Smaggie

My Smaller Half and I became bogans yesterday for the day.  It was a bit like that Bowie song, We can be heroes, except boganish because we ate at Ikea.

We took the Hatchling along for a shopping trip because my Smaller Half wanted to suss out ... something ... I can't remember what it was any more, because we emerged blinking into the sunlight 3 hours later with some picture frames, a hanging photo thing that looks like a roll of film, and some fabric.  I almost bought some fake bamboo plants but it was wrestled out of my hands by my Smaller Half who failed to appreciate my primal urge to cannibalize Ikea products to make wargames terrain.  Tragic.

Anyway, after we'd been careening around for a while looking at Molger, Stokki, Ribbi, Svalbo and the other Swedish dwarves, the Hatchling decided that she really needed to be fed RIGHT NOW so we plonked ourselves down in the cafe and plugged her in.  Then I discovered that Ikea sells bottomless cups of coffee for a buck ninety five.  Even the worst coffee in the world is a bargain at that price.  (Side node: why is it called "bottomless"?  It's a very poor analogy indeed. A bottomless cup would be absolutely useless and you'd get nothing to drink at all.)  So I filled up on cheap coffee which was actually about 3 stars out of 5, so not the worst coffee I've had recently.

Oh, and the reason I've been banging on about Ikea at all is that the checkout chick's name tag said "Smaggie".  I asked her if her name was really Smaggie, and she said that it was a nickname because her real name was very long.  I said that Smaggie sounded just like an Ikea product and I'd thought that maybe the staff all Ikea-ize their names.  Smaggie just gave me a funny look.  I thought it was a fair question though.

My philosophy of life

When I was young I thought that life was like a simile.  Now I think it's a metaphor.  But I'll probably end my days thinking it's a synecdoche.

Tech support

I got an email this afternoon from the Fine University reminding me that I'm supposed to submit a form to get approval for my elective 6 weeks before it starts.  And it starts in less than 2 weeks.  Oops.  I really really really don't want to miss this elective because I'll get to fly in helicopters and jump out of submarines and kill snakes to drink my own urine from their freshly stripped skins and so on.  So I quickly grep up the form and try to print it.  But I'm at my Aged Mother's house for Christmas and nothing here works exactly as advertised so, as unlikely as it may seem, I go to my Aged Mother for tech support...

PTR
Mum, does your printer work?

Aged Mother
Err, why?

PTR
Because I want to print something.

Aged Mother
Oh well, it works off and on.

PTR
So you're saying I should try it and see what happens?

Aged Mother
Yes

PTR
It's not working.  It says the cartridge is broken.

Aged Mother
Yes, it's been doing that for a while now.

PTR
So when you said it worked off and on, you really meant that it used to work and now it doesn't.

Aged Mother
Yes, that's right.

Vital statistics

People have been demanding that I publicly release the all-important birth parameters of the Hatchling.  So here they are.

Age: zero.
Density: 1.01 kg/m3
Temperature: 310.15 K
Head circumference: 0.0001836 nautical miles
Resistance: > 1000 ohms
Str 3
Int 18
Wis 12
Dex 4
Con 16
Cha 25

It's a hard life

It's a tough gig being a dad.

First, there's the whole birth thing.  We went into the hospital after midnight and I kept being woken up by these bloody midwives who were coming into the room to check on my Smaller Half.  And I didn't even have the nice comfy hospital bed that my Smaller Half had - just a scuzzy fold-out arm-chair.  And when I tried to take blankets from the blanket warmer to snuggle up in, they told me that those were for newborn babies only and made me put them back.

Nobody paid me any attention at all.  They just kept asking if my Smaller Half was okay and they offered her painkillers and foot rubs and swiss ball rides and aromatherapy whereas I got not so much as a chupachup.

And as for the rest of the day, it was a nightmare.  Breakfast was okay but there was no honey for my cereal.  And I didn't get any coffee until after lunch, which I didn't get to eat anyway because all the panicky doctors took the table away.  And the only reason I got coffee at all was because during a part of the birthing process that I didn't like the look of I excused myself and went across the road for a break.  And anyway, when I got back, feeling much better and more alert, it was still going on.  Man.

Then there's whole baby thing.  That's tough for dads.  While my Smaller Half is having a great time breast-feeding every few hours, I have to awaken up to twice each night to change the Hatchling's nappy - a task which takes up to 5 minutes each and every time.  It's debilitating.

And is the Hatchling grateful?  No, I do not believe so.  She gave me this look today when I picked her up.  She opened her eyes and sneered at me as if to say, "Oh, it's you.  Sure, you may be good for entertainment but you certainly aren't very nutritious.  Not like the other one."

I tried to explain Maslow's Hierarchy of Needs to her and pointed out that I was providing the upper four levels, with a particular emphasis on self-actualisation through my special program of hot-housing which I'm pretty sure will succeed in getting her into an astronaut suit by 15 or 16, and that food would be provided to her contingent on her continued progress through her educational programme.  But she just kept trying to suck my fingers so I gave up and handed her to my Smaller Half and grabbed some much-needed zzzz's.

Super Friends redux

Oooh, how exciting!  Today the Hatchling made a new friend: Holly.

L to R: Willie Nelson, Racially Sensitive Gollywog, Fiennes the Giralph, Holly, Mankey Monkey, Elzee Waverider (front)

From the family album #7

Dot, sister-in-law.
You can see where the Hatchling
Gets her fine looks from!

Super Friends

For someone who has only been around for 10 days, the Hatchling has already accumulated a healthily diverse range of pals.

L to R: Willie Nelson, Racially Sensitive Golliwog, Mankey Monkey, Fiennes the Giralph, and (front) Elzee Waverider the Ballerina Mouse.

Meet the Hatchling

The arrival of the Hatchling has caused much excitement in our families.  We'll be going home for Christmas to my Aged Mother's place which will be the first time that everyone else will get to meet her in the flesh.  Until then we are stringing them along with a drip-feed of photos every couple of days to illustrate astonishing developmental milestones such as lying on her left, lying on her right, kicking her feet, wearing a cute new outfit, being held by various people, and being generally gorgeous.

I was particularly amused this morning to receive a photo back from the Clan with this picture, a robot version of the Hatchling constructed spontaneously and surprisingly accurately by one of her talented cousins out of Lego:

Welcome to the world

Okay, so the people have spoken!  They demanded, in the most recent poll, that I have a baby girl and I, in my wisdom, did so order my Smaller Half.  And fortunately, that's exactly what happened or else I would have ended up looking pretty silly and my sense of masculine authority over the reproductive outcomes of mine own loins would have been severely compromised.

So yeah, my Smaller Half and I are the proud parents of a leetle baby girl.

Yay!

What should we have?

