.

As I mentioned in my previous post, we arrived at our hotel, the magnificent Inca Real and walked to the hospital from there. The main purpose of Saturday afternoon was to unpack our bags which had now arrived and also to unpack the equipment we had left behind in storage the year before. While we did this the surgeons had a follow-up clinic where they saw patients who had been operated on in years past. Some of these patients would be having surgery on the other side this year. We ate our first of many excellent dinners at the hotel in the evening. Our group has over fifty people in it between adult surgery, pediatric surgery, dental and camp followers. Dinner is a large social event where we meet at the end of the day and each individual "team" will give a report on how their day went. Depending on who gives the report, these can be wordy and long. This being the first day, there was not much to report.

On Sunday after breakfast Mary, I and several others in the group attended Mass at the huge cathedral two blocks from our hotel. After Mass I met my resident Riley who had arrived from Quito that morning.

After lunch at the hotel we went back to the hospital for pre-assessment clinic where we select patients who will have surgery the following week. This is the one part of the mission I find daunting if somewhat rewarding. Every year there is a huge crush of patients and family waiting to see if they or their relative will get surgery this year. They block the halls and spill outside. We were set up in part of the hospital's emergency department which was stifling hot. There were only three closed exam areas which were taken up by adult and pediatric surgery as well as the dental team. The Dental team's work is quite important as we want to clear all the rotten teeth from people who are going to be getting hip and knee implants. This of course relegated Anesthesia to seeing patients out in the open on chairs. While we target 40 surgeries, for various reasons we see many more patients. During the afternoon, there is tremendous competition for space, interpreters and oxygen but at the end of the afternoon we have 40-50 patients screened and awaiting surgery the following week. We were also able to move some our equipment into the operating room so that we could get a quick start on Monday.

Sunday was also Super Bowl Sunday and the hotel was nice enough to serve those who wanted, dinner in the bar where we watched the game on the big screen.

Weekdays on this mission follow a predictable pattern. Between 0630 and 0730 people straggle into the large dinning room for breakfast which is a buffet with eggs, bread, pancakes, ham or bacon, slices of fruit and some type of fruit juice. This is in addition to strong coffee which we usually mix half and half with hot milk. Soon people start the walk to the hospital, the ward nurses and OR nurses leaving first, followed by anaesthesia and just like at home the surgeons eventually make their leisurely way to the hospital.

The hospital Santa Innes is a 15 minute walk thru the colonial streets of Cuenca, crossing the river and then on to the hospital. Even early in the morning Cuenca is bustling with people getting their day started. The walk to the hospital in the morning is one of the best parts of the day for me. The dental team literally "head for the hills" going out to isolated mountain hamlets to treat the children.

Monday is a slightly different day as we have to set up for the rest of the week. The first eight patients who aren't yet in hospital have to arrive and be processed. Meanwhile equipment has to be moved from the store rooms to the two vacant operating rooms that the hospital allows us to use. This year both the floor nurses and OR nurses worked extremely hard and efficiently and quite soon we had our first patient down, IV already started. Traditionally the rookie on the anaesthetic team does the first case and so my resident Riley did the first spinal. The second patient to be done in the other room arrived soon after. Being the first day, there were glitches but we were able to get eight patients done and I was able to head for the hotel where a cold cerveza grande awaiting some time after 1700 hours.

At 1900 we ate another spectacular dinner, had the usual long winded reports, laughed a lot and were in bed by 2200, ready to do it again the next day.

Ecuador Mission Getting There

While I had good intentions of blogging about my seventh trip to Ecuador, I have been a little busy and in between internet connections so I am just getting around to posting now on “hump day” which marks the middle of our mission in Cuenca.

The trip started out at 0330 when Mary and I arrived at the airport for our scheduled 0630 departure toting 2 hockey bags each of (mostly) medical supplies and some personal items. This was in addition to the rolling carry-on bag of personal items and a small backpack. Even 3 hours in advance of our departure the line-up at the United counter was already snaking back a bit, mostly with our group. The United counter opened a little early and we were able to check in and it was off to customs. We were able to dump off our hockey bags before going thru security and then to the friendly happy US customs agents. Ours actually smiled at us. The advantage of being so early was that we were able to negotiate customs and security quickly, those who arrived later took a lot longer.

