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We've recently got back from a holiday in Cuba, and yes, it included all the clichés - drinking rum, smoking cigars, salsa dancing and driving down the Malecón in an open-top car that was older than I was!

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Just down the road from our hotel in Havana was a veterinary clinic, and I couldn't resist a look inside. The single room can't have been more than 3-4 metres squared, with a corner blocked off for a toilet, and the most sophisticated piece of equipment visible was a drip stand. The door was open because of the heat, and clients queued out into the street. Towards the back of the dimly lit room the vet sat at a cluttered desk, one corner of which she'd cleared for the client seated opposite to offer her fluffy puppy for examination. After the vet had finished, she passed it across to her nurse to administer what was obviously a painful injection, and then she took it back to make a fuss of it (I wonder if I could persuade my nurses to do that for me?).

After the consultation I introduced myself with some hastily learnt Spanish. ¡Ah, colegas! she exclaimed. We smiled and shook hands and then I left her to her work. As in so many cases in Cuba, the vet was making the best she could of limited resources, but as she welcomed the next client, it struck me that she was focussing on was the most important element of any practice, the relationship between the vet, patient and client. And if you get that wrong, then all the other equipment we accumulate is really just a load of fancy toys, isn't it?.