Okay, so this baby is coming soon and I still haven't decided whether to tell my Smaller Half to have a girl or a boy.  I'm such a terrible procrastinator.  Help me make up my mind by voting in the poll to the right.  Once a clear majority emerges I shall issue instructions post-haste, so vote promptly, because I really should get this finalized.

From the family album #6

My nephew Fernando, age 21.  A model train enthusiast from a young age, his duplication in miniature of the rail system of the state of Perak, Malaysia, was the cover story in the June 1987 issue of Railway Modeller.  He was also an enthusiastic body-builder but his involvement in a sketchy protein supplement import business led to his imprisonment for 3 months after a standover incident with a local producer of music videos.  He was later pardoned after it was revealed that he had been blackmailed into confessing by an unscrupulous Welsh architect with links to the trade unions.  Today he resides in Peru where he is conducting background research on the Kokubunji Railway Station, Japan in anticipation of a new masterpiece.

On the economics of stress

Before my exams last week, my stress levels looked like this:

My theory is that the total amount of stress available to a person is fixed, so the more you have to stress about, the less the impact of each individual item.  And the other part of my theory is that you only feel the impact of the most stressful thing you're stressing about.  So I was comparatively unstressed, especially when compared to my Esteemed Colleagues who were not moving house, having babies or dealing with idiot bosses, and whose stress levels therefore looked like this:

But now my exams are over, I've moved house, and I don't have to see my idiot boss again.  So my stress has been redistributed to look like this:

So I'm freaking out.

From the family album #5

Great Aunt Eunice, the pioneering aviatrix, mugs for the camera upon her arrival home from the Dutch East Indies, where she had set all manner of female altitude records.  Her accomplishments would later be immortalized in the fictionalized novella Wolf Slobber which was a minor hit in Denmark.  Her later years were blighted by a mysterious disease contracted from tropical biting flies, but she pressed on, securing a voice-acting role in the Pink Panther cartoon series as a colonial matron which sadly ended up on the cutting room floor due to time constraints.

From the family album #4

My step-uncle Edwin, who now goes by the name of Shariff.  An early dial-up internet entrepreneur, he styled himself "the modem king of the Murrumbidgee catchment".  He served as Treasurer of the local council for many years and used the platform to make a name for himself as a celebrity weatherman and guest on the summer telethons raising funds for charity.  He recently had a falling out with a major local business figure and friend and found himself shunned at the Rotary Club.  As a result he is thinking of relocating to Western Australia to stage some of the plays he has been writing at night for the past few decades.

From the family album #3

My second cousin Corky.  This was the last photo taken of his "special" hair before he got it cut off because he was going to attend theological college in Switzerland.  However, he never even got as far as Basel.  While trekking in Bhutan en route to Europe he befriended the coach of Transport United in the Bhutan A-Division and ended up securing a job as the team masseur. Corky's other claim to fame is that he had a species of butterfly named after him by a school friend after Corky bailed him out of jail following his arrest in the King's Cross red-light district under mysterious circumstances.

From the family album #2

A rare photo of my cousin twice removed, Warren, taken at the age of 30.  This picture was a publicity shot for his prog-rock power trio, The Ottoman Corsairs, in which he played the electric lute.  Warren was a high school music teacher by profession but was sacked after a scandal in which he was found to have stolen melodies from the homework of a Japanese exchange student.  Fleeing Australia for the United States of America, he was last known to be earning a living penning aphorisms for football commentators and may have been engaged to an ornithologist.

From the family album #1

 

My Uncle Viktor at the age of 27.  He'd recently returned from a lengthy tour of the Caucasus, convinced that there was a fortune to be made in contracting the construction of football stadiums there.  Although his father disapproved, Viktor somehow secured an enormous loan from him which was subsequently squandered on his true passion, buying 1930's German art photographs at auction.  Tragically, all of the prints and negatives were seized and destroyed by Swedish customs officials in a misunderstanding over a university endowment.  Viktor never really recovered from the shock but managed to eke out a marginally successful career as an arms dealer operating via mail order.

Over

I'm done.

Three hour multiple choice exam this morning over and done with.  Now I can sit back and relax... until Wednesday afternoon when I'll find out if I have to sit the this-is-not-a-sup exam on Thursday morning.

Honestly, this is the stupidest exam system I have ever encountered in any of my thirty four degrees.

Serenity now

There comes a time before each exam when you must find the balance between learning and de-stressing.  For me, that time is now.  And the balance is learning 0%, de-stressing 100%.

This is particularly true of studying medicine because there seems to be no limit to what we might reasonably be expected to know, even though in actuality what we are expected to know is quite reasonable and sensible.  In fact, to put it in the words of an Esteemed Colleague, "They just want us to be sub-lethal".  Just make sure you know Plummer-Vinson (Paterson-Brown-Kelly) Syndrome back to front.  Sure, it's rookie stuff, but you'll look silly if you haven't reviewed it.

Everybody de-stresses in different ways.  Some people hit the gym.  Some people meditate.  I like to behave like an effete retired dilettante.  So here's what I do:

• Feed the birds.  Tut-tut over the crows that have been pushing the rosellas around.
• Put some string quartets by Mozart on the stereo.
• Slowly nibble some avocado and smoked salmon on whole-grain ano-bread while sipping my eco-coffee and browsing The Guardian online.  Tut-tut over government spending cuts in the UK.
• Gaze vacantly out the window at the garden, thinking about where I might plant some bulbs for the winter.
• Put some waltzes by Chopin on the stereo.
• Go to my blog and dispense some patronizing and sanctimonious advice to my long-sufferering readers.
• Do some tai-chi in the front yard where the neighbours will be sure to see me.
• Throw open all the windows in the house and stand in front of them with hands on hips breathing deeply and saying, "Aaah, it's a beautiful day!  Feel the air in your lungs!"
• Put some Bach violin sonatas on the stereo.
• Idly wonder what might be on the OSCE tomorrow.
• Hurriedly snatch up an excrutiatingly detailed textbook and attempt to memorize specific gene defects for a range of rare diseases for the best part of an hour before collapsing sobbing into a corner.
• Put some Rachmaninoff piano concertos on the stereo.
• Tell everybody on Facebook how bored I am.  Tut-tut over the young folk these days.

The next time you have a big exam looming, why not try my method?  It's never failed me!

I am going to make it through this year if it kills me

Well that's the last time I try to draw anything with this stupid touchpad...

Good guessing

Hopefully the upcoming MCQ exam will have a lot of questions like this one I saw today:
Here is a medical investigation finding.  Which of the following statements is true?
A.  This can be found in normal people.
B.  This can be found in X syndrome.
C. None of the above.
D. All of the above.

Logically, the answer can't be D, since then the answer would be (A,B, and neither A nor B).  So my odds just improved from 1 in 4 to 1 in 3.  Sweet as bro!

Third Year Desiderata

o placidly amid the noise and the haste,
and remember what peace there was in second year.