After eating breakfast and coffee in the departures area we boarded our flight to Houston. When about 40 people with carry-on luggage descend on a plane there is always a little tension over the overhead compartment space something that would be repeated later in the day. We left a little late due to de-icing. I alternately slept or read on the way to Houston; I had my iPod playing Jimmy Buffet which made for some interesting dreams. Arriving in Houston most of us headed off the Pappadeau's a Louisiana style seafood restaurant where we usually have the lunch buffet. This is usually busy but we were able to get tables fairly quickly and had the buffet and a beer. We had a 5 hour stopover in Houston. The Houston airport is a little like a shopping mall but we mostly just wandered around. Some of the people from Calgary and Vancouver who were joining us in Houston met us there. We more or less boarded our flight on time with another fight for overhead space and some of our group had to check their carry-on. There were two other missions on the plane with us.

It was a five hour flight to Quito but finally the plane descended over the mountains into Quito. Quito is said by some to be the mostly difficult airport in the world to land in. It seemed like we had to go around a mountain which seemed uncomfortably close before flying down the valley where Quito is, flying low over houses landed roughly and braking hard. We deplaned, got thru customs in short order and went to get our bags. It was in the baggage area that a man approached me and asked in quite good English whether I was from Edmonton, and on replying, yes, explained that about 32 of our bags had been left behind in the Houston because of weight restrictions. This is something that has happened in the past; this time however they actually had a list of exactly what bags had been left behind, had the lost baggage claims already filled out and photocopied our passports so that the bags could be sent to our hotel without having to return to the airport. All in all pretty good service. After X-raying those bags that had arrived we were spat out into the crowded Quito arrival area where Manuel Avila the local physician who arranges our trip was waiting for us.

Because in the thin air of Quito planes cannot take off heavily laden, our hockey bags are transported over the mountains from Quito to Cuenca in a truck, so we loaded the bags on the truck and took a bus to the Savoy hotel. It was now getting towards midnight. The Savoy where we stay in Quito is near the airport. Judging from the decor it was built in the 60s or 70s. It has been renovated over the last few years and the rooms are now cleaner and more comfortable with showers where you actually feel cleaner rather than dirtier after using them.

Despite the noise of planes landing and taking off, dogs and car alarms we slept fairly soundly. Breakfast was at 0800 served in the basement which backs out onto a garden where you can see hummingbirds flying around. We had our first cup of thick Ecuadorian coffee with hot milk and ate fruit, pastries and huevos. It was a beautiful sunny day.

After 0900 most of us left on a small bus for Otovalo, via the Equator monument. The after winding its way thru the streets of Quito and the suburbs, we got onto a substantial highway and were at the Equator museum fairly quickly. The Equator monument we visited is about 200 metres south of the “official” monument measured in the late 19th century. The museum we visited which is where the indigenous people believed the Equator actually was, was proven by GPS to the be the correct site. We had a tour demonstrating the Coriolis effect and learned something about the indigenous people of Ecuador including a demonstration of shrunken heads.

Leaving the monument, it was off to the fabulous Otovalo market. The Otovalo market is a place where one can buy all sorts of local merchandise such as sweaters, ponchos, table clothes and scarves, made of alpaca and other fibres. Having been there several times we have bought most of the popular items but we did pick up a few other items; first buying a cloth bag to carry our purchases. From there we took a short bus ride to Cotacachi (Catch a Coatie), otherwise known as Leather Town. The main street of this town has leather stores on both sides of the street stretching for several blocks. Unfortunately because we were late, we only had 40 minutes. Leather Town is somewhat overwhelming with the selection of coats, purses and hats and 40 minutes was probably not enough but we did it justice. Finally rounding up all our group we headed back to Quito which was 2 hours away.

While most of the group went our for Chinese food (in Quito go figure), Mary and I were tired and I had a bit of cold so we ate at the hotel which was actually not bad including beer brewed at the hotel. Then to bed and we slept thru the planes, dogs and car alarms.

Manuel and Dr. Greidanus went to the airport the next evening to pick up the rest of our bags. We were able to get most of them but there were still 7 outstanding.

