Anybody who goes to work in a different part of the world should expect a culture shock. Faced with unfamiliar attitudes and customs you are constantly uncertain about how to behave and, therefore, ill at ease. Before we left for the Middle East we read a lot about Arab culture and customs and tried to fit in some language study as well. We now feel most stress not in the shops or with the language but where we did not expect it, in our medical work in the culture of the hospital. We work in the Arabian Gulf alongside mostly Indian doctors. Our hospital began life a century ago as a charitable institution. When the increasing standard of living made it possible to charge a fee our hospital started doing so. We now function as a small, private, open access hospital with a total workforce of about 220 people. The general health of the people is excellent and most speak English well enough for …