As far as possible, be on good terms with all persons,

until you get their notes. 

Give your excuses quickly and clearly;
and listen to your patients,
even to the opinionated and the loquacious;
they too have their story.
Avoid loud and aggressive surgeons;
they are vexatious to the spirit.

If you compare yourself with others,
you may become discouraged or lazy,
for always there will be both gunners and muppets.
Enjoy your coffee as well as your cake.
Keep interested in your own "career", however humble;
it is a pleasing fantasy to dwell on in the early morning darkness.

Always document everything,
for the world is full of bullshit artists.
But let this not blind you to what virtue there is;
many persons strive for high standards,
and they may be able to help you, come swot-vac.
Be yourself. Especially do not feign incompetence,

everybody is sick of your shit.

Neither be cynical about psychosocial histories,
for in the face of all PCRs and MRIs, 

they are as perennial as the grass.

Take kindly the counsel of the years,
gracefully surrendering the things of youth,

excepting perhaps certain tactical wargames and the odd bit of Scrabble.
Nurture strength of spirit to shield you when pimped on the ward.
But do not distress yourself with paranoid delusions,
most consultants don't know you from a bar of soap.

Beyond a vigorous handwashing before lunch,
be gentle with yourself.
You are a student of the university
no less than the midwives and nurses;
you have a right to be here.
And whether or not it is clear to you,
no doubt the year is unfolding as it should.

Therefore be at peace with your Supervisor,
whatever you perceive Him to be.
And whatever your labors and aspirations,
in the noisy confusion of Medicine,
keep peace in your soul.

With all its sham, drudgery, and broken dreams,
it is still interesting from time to time. 

Don't be a freak. Strive to be normal.

Practise MCQs

Which of the following are good reasons that you'll pass your exams?

1. You are a genius - you mother told you so.
2. You're part of a generously funded rural education program so the university can't afford you to fail.
3. The year after you already has too many people repeating from your year so the university can't afford you to fail.
4. You have the dirt on the political heavyweights so the university can't afford you to fail.
5. All of the above.

Why is it that beft always go to the left?

1. Levorotatory motion induced by perinatal prostaglandins.
2. Differential homeobox gene expression.
3. Torsion of the sigmoid mesentery.
4. Peyronie's disease.
5. None of the above.

Medicine as a career is:

1. Overrated
2. Underrated
3. Serrated
4. Frustrated
5. Adulterated

I hate the internet

But I so desperately want to access it.  Actually, it's computers that I hate.  And ISPs.  I hate them too.

We moved house two weeks ago which means that I've had only intermittent internet access since then because of course I was slack and didn't arrange transfer of my access 10 years in advance because I was preoccupied with freaking out about the fact that I wasn't freaking out yet.

Finally on Thursday the phone guy turns up to pluggle me in.  He had a little box with wires and lights which he fiddled with for a while, then he made a phone call, then he told me I was good to go.  So I pluggled myself in and it worked!  Except it was really slow.  Reeeeeeeally slow.

Which was strange because it was only one of the three computers in the house which was slow.  Yes, I know that three computers between two people is stupid, but one of them belongs to the university, so it's not my fault.

So I, having Masters degrees in Engineering and Computer Science, decided I could fix it.  So I broke it.  And then none of the computers could pluggle in any more.  Sad face.

I spent several hours fiddling around with the acronyms on my modem on Friday.  I fiddled with the PPPoE, the DNS, the SSID, and the PSK.  I became so enraged that I contracted a cold and went to bed angry and congested.

I got up this morning and drove off to uni so I pluggle myself into the computers there.  And that was when I realized that I must have forgotten my ISP password.  Slap.

So I came home and called the ISP and asked them to reset my password.  They told me it would take effect within 15 minutes.  So I waited 16 minutes just to be sure, and then spent the next few hours fiddling with more acronyms to no avail.

I became so enraged that I sat on the couch and studied obstetrics and gynaecology.  Which enraged me further because it now becomes apparent that there's more to it than I suspected.  So I did some crosswords, but that also enraged me because one of the answers turned out to be soupçon which is, in my opinion, a stupid French word.

So I pluggled myself back into the computer and for whatever reason, it worked without me changing any acronyms at all.  What the hell?  This country is stuffed.

Disease of the week

I got excited the other day because I peered over a doctor's shoulder at a patient's notes, and saw that one of their previous illnesses listed was ELEPHANTIASIS.

Wow!  What are the odds of that?  I started looking at the patient, trying to figure out which bit of them was affected.  Hmm.  They looked normal enough to me.  So I glanced back at the notes.

ELEPHANTIASIS?  No - BLEPHARITIS.  Inflamed eyelid.  How dull.

I think I can

Why yes, I did have a lovely weekend.  Thank you for asking!  We got out of town and caught up with lots of old friends, all of whom happen to have young children.  It was tiring, as young children are, but none of our friends have gone completely insane and some of them have even had second children, so it was encouraging for me and my Smaller Half and gave us a sense that we could perhaps cope with the coming onslaught. 

Thanks friends!

Sharp as a razor

Stoner Girl

Hey, are you pregnant?

Smaller Half (8 months pregnant)

Yes.

Stoner Girl

Ohhhhhh!

Suits me

Phone
Brrrrrring!  Brrrrrring!

PTR
Hello?

Gym Person
Hello, I'm Gym Person.  I'm just calling to check if you know that we have new spray tanning booths being installed next week.

PTR
Oh, that's exciting!

Gym Person
Yes, so if you have any women or you need a tan you can get it done right here for only $25.

I have no idea what she meant by "if you have any women".  I'm hoping she just mis-spoke because she was so startled by my rapturous enthusiasm for spray tan booths.

Chuz out mang

At a time when many of my Esteemed Colleagues are having brain implosions from the tension and stress of having to prove that they are not idiots, I am floating in an ethereal world of bliss and happiness - it's like Nirvana but with cheese on toast and a gin and tonic. 

What is the secret of my success?  Simply this: I have so much on my plate that I can't even see the turd underneath the mashed potato.  So I'm just digging away with my fork saying yum yum yum, due to get a nasty surprise soon but carrying on regardless.

I'm moving house on Tuesday.  Actually, we've already started.  Yesterday my Smaller Half and I spent all day smashing our possessions into small pieces, tipping the debris into boxes, loading the boxes into our cars, driving up to town, unloading the boxes from the cars, tipping the boxes out onto the floor of our new house and gluing the pieces back together again into new and exciting combinations like some kind of domestic version of Voltron - Defender Of The Universe!

I hate moving so much that at the moment it completely dominates my every waking moment.  Intellectually I am aware that I have my Death Star Exams in a few weeks but it is having no emotional impact on me at all.  I'm not boasting about this - I think it's actually quite bad because it means that until the end of this week when we are finally mostly settled in to our new place, I am highly unlikely to actually do anything studywise.  Shrug.