We had a 1200 flight to Cuenca the next day which made for a more relaxing morning with another breakfast at the hotel, time to pack and the bus picked us up at 1000 to go to the airport. Air travel in Ecuador is always interesting even when we have tickets as we did this year. Arriving at the LAN desk the staff didn't seem to believe we had reservations. Apparently you are supposed to check in online. Eventually after some negotiation we were able to check in and go through security. Joining us at the airport was Mitch Giffin the other anaesthesiologist who had flown in from Vancouver the night before with his wife and 16 year old daughter. This is my fifth mission with Mitch so it was nice to see him again and catch up on things.

After a short one hour flight we arrived in Cuenca. We picked up our luggage and left the luggage area where we were met by the local Rotarians who presented us all with a rose and a chocolate bar. Then we piled into a bus and off to our hotel in Cuenca.

Every year that we have stayed in Cuenca since I started, we have stayed at the Inca Real Hotel which has really become a second home for me. This is a beautiful hacienda style hotel with a covered courtyard. The staff seemed genuinely happy to see us all again. Mary and I checked into our room and then out to the courtyard for a bag lunch and a chance to talk things over before heading over to the hospital to unpack our bags.

How I spent my summer vacation

My wife who reads my blog pointed out that I haven't posted on my blog since July.

After going to Rwanda last year, I had planned a quiet summer with only a few weeks of vacation. This was not to be and I had quite an eventful (in a good way) summer.

I went cycling in Quebec

My wife and I have now gone on a few cycling holidays with Freewheeling adventures an outfit based in Nova Scotia with tours all over the world. I have been to the Czech republic and Mexico with them, my wife has done a few others. We had a $500 gift certificate we had to use so decided to go to Quebec. Originally my plan was to link this to the CAS meeting but we couldn't find a trip which coordinated with the CAS meeting, so no tax write-off. We were able to use frequent flyer points for the flight and hey who says the Queen has to subsidize all your vacations. On top of this my wife's sister and her husband from the US were able to come along.

We flew into Montreal and stayed at our favourite hotel in Montreal, the Hotel Nelligan in Old Montreal, arriving in the evening and eating on their fabulous roof-top restaurant. Sunday we had a little time to look around Old Montreal before getting a taxi to the train station and off to Quebec city by Via Rail. Via Rail while nothing like the service in Europe I was to experience later in the summer is still pretty good. We arrived in Quebec City had a short taxi ride to our hotel an pleasant "Auberge" in an old restored building, walked around Quebec City and had dinner. My sister in law and her husband arrived around 2300, we took them out to the Old Town for a beer.

I got to play tour guide the next day, showing them around Quebec City and boring them with my knowledge of Canadian history. I only had to make up a few facts I wasn't sure of. Around 1600 the van from Freewheeling came to pick us up and we got to meet our fellow cyclists, another American from Baltimore and an older (than us) couple from Waterloo, Ontario.

I could really bore you with what we did in detail the next five days; it was a fantastic trip, we stayed in some great hotels and ate like kings. The weather was crappy but but instead of making everybody miserable, it brought the group together. The trip was labelled green or easy; the longest we rode was 60 km and there were a few hills.

On the last day we got dropped off at the train which we took back to Montreal, and our favourite hotel. We rolled into Montreal and crossed the St. Lawrence River as the sun was going down and got to our hotel in time to hear the Canada day fireworks. We flew back home the next evening.

We got the house re-renovated (still in progress)

I am beginning to learn that renovation is a two step process. First you do the renovation and then a couple of years later, you redo of the stuff that the contractor didn't do (or wouldn't do) right the first time or that you didn't think you could afford when you did the renovation. We renovated our house in 2008 at the crest of the biggest housing boom in history (followed by the biggest crash in history). This of course meant that we considered ourselves lucky to even have a contractor (2 in our case) which meant paying a lot of money and generally sucking up to them. About two years ago we noticed that the carpet upstairs was loosened and wrinkling. This meant that we would have to move all our furniture out so someone could come and fix this. Anyway I had this brilliant idea, why don't we get rid of the carpet and put in hardwood floors. Then I had another brilliant idea, why not put in built in bookcases in my office. This required dealing with a hardwood guy and a cabinet guy. I had this vision of them actually working together so that on a given week of their choosing, we could get all the work done in close sequence preferably while we stayed down at the dacha. Then again I still believe in the Easter Bunny. Eventually we got a date for the cabinet installation with the hardwood installation booked safely in the future in case there were snags (which there weren't).