The other thing I have on my plate is my fractious relationship with my supervisor.  After last week, when I emailed him and the university informing them that I was not prepared to have him supervise me any more due to his almost total lack of constructive criticism and fondness for asking "Have you stopped beating your wife"-style loaded questions, things have kind of died a whimpering death.

The university people were all very supportive of me, my supervisor sent me an lengthy email talking about a different issue entirely, and that's about it.  I went back to the clinic during the week and I was like the invisible man.  I saw a few patients, helped out a bit with a collapse and a chest pain, but none of the doctors or admin staff talked to me about what's going on.  My supervisor gave me a strained smile and waved across the waiting room at me.  So right now I don't now if my name is Mudd, if I have a new supervisor, or if the whole thing has been written off as me having a pre-exam mindfart that we should all awkwardly pretend never happened.  Shrug.

In the meantime, I'm going to spend today doing some study.  Eeeeexcept I just realized that all my textbooks are up in town, glued together in the shape of a giant marauding ant robot.  Bugger.

The OSCE is like a dose of clap

In a few weeks I'll be sitting our final OSCE (a practical exam).  There will be twenty stations, each of five minutes.  Because there are more than twenty people in my class, we're divided into in four groups: a morning and afternoon session each of which has two parallel "streams" running at the same time with the same stations.

Yesterday we got the email allocating us to our spot in this big chaotic event.  I am not pleased that I am in the "yellow" stream.  This immediately made me think of Whistler telling the Prince Of Wales that he was like a stream of bat's piss in the Monty Python sketch about Oscar Wilde.  That's not really the image I need to get me psyched up.

So I'm going to think of it as the gold stream.  When the rebels attacked the Death Star, did they have a yellow squadron?  No, they had a gold squadron.  Red, blue, gold, green.  Much better.

Actually, since I am listed first on the list of stations, I think of myself as Gold Leader.  A quick check on Wookiepedia shows that this makes me Jon "Dutch" Vander.

Which is nice, sure, but there are a few problems with it.  First, Gold Squadron was flying Y-wings, not X-wings.  Y-wings are pretty gumby starfighters if you want my opinion.  X-wings are where it's at.  The Y-wing is to the X-wing as C-3PO is to R2-D2.  And second, Dutch was shot down and killed by Darth Vader after he panicked during the trench run on the Death Star exhaust port.  Not a good omen for my OSCE outcome. Hopefully none of the OSCE stations will involve exhaust ports.

Still, at least I stood up for what is right and sacrificed myself to help defeat the Empire.  Maybe I'll get bonus empathy marks to make up for my lack of galactic competence.

Plummer-Vinson (Paterson-Brown-Kelly) syndrome

Dysphagia and ... ...
Screw it, I'd rather be a
Landscape gardener

Buerger's test

Elevate the leg
And observe it for pallor,
Dependent redness.

Myasthenia gravis

Eye muscle fatigue
Is often the first symptom -
Pyridostigmine.

Henoch–Schönlein purpura

Little red bumps, sore knees,
And a bad pain in the tum?
Monitor kidneys.

Hyperglycaemia

The patient must have
Much too much glycaemia -
So give them no more.

Hypoglycaemia

The patient must have
Not enough glycaemia -
Give glycaemia.

Concerning poems in the haiku form

The more keen-eyed of my readers will have noticed that I've been on a bit of haiku fling recently.  It's kind of my thing - I get caught up in an idea and have trouble moving on until I've wrung all the fun out of it and given it a few more squeezes just for good measure.  You may remember my similar binge of appalling Ernest Hemingway jokes about six months back.  Or my stuttering War On Innumeracy.  Or perhaps you've suppressed those memories.

Anyway, some of you are getting sick of my poems in haiku form.  Some of you like them.  And some of you are getting freaked out by them.  The first two responses are fair enough.  But please, please, do not respond by getting freaked out.  These poems in haiku form (dammit, that's getting tiresome to type, I'm just going to call them haikus from now on!) are not, as you may think, a representative sample of my medical knowledge.  They are the entirety of it.  Every time I learn something new, I write a haiku.  So if you come across something you don't know yet, just think of all the things you do know that I haven't written about yet.

I had a big start to my study binge.  I learned 4 or 5 new things that day.  Since then I've really slowed down.  But that's okay, medicine is not a race.  Not unless somebody is dying right in front of you, in which case it kind of is a race, except it's the winner who dies.  So why rush?

So I'll finish this post with a haiku about medical haikus just to be a little bit post-modern.

Medical haikus
Encapsulate my knowledge
In pithy verses.

(image swiped from savagechickens.com without permission but with much admiration)

Neostigmine

Quickly reverses
Neuromuscular blockers.
Give atropine too.

Hypoparathyroidism

Back pain, cataracts,
A tourniquet makes hand jump,
Tap the cheek for twitch.

Seven affirmations

As you may know, I live in interesting times.  Just had a bust-up with my supervisor, moving house next week, exams in a couple more weeks, baby due a couple of weeks after that.  By this time in December I will be a tiny wizened old man.

My Aged Mother was clearly concerned about me so she emailed me to remind me to recite my Seven Affirmations every morning to keep my spirits up.  I had to admit to her that not only do I not recite them, I do not actually have Seven Affirmations.

Sure, I have a morning recitation, but it goes like this:

1. Arrrgh, somebody get that cat off my face!
2. What's that godawful noise?  Snooze button!  Snooze button!
3. It's happening again!  Turn it off!
4. Oh my god, look at the time!  Get up!  Get up!
5. It's freezing in here!  Where are my ugg-boots?
6. I think my bladder is about to explode!  Run!
7. Maybe I'll cut back on coffee next week.

I don't those are the type of Affirmations that my Aged Mother wants me to make.  I think she wants me to leap out bed and say something like:

1. I am beautiful.
2. I am intelligent.
3. I am certified in the use of power tools.

and so on.  But (as is probably obvious from the paltry list above) I can't actually think of seven things that are positive (as opposed to not negative, such as "I am not anaemic").  I think the problem here is that I'm a medical student. Somebody is paid a rather large wage simply to tell me what a hopeless sack of shit I am.

Well, the joke's on them.  I am certified in the use of power tools.

Hyperparathyroidism

No get up and go?
Drink so much and pee a lot?
Find adenoma.

Haemochromatosis

Bronzed diabetic,
Arthritis and bad liver -
Treat bloody often.

Kawasaki disease

Red eyes, mouth, palms, soles?
IVIG will reduce
Ruined heart vessels!

PR, RR, BP for birth, infant, toddler, child.

One sixty, fifty,
Seventy at birth.  Fifteen,
ten less, fifteen more.

Red flags in paediatric heart murmurs

Loud diastolic
Harsh heart sounds when lying,
Aortic symptoms.