Now even in our oil-rich province, we are in a recession and it is safe to safe that there are not as many hardwood floors and built in cabinets being installed as there were in 2008. Like maybe you have to be nice to the customer and act like you appreciate their business?. For example I had to sign and initial a two page long contract by the hardwood company which mostly outlined what they would not do; we had to put down rather large deposits well in advance of the work being done and finally my wife had to wait around all day waiting for the hardwood to be delivered because they would only give us an 8 hour window and we were last on the list (apparently they have never heard of cell phones). We do have the cabinets in and they look marvelous tomorrow the hardwood installers may just show up. We had to hire movers to move our large heavy furniture into our garage and my wife and I are sleeping in the basement and coping quite well I must say.

I screwed up my shoulder

I had a week of vacation booked at the end of July/ beginning of August which I do to ensure that I will not be on call on my birthday which usually falls on the 3 day weekend. I had planned to spend the first weekend moving stuff from upstairs where the renovation was to take place but my parasite son who lives at my dacha needed his bike for a race so I had to leave Saturday with the bike. My wife wanted to stay in town, presumably happy to have some time to herself. I arrived in the early afternoon, my son took his bike then his brother and he took off for Golden for their race the next day. They may actually have thanked me.

I tidied up the dacha, half-heartedly tried to deal with the weeds, took a nap, BBQed a steak watched some Olympics and went to bed, vowing to be more active the next day.

I arose to the beginnings of a sunny hot day and immediately I knew what I had to do. I had to ride my mountain bike to Banff on an XC trail, eat lunch in Banff and ride home on the new paved trail along the highway. There are two XC trails between Canmore and Banff. The easier one, the Goat Creek Trail starts high above Canmore and while it is possible to ride from Canmore up the dusty dirt road, one usually gets dropped off. As my children were away, this was not an option. The more difficult one the Banff/Rundle/Riverside trail is easily accessable from Canmore but I remember it as a tree-root infested ordeal when I rode it many years ago. Nonetheless, that was the route I decided to take. I climbed up to the Canmore Nordic Centre, stopping for a coffee at the cafe there. I made sure I texted my boys and my wife to tell her where I was going so that they would know where to look for the body. You might think riding alone was pretty stupid and maybe it was but I figured it is a pretty busy trail, there is cell phone reception all the way and I was a much better rider than a few years ago.

I climbed up from the Nordic Centre along the wide trails arriving at the National Park Boundary in about 30 minutes. Inside the park, the trail narrowed and headed downhill. There were lots of tree-roots and rocks. Occasionally I got off my bike to walk around some of the worse obstacles but gradually I gained more and more confidence. From time to time my bike balked at tree root and stopped dead but I was always going slow so stayed on my bike. As I said, I was gaining more confidence and probably going faster. All of a sudden my bike hit a tree root, and stopped abruptly. I didn't and sailed over the handlebars, landing on my outstretched right arm. I felt my shoulder pop out and then pop in. This was accompanied by significant pain which actually made me feel a little nauseous. I sat down on a log, drank some water and paced around for a few minutes. I was pretty sure my shoulder was back in, it was sore but I could move it thru a limited range of motion. I decided to keep riding vowing to be more careful. I didn't really have much choice, I was half way between trailheads and it was either ride or walk.

About 5 minutes later, I brushed a tree and fell over sideways. As I pushed myself up with my right arm, I felt a searing pain and I could not move my shoulder at all. SHZT. It didn't look like it was going back in. The circulation looked okay and there was no numbness or paresthesia. Okay, I thought I am going to walk out to the trailhead, call a taxi and go the emergency in Banff. Off I went pushing my bike with my left arm. After about 5 minutes my shoulder decided to pop back in. I walked and rode to the trailhead and then from there rode into Banff. My shoulder was feeling pretty good all considered and I didn't relish spending time in the ER so I had and ice cream cone at COWS and rode back uneventfully along the paved trail 20 km back to Canmore where naproxen and beer awaited (I do not by the way advocate this analgesic combination although I remember it worked pretty well).

I took things pretty easy the next few days. I flew to visit my parents for a couple of days, attended the Canmore Folk Festival and was back at work the next week. It must of been my grimacing that got one of the Pain Clinic nurses to get an orthopod to see me and 10 days after the accident, I was in a sling. Of course because I am right handed, I had to take it off to work. It was and still is hard to get used to using my left arm. I can only hope this is helping to develop my right brain.

I wore the sling on and off for the next week. At the Edmonton Folk Festival I started noticing all the other people in slings, and felt a subtle solidarity with them. (I was a little disappointed that by wearing a sling I didn't get to go to the head of any lines or sit in a special disabled viewing area) Travelling around Europe hauling a saxophone and way too much clothing hasn't really helped. I got back home and saw my orthopod in the coffee room. We better get an MRI he said. He even made me fill out the req. I am still waiting for the MRI (this is Canada after all).

Did I learn anything? I have learned that I will never ride single track again. I have learned that at 55 you don't bounce back from injuries. I no longer regard all the people I saw in the pain clinic with shoulder pain as wimps and complainers.

I went to Band Camp




Playing the saxophone was a dream of mine realized as an adult. Fortunately or unfortunately the saxophone is irrevocably linked to jazz, a genre I have very little background or for that matter taste for. This has not kept me from playing in two jazz bands and attending two jazz workshops. Anyway a few years ago I figured that the only way to see if jazz and I were compatable was to get some intense experience. Hence I googled "adult jazz band camps". I came up with the Jazz Summer School an English outfit which runs a summer camp in a French chateau (along with a winter camp in Cuba). I made the usual inquires and got put on their mailing list.

Time passed, I always had something else on. I left my jazz band partly because of time and partly because I was frustrated at how badly I thought I was playing.

This summer I was going to attend the IASP meeting in Milan at the end of August. Just after I registered, the mailout for Band Camp came along. Hmmm, I thought this is just before my meeting. I checked and there was a vacancy for a saxophonist, I was able to change my flights and I was heading off to band camp. As the date approached I had the usual misgivings.... I suck at jazz, I suck at the saxophone, I won't know anybody there etc. Injuring my shoulder and my impending renovation which my wife was going to have to deal with, played a part.

The camp is held at Chomerac. Chomerac does not appear in any guidebooks nor does Privas the nearest large town. The town is south and west of Lyon, a one hour taxi ride from the nearest train station at Valence.

I flew to Milan where the conference was to be, stayed a couple of days to get acclimatized and then caught the train for Lyon which left at 0607. It was a pleasant trip through the Alps and in about 5 hours I was at the Lyon St. Exubery TGV station at the airport. After a two hour stopover, from there it was a 30 minute ride on the TGV to Valence. The course organizers had given me the names of two people who would be on the same train and and could share a taxi. I looked at them on the platform but couldn't see anybody so I walked into the station where somebody seeing my saxophone case introduced themselves and soon 4 of us were heading in a taxi to Chomerac and the chateau.

For some stupid reason I had envisioned a castle but the chateau was a rather large 3 story building although one with turrets and arrow slits (probably ornamental I am thinking). The course organizer, Clive was there to meet us and we sat at tables in the shade outside while he organized our rooms. My room which I shared with one of the other campers was quite larger and one of the turrets had been made into a shower. Gradually other people started to arrive. Everybody seemed to know everybody, in fact there were only 3 of us who had never been. Some people were starting their second consecutive week. Despite this, everybody was very friendly.

After getting organized, we had dinner at 1900 with carafes of wine on the table. Although the "chef" was English, the food was excellent. At 2100 we had a "play around". It was a bit of a humbling experience as there were some excellent players with a good knowledge of jazz. I did get up to play in a few blues jams and acquitted myself reasonably well.

As I said, I have been two weekend jazz workshops in North American. These tend to be structured busy affairs where your face is sore at the end of the day. This camp was much less structured with a lot of different teaching techniques. We would have breakfast at 0800 and would start playing around 0900 either all together or in groups. At 1300 there was lunch and you were theoretically free until 1630 when you got together with your small group which played the piece you had worked on for the whole group. Between 1400 and 1630 as mentioned you were theoretically free however most people used that time to work on pieces they planned to play at the evening "cabaret".

After dinner at 1900, we had the evening cabaret where small group of 2-6 people played songs they had worked on in the afternoon. Beer, and wine were available at cost during this session which went on until midnight. The instructors would usually also play a set a some point.

All and all a very relaxing place out in the French countryside, overlooked by a large hill or small mountain. There was a swimming pool to relax by.