Kallman syndrome

My dog has no nose!
Oh really? How does he smell?
Simply terrible!

A simple question

So what is the plural of haiku?  "I wrote a haiku.  I wrote many ..." what?

Haiku?  Maybe it's like giraffe or wildebeest to hunters.  "I shot a brace of giraffe today."
Haikus?  Perhaps, but it's not an English word, so do you still pluralize it like an English word?
Haiku's?  That doesn't seem right.  As far as I know the only place that apostrophes are correct for pluralization is for things like the 60's and 70's.

Perhaps someone could google it for me. I'm a busy man.  I have bridges to burn.

Pertussis

Paroxysmal cough,
So bad you thought you'd vomit.
Vaccine lasts five years.

Decelerations on CTG

Squeeze head for early,
And cord for variable.
Late? Think placenta.

Ring worm

Discoid skin lesion
With red ring? Rule out eczema,
Use Clotrimazole.

Otosclerosis

Conductive deafness
Early on, but then becomes
Sensorineural.

Cauda equina syndrome

Low back pain, wet pants,
Sensory change between thighs -
Call neurosurgeon!

Breast lump

Young?  Likely a cyst
Or fibroadenoma.
Still investigate.

Give me malaria or give me death!

Goya knew a thing or two about medical education.

This haiku thing is really catching on.  Today a psychiatrist started speaking to me in verse.

He was a pretty odd guy but I really enjoyed his company.  The conversation began by him asking me, "What's your claim to fame?"  I claimed to have no claim to fame but gave him the short version of my life story ("I'm spending 3rd year in Hometown, I used to be an engineer").  He sat staring down at his desk, deep in thought. 

"1940", he said.  And he wrote "1940" on his pad of paper.  "Was the year I was born".

"1949", he said, and again he wrote "1949" on his pad of paper, and he drew a box around it.  And then another box around "1940".  "Was the year I first thought to become a psychiatrist".  He would leave long pauses

in the middle of his sentences

so his speech sounded

quite poetic.

He continued to tell me his life story, accompanied by little illustrations of what he was talking about.  For example, when he was talking about the hypothalamic-pituitary-adrenal axis, he drew some little adrenal glands.  And when he used the phrase, "Following on from that", he would draw an arrow to a different part of the page and begin anew.  The whole page got filled up with a crazily complex flow diagram illustrating his professional life.

And much more!  For example, he asked me who won the first Nobel Prize related to psychiatry and I guessed that it was the guy who invented the frontal lobotomy, but he said it was much earlier than that.  Apparently it was given to a guy who was able to treat General Paralysis of the Insane, which was actually caused by cerebral syphilis, by deliberately giving people malaria.  The diagrams for that got a bit confusing, let me tell you.  We talked like that for more than 45 minutes because his first patient didn't turn up and he didn't realize that next patient was waiting already.

Anyway, the whole time there was this enormous blowfly careening drunkenly around the room, smacking into the light fittings and dipping distractingly in and out of our line of sight.  And that was when he spoke to me in haiku:

If we were at home
I would catch that fly and feed
It to my turtle.

It was really striking stuff.  So much so that at the end of the afternoon, after I'd seen him run through his list of patients and it was time to go to home, I thanked him for his time and said, "I hope you catch lots of flies for your turtle".  He let out a great bark of a laugh, like a seal, and waved me out the door.

I think I want to be a psychiatrist.

HELLP syndrome

Abdo band pain and
Hypertension?  Get coags,
Have the baby now!

Erythema infectiosum

Slapped cheeks and fever,
You're no longer infectious,
So no day off school.

Heart disease

You must be kidding!
I can't fit that much into
A simple haiku.

Measles

Fever, Koplik's spots.
Why aren't you vaccinated -
Gullible parents?

Acute post-streptococcal glomerulonephritis

Haematuria,
hypertension, oedema?
Supportive treatment.

Cluster headache

Alarm clock torture,
Angry eye, rhinorrhea.
Try Verapamil.

Thrombotic thrombocytopaenic purpura

Bruising and fever -
Haemolysis? Schistocytes?
Plasmapheresis!

Pericarditis

Friction rub, fever,
Sit forward to fix chest pain,
Diffuse STE.

Encopresis

Bad constipation,
Overflow incontinence.
Parachoc, star chart.

Pulmonary embolus

Virchow's triad, cough,
Sudden onset dyspnoea?
Warfarin for you!

Typical

Mobile phone rang yesterday while I was on another call.  No message left.
Mobile phone rang this morning soon after I struggled out of bed.
"Did you get the voicemail I left yesterday?"
"No."
"The room we were going to use for the videoconference here in Hometown is double booked.  You have to drive to Dustbowl."
"Okay".
Rushed to get ready, drove to Dustbowl.
Saw on videoconference that the camera was on in the room in Hometown.
"Hey Mr Videoconference-Guy, shut that one down, it's being used by other people".
Brrrrrrring!  Brrrrrrring!  It's my Esteemed Colleague calling.
"Hello?"
"Hi PTR, I'm in Hometown.  Can you get Mr Videoconference-Guy to turn the videoconference back on?"
"What? That room is double booked, what are you doing there?"
"Well, nobody told me so I came here.  And it turns out it wasn't double booked after all".
Wise Professor turns up at distal end of videoconference linkup.
"Hi guys, I've been roped into this at short notice and I don't really know what I'm supposed to be doing.  How do you normally run these things?"
"Well, this is the first time we've done it, so however you like really."
"Okay, how about I just run through the PowerPoint slides that I sent you?"
"Okay".

Emoticons

Did you know that <3 is like a little love heart if your tilt your head to the right?  I only realized it recently.  I've been tilting my head to the left because that's how you read the :) face.  I thought that <3 meant "boobs".  I could never understand why they would say things like: I <3 Bieber. 

I boobs Bieber???  What???

Antenatal class

We went to an antenatal class on the weekend.  It took the whole day, unlike the antinatal class where you are simply given a pamphlet on birth control.  I, in my typical medical student way, was expecting to be bored stupid because I am a professional smartarse.  My expectations were met in the first hour or so when the midwife running the class imparted such valuable knowledge as:

• the uterus is like a bag inside the mother that the baby grows in,
• you have to take off your pants to give birth,
• the placenta is a special organ made by the mother's body to provide nutrients to the baby.

When she said that last one I shot my hand up and said, "Actually all trophoblastic tissues are derived from the blastocyst and thus are distinct from maternal uterine parenchyma."  She thanked me for my wisdom and all the brickies, cooks, accountants and lawyers in the rest of the class gave me admiring glances and left the nicest sandwiches for me at lunch time.