On the Friday we played a concert for the villagers. There must be very little to do in Chomerac because about 30 people showed up.

Overall it was a very positive experience and I may just come back next year.

I got to tour southern France and Northern Italy a bit

I was able to get business class on points which is really the only way to fly 8 hours. With the help of the little blue pill I got about 3 hours of sleep and arrived reasonable refreshed. When I leave North America to travel to Europe I usually take Melatonin at the time it is going to get dark where I am heading and I have found this makes a huge difference.

I took the airport shuttle to Milan which only cost 5 Euros and deposited me at the Central Train Station closed to where I thought my hotel would be. The hotel didn't seem to be within walking distance so I got a taxi and paid 8 Euros for a 2 block ride. After showering and changing, I took the metro to the Duomo area which is the massive Gothic cathedral and walked around the area. It was a holiday in Milan and except for tourists the streets were deserted. I ate supper at an outdoor cafe and took the metro back to my hotel.

The next morning I packed a small daypack with a change of clothes, checked my luggage and took the train to Como where I took a ferry ride to Bellagio and back and stayed overnight in Como returning to Milan the following afternoon to my original hotel.

I left for Valence and band camp the next day.

After band camp which ended on a Saturday, I had not made any arrangements until I was to return to Milan on Sunday, figuring I could spend Saturday looking around the area. After talking to people, I decided to go the Avignon, so on Saturday I shared a taxi with the first group out. On arriving in Valence, I found that there was a train to Avignon leaving in 10 minutes so I was able to get on it and was in Avignon by 1100. I found the hotel I had booked on Expedia, dropped off my luggage and visited the Palais Des Papes and then the Avignon bridge.

I had to be at the Valence Ville train station by 1440, the next day in order to make my train to Milan. In order to do this it was necessary to take a bus to Avignon TGV station which is outside of Avignon and catch the TGV to the Valence TGV station and then catch a bus to the Valence Ville train station, where I could then catch the train I had booked a couple of months earlier. Miraculously this complicated arrangement worked, depositing in at the Valence Ville station with enough to time eat lunch at an outdoor cafe across from the train station. I then caught my train to Lyon airport and after a two hour stopover was on the train back to Milan arriving around 2200. I took a taxi to my conference hotel.

The following day I had booked a cycle tour of Milan. I find that the best way to see a city is on a bike. You can cover way more ground than on foot and you miss a lot in a car or bus. I had booked in advance with Bike and the City. This is a really great tour which I would highly recommend. The guide was very passionate about the history and architecture of the city. Her English was pretty good despite adding a vowel to every word.

For the next 4 days I attended the IASP meeting which I found a little disappointing. The IASP has recently gone to World Congresses every 2 rather than 3 years and 2 years doesn't seem to generate a lot of cutting edge material. There was also the matter of it coming at the end of a pretty jam-packed trip. I did have a couple of fantastic meals thanks to the pharmaceutical industry and one night a bunch of us participated in "appertivo". Appertivo is a Milan tradition where buying a drink entitles you to eat at the buffet for the rest of the evening.

All good things had to come to an end. I actually managed to last at the meeting until 1800 on Friday, after which I picked up my luggage and taxied out to the airport hotel, I had booked. This, like many airport hotels was a bit of a disappointment. The Russian dragon boat team was staying there so I anticipated a noisy time but they were pretty quiet.

I flew out of Milan at 0730. I had the usual panicky 1 km run thru the Frankfurt airport to catch the flight I thought was boarding 10 minutes after we landed (it was an hour late). After a 6 hour stopover in Toronto, I was home by 2100.

I managed to book the entire trip without the help of a travel agent. I found the Rail Europe website incredibly helpful and two days after I booked my trains, the tickets were couriered to my home. They did sell my two meal vouchers at 20 Euros which the train staff wouldn't honour but otherwise the service was great. I booked all my non-conference hotels through Expedia. There are lots of horror stories abounding about Expedia but I use them for most of my travel and have never had any trouble. The Hotel Mini Tiziano where I stayed during the conference was booked thru the conference website. In this respect I was lucky as the hotel was a 20 minute walk from the Congress Centre and close to a Metro station, bars and restaurants. Many people found themselves having to take a 30 minute taxi ride every morning and evening.