But the day improved from there.  We were shown a movie about the stages of labour which I found quite useful because simple stuff like that is often not well described in books or lectures.  One of the annoying things about being a smartarsed med student is that people often assume that you know quite basic stuff about life that you somehow managed to miss along the way.  They'll happily bust your brains out of your ears with detailed descriptions of protein cleaving but will forget to mention the bit about having to take your pants off to have a baby only applying to the woman.  Knowing that will save me plenty of embarrassment when B-Day arrives.

Wants

My holiday in the Philippines was a great success.

One of my favourite parts of each day is when my Word Of The Day email arrives.  Each one has a feature word, the origin of the word, other words from that same origin, one or two examples, and, tucked away down the bottom of the message, an unrelated quote.  The quote is actually the best bit, in my humble opinion.  The feature words are often too obscure to be of use in daily life, although from time to time I do work them into a blob.

Today's quote was interesting:

To be without some of the things you want is an indispensable part of happiness. - Bertrand Russell, philosopher, mathematician, author, Nobel laureate (1872-1970)

Now "Plastic" Bertrand is a smart guy.  Nobel prize, philosophy, books, mathematics, and he was a dab hand at the old "pull my finger" joke too.  But in this case, he's talking bunkum.  The list of things that I want is short but I can guarantee you that if you generous readers would pool your resources and get them for me, I'd be happy as a clam.

So if any of you have the following things just lying around, please send them to me.

• Mazda MX5 hardtop.
• Twelve or so 25/28mm Persian cataphracts.
• A CD unscratcher.
• A barbecue.
• A fringed buckskin jacket like the one in that film with Jon Voigt that I haven't seen yet.
• A card marked "Get out of jail free (also good for exams)".
• A banjo and the inclination to practise.

Chip in now and put a smile on my dial.

Swept away

(From an interactive display in the National Museum, Edinburgh, which was trying to get children to think about how their lives would change if they were forced to leave their homes and move to somewhere new with almost nothing.)

Improvisation fail

Being typecast as Batman was ultimately damaging to my career.

You know, sometimes I sit back and think about this blog and it surprises me.  I can't believe you people come here and read this stuff.  Maybe you just look at it for the pictures...

Anyway, the other day I was sitting in with a GP who was running pretty late.  He got up to go and get the next patient and gave me a quick rundown on her problem list.  Somehow, probably because he was already so late, I got the impression that he wasn't going to get me to talk to her, plus I was very tired and was doing that thing where I clench my jaw so hard so avoid openly yawning that my teeth crumble into chalky dust inside my mouth, so I just tuned out and went to La-La Land while he was still speaking.  So the whole problem list sounded to me something like this: "So she's been out of hospital for three days and blah blah blah blah blah blah blah blah blah".

He left the room, came back in with the patient and then, to my horror, said to me, "Why don't you review Mrs Kafoops for me?"  I had no idea what to do.  He'd mentioned that she was garrulous, so I threw the dice and went generic.

PTR

So how have you been?

Mrs Kafoops

Oh pretty good thanks.

PTR

And how have your... symptoms... been?

Mrs Kafoops

Much better I suppose.  Yes.

PTR

Excellent.  Yes.  What sort of changes have you noticed?

Mrs Kafoops

Well I'm just better all over I think.

PTR

Good.  Good.  ... Good.  And how are you finding your treatment?

Mrs Kafoops

No problems at all.

PTR

Good.  Any side effects?  That you might not have been expecting or that you don't like?

Mrs Kafoops

No.

PTR

Gooooooood...  Goooooooood.  

It went on like for what seemed like hours but surely was only minutes.  It was agony - she was far from talkative and I still had no idea what was actually wrong with her.  Eventually I cracked and turned to the GP and said, "I'm not really sure where to go from here".  He must have been on to me because he just said, "What other questions might you want to ask someone with depression?"

Aha!

Empathy

I saw a patient today who kept making odd comments in response to my questions.  His wife ended up answering for him most of the time.  I assumed that he was just deaf, but as we left the room he said, "Goodnight!" in a cheery voice.  It was 10.30 in the morning.

So I said to the GP who was there, "Does he have a bit of dementia?"

"Oh yes", said the GP, "He's as nutty as a fruitcake".

Father Hood

For those of you who don't know me in Real Life (tm), we're pregnant!  Or, to put it in a less nauseating way, my Smaller Half is pregnant.

I'm not just making the obligatory morning sickness joke, by the way.  I actually feel physically ill when I hear people use the phrase "We're pregnant".  I want to grab them and shake them and scream at them.  Because are we really pregnant?  I know I'm certainly not.  My Smaller Half is pregnant.  I'm going to be a father.  But that's about as cooperative as it gets.  Pregnancy is not a collective state of being like getting married is.  Sure, I was briefly involved in the process for two minutes or so, but my physiology has returned to normal since then whereas hers - sheesh!

Mentally, emotionally, socially, sure - we're pregnant.  But saying that "we" are pregnant makes about as much sense to me as saying that "we" are going to have "our" prostate reamed out at some stage down the track.

I'm excited, of course.  A friend asked my Smaller Half yesterday what I was doing to prepare for fatherhood.  My Smaller Half said that she didn't think I was doing anything in particular.  But that's not really true.  I think this is something I've been preparing for all my life.

For example, I have developed an unearthly ability to synthesize awful puns combined with the fearlessness required to unleash them in the most inappropriate circumstances.  Plus I am pretty good at the old "pull my finger" gag.  Especially the gag part.

I have also learned reams of tiresome trivia about old wars, grammar, etymology and science.  And I can draw almost anything (except horses, which always end up looking like dogs).  As a handyman I am appropriately unskilled yet enthusiastic, being happy to tie things up with tape or wire and then forget about them.  I told my Smaller Half the other day that I was thinking of buying a jigsaw (no, not the puzzle, the tool) because that way I could cut things out and assemble the pieces into useful things should the need arise.  She was really impressed.  I own a paintbrush and I once painted a chair red.

I am great at making up bedtime stories and hardly any of them are terrifying enough to induce nightmares.  I can catch spiders inside a glass.  I can use a lawnmower.  I can cook food well enough to be able to extract grudging compliments with a few simple ploys. 

I can clean flat surfaces like benchtops, floors, and windows.  I am the designated Person In Charge Of Cleaning Up Cat Poop And Vomit, even from carpet.  I can sing.  I can dance.  I can hide behind chairs and pop out saying "RAAAARHHH!" so it's scary enough to make you laugh but not so scary that you wet your pants (except for that one time).

My hairline is receding and I have the odd grey hair in my eyebrows, which lends me a certain air of maturity to offset the sprightliness of my childish and petulant behaviour.  Like all good fathers, I am patient.  And like most fathers, when I snap, I carry on like an idiot and make a fool of myself.  Exhibition A: this whole blog.

So yeah - I've been preparing.  I'll be a champ.  It's got me thinking about nominating myself for Australian Father Of The Year.  Just look at the chumps who've won it in the past.  John Howard.  Mark Taylor.  Steve Waugh.  Ken Done.  Dr Karl.  Malcolm Fraser.  John Kerr.  Robert Menzies.  None of them could have done a decent "pull my finger" if their life depended on it.  Well, maybe Malcolm Fraser could.

Send me the bill

PTR
Mmm, this bolognaise is very tomatoey!

Smaller Half
Did you use two cans?

PTR
No, beef.

Enraging

I don't often write a blob just for one person but this is an exception.  In the last couple of months I've noticed that the little-used check-boxes at the bottom of each blob that allow you to choose between "engaging", "enraging" and "absurd" is being consistently checked as "enraging".  Just once for each blob, usually within a day of me posting.  My assumption is that it is a single reader doing this rather than an emergent behaviour of the interwebs as a whole.

Here are the questions I would like to ask that strangely devoted reader:
Are you really enraged?  If so, why do you keep coming back?  Do you like feeling angry?  Or is it your way of marking the blob so that you know you've read it because you have some kind of memory deficit?  If that's the case, how do you remember what your method is?  And why not just bookmark your favourite post and read it anew each day?  Or are you trying to inspire your fellow readers to vote more often?  Or is it perhaps your way of giving me a little wave so I know that you've visited even though I don't know who you are?

I know you're out there, enraged man, in the dark so utter,
For when I put my blobs online I hear you gasp and splutter.

OSCE stations for the real world

Having recently undergone trial-by-OSCE, it concerns me that the stations were extremely unrealistic.  Oh sure - they may well be very similar to the stations we'll get at the end of the year.  But they bear absolutely no similarity to the tasks that medical students are required to undertake every day and thus they are a poor measure of medical student core competencies.  Here are some model stations I've come up with to make the OSCE fairer.

Obstetrics and Gynaecology
Student Instructions
You are in a pre-natal clinic doing routine checkups.  You haven't seen a birth all year and realize that this is your last chance to get on board.  Please convince the patient that they should boot the student midwife off the list and let you assist with the birth instead.

Standardized Patient Briefing
Do not agree to let the student be present at your birth even if they cry and beg.  It is important that you mention the following counter-arguments provided to you by the midwifery student:

1. The doctor always misses the birth anyway then swans in with a muffin saying, "How are things going in here, ladies?"
2. On the off chance the doctor doesn't miss the birth, he/she will want to do an unnecessary caesarian.
3. Oh, and doctors are always pressuring you to agree to drugs that will give your baby autism.

As the student leaves the station, let him/her know that you would have agreed if he/she was more experienced.

Surgery
Student Instructions
You are in clinic with Dr Bastard, a surgeon.  He instructs you to examine the patient's Ossicles of Zeno and give him your top ten differential diagnoses and the associated aetiologies.

Standardized Patient Briefing
The student will attempt to examine your Ossicles of Zeno whilst being glared at by Dr Bastard. Ensure that you ask the student the following questions as he does so:

1. Is it true that they don't teach anatomy any more?
2. If that's the case then where is my spleen?
3. No, I'm sure the left is where the liver is.  My cousin has his liver removed when he was five, how long can you live without a liver?
4. So you want to be just like Dr Bastard do you?

General Practice
Student Instructions
It is lunchtime.  You have been consulting with your supervisor all morning and feel that you are finally getting the hang of this stuff.  Enter the staff lunch room and converse with your supervisor.

Supervisor Briefing
The student will attempt to interact with you as if you are human.  Behave capriciously and imperiously.  Ensure that the following points are covered in your conversation:

• Ask them where they have been all morning.
• Introduce them to someone that you know they have met before.  Get the student's name wrong.  Be incredulous if they correct you.
• Ask the student a question about themselves then start talking to someone else while they are answering you.
• Reminisce fondly about previous students who were much more engaged, competent and intelligent.
• Criticise the university and its terrible teaching and newfangled course that has resulted in such a poor student being sent to work with you.
• Announce that a drug rep is turning up soon and throw the student out.

Paediatrics
Student Instructions
Please give the child in this room an injection.

Standardized Patient Briefing
Your child is to receive an injection.  Please follow these steps:

• Instill fear in your child by getting very tense and promising them a huge reward afterward if they don't scream.
• Instill distrust in your child by promising them that it won't hurt at all.
• Overdress your child in multiple layers so that getting access to even a single limb is impossible without a struggle.
• Wait until the child has spotted the needle and has started screaming before raising your concerns about the possible side-effects of the injection.
• Restrain your struggling child until the needle is almost touching their skin.  Then release your child suddenly, allowing them to flail around wildly and maximise the chance of the student stabbing themselves with the needle.

Medicine
Student Instructions
You have been sent to buy lunch for a senior consultant.  You were told to go to "Jack's Cafe down the road to the right" and buy a tandoori chicken, avocado and edam sandwich on white bread, and a large soy macchiato.  You have discovered that Jack's Cafe has been closed for six years.  There was only one other cafe within a reasonable distance and it didn't have much to choose from.  You have returned with a bacon, pumpkin and cottage cheese flatbread wrap and a small latte.  Enter the room and give the consultant her lunch.

Consultant Briefing
Ensure that you raise the following issues with the student when he/she returns with your lunch:

• They have been gone a long time and missed seeing lots of interesting signs in patients.
• This is not the sandwich you wanted.
• This is not the coffee you wanted.
• Jack's Cafe was there last week.
• This is not the sandwich you wanted.

Do not offer to reimburse the student for the cost of your lunch.  If they do ask for money you should remind them that this is not the sandwich you wanted.  If they still persist, point out to them that the university doesn't pay them very much for the teaching you provide.

Psychiatry
Student Instructions
Please observe the following conversation between doctor and patient for five minutes.  At the end of this time you will asked to diagnose each of them with a mental illness and/or personality disorder.

Examiner Marking Sheet
Bonus marks if the student also diagnoses themselves with depression.

Power

Reginald Machiavelli, my old high school principal, used to say that it was better to be feared than to be loved.  Clearly you, Gentle Reader, disagree.  You thought it was better to be overlooked than loved, better to be loved than feared or respected, better to be feared or respected than admired, and better to be admired than to be scorned.  Good luck with that.  People are going to think you're nuts.

Since the most popular response was that it is better to be overlooked, I declare the winner of this poll to be the most overlooked choice.  Thus it is clearly best to be scorned.  And if you think what I'm doing is unconstitutional - tough.  I've got a friend with two angry rabbits who thinks otherwise:

Flopsy and Mopsy are VERY disappointed...

Expecto Patronisum

No.  No no no no no.

We had a practise OSCE this evening.  Oh how we laughed.  Eight stations, five minutes each.  All pretty straightforward stuff.  Or it would be, if you had any freaking idea what you were doing. 
Case in point: x-rays.  Now I know all about x-rays.  But clearly I don't know much about anatomy or pathology because I tanked that station.  Really badly.  But hey - that's why we have radiologists, right?  I mean, apart from having to find somewhere to put all the oddball graduates.

Anyway, that's not what this blob is about.  This blob is about the post-OCSE feedback session in which we were ruthlessly patronized by our supervising doctors who marked us.  Here's what went down...

First, we were subjected to a lengthy mealy-mouthed pep talk which actually contained nothing of substance whatsoever.  "The best advice for the OSCEs is to go into each station and genuinely try to address the clinical problem that is given to you."  Swerving that violently to avoid colliding with actual content left me reeling with mental whiplash and in no state for what was to follow.

We were then given a little finger wagging lecture about how if we are ever in the position of not knowing something we should always ask for a little lesson on it right then and there to "close the gap" rather than just shrugging and saying, "Meh, I can haz brains L8R", presumably because we are all adolescent dipshits rather than responsible adults.  At this point I bit my tongue and refrained from pointing out that, in my experience, asking questions of doctors leads to one of two possible answers:

1. You should know this by now.
2. It's not my job to answer questions that you can look up in a textbook.

Then, we were told in feedback for one of the stations that it was disappointing that so few of us knew the dose for drug X.  There were two marks available for knowing the drug and the dose but if you didn't know the dose you got zero.  Right. 

We did point out that we've been specifically told that we don't need to know the doses of drugs, to which the response was the evergreen and fanciful idea that we can get some kind of mythical "bonus marks" for impressing the examiner with knowledge like drug doses (as opposed to the cruel reality of disappointing your examiners by being unable to distinguish the bum from the elbow).  Buddy, the day I start spending my time planning ways to "impress" my examiners is the day I'm not devoting enough time to my stamp collecting.

Seizing the opportunity presented by our collective stunned silence in response to the feedback about the dose of drug X, I asked a question.  "Oh wise practitioners", I asked, "To enable me to close the gap and to ensure that I learn something from this encounter, couldst thou in thy wisdome inform me of the correct dose for drug X?" 

There was widespread hilarity.  My Esteemed Colleagues laughed because they know me well and recognized that I was being at least somewhat of a Smart-Arse.  The doctors laughed because I should know this by now and they are not here to answer questions that I could look up in a book.  I kid you not - the doctor next to me said, "You'll remember it better if you look that up yourself when you get home".  And then another doctor said, "The correct dose is one ampoule", and chuckled to himself behind his little doctor's beard.

I love it.

Plan D

So I finally came up with a plan for what to do when I drop out of medicine.  I'm going to start my own garden improvement business, specializing in building those latticed structures that you put in gardens and train plants over, as shown in the picture.  They'll be the best ever, renowned throughout the land!

I'll call the business "Hypergolae".

I am shriven

"Surgeons are fine.  I have no problem with surgeons.  It's the people who want to be surgeons that you have to watch out for." - My doctor.

Jokes about surgeons being awful people are stock in trade for this blog.  But I have an appalling confession to make.  After my exposure to surgery this year, I'd actually quite like to be a surgeon.  It looks really interesting.

I'm so ashamed.

That's my hatstand

In 1983 Paul Young topped the charts with his cover of a Marvin Gaye song in which he sang, "I'm the type of boy who's always on the roam."  I remember wanting to be that kind of boy when I grew up, probably because it seemed like a good way of getting on television.  Although I haven't done much in the way of "love them and I leave them, break their hearts and deceive them", I do have a history of career instability so perhaps I have achieved my aim in other ways.  Nobody's written any songs about me yet though.

It made me start wondering - what type of boy am I?

I'm the type of boy who:

• gets the Vegemite out of the cupboard, opens it up, realizes there isn't quite enough left to top one piece of toast, and puts it back in the cupboard again.  And does the same thing the next day.
• spends more time doing background research on his lecturer's unusual given name from Greek mythology rather than going through the respiratory physiology pre-reading that the lecturer gave him.
• has seven books in progress at his bedside and goes looking for another one because none of them are quite right.
• piles stuff up on one desk until it is unusable then moves to a new desk and starts piling stuff up on it too.
• writes a shopping list using the word "the" in front of everything because it looks funny: the onions, the celery, the butter, the paper towels, the soap, the tinned tomatoes.
• knows your name but is too afraid to use it in conversation just in case he appears to use it too hesistantly and makes you think that he's unsure of it.
• will give you a large though unspecified number of chances and then hold an iron grudge against you for the rest of his life if you screw up that last time.
• often tries so hard to do something well that he does it badly.
• bought some headless plastic Roman legionaries on eBay for 99 cents and free shipping because it might be fun to glue monster heads on them.

Do you think Marvin Gaye could write a good song about me with that material?

I suck

Out here in GP land it's hard to get much in the way of exposure to obstetrics and gynaecology.  The university lures you in by getting previous students to boast that they were delivering babies before breakfast on their first day.  But it's been my experience that unless you are prepared to stake out the labour ward in drag you won't have much luck.  Only one doctor in my practice does deliveries any more, so of course early in the year I made the point of having a conversation with him about how hard it was to get access to these patients and he made all the right noises about how important it was and so on and so forth, and then ... that was kind of the end of it.  Zip.  Zilch.  Nada.  I also harrassed another doctor I know and he agreed to help out but nothing came of that either.

I saw my first birth not long ago when I managed to guilt a midwife into persuading the mother (who was a nurse) into letting me hang around.  And recently I saw my first caesarian delivery because the scrub nurse in the operating theatre mentioned that it was going to happen that evening and perhaps I should hang out in the tea room munching on biscuits until then.  So my advice to any future medical students reading this blog is this: don't bother asking doctors for help, bug the nurses instead.

Not only did I get to see a caesarian, I also scrubbed in, which I haven't been allowed to do much this year on account of being a jerk and a klutz.  But most excitingly of all - I got to drive the suction thingy.  It turns out that when you cut your way into a full uterus, there's an awful lot of blood and amniotic fluid waiting to rush out.  So it was my job to hover there, sucking it all up with my little plastic tube.  Sluurrrrrrrrp!!  It makes a noise like a kid reaching the end of a giant slushie.  A raspberry slushie.

A couple of times I got too keen and started sucking up the doctor's finger or a swab or bits of the baby's face so I'd then have to wrestle the suction thingy free before somebody went missing.  It was great fun, certainly a change from the rest of the day with the visiting surgeon where my contribution began and ended with me being asked to fish his glasses out of his top pocket and stick them on his face because he'd scrubbed, gowned and gloved before remembering where they were.  And the only reason he asked me was because I'm tallish and so I was able to get my hand down the front of his gown.  Who'd have thought that was a skill that would come in handy in my professional life?

Words of wisdom

Which reminds me to pass on the excellent advice given to me recently by a general physician:

"Never go drinking with a painter.  The solvents in their paint induce their liver enzymes so they'll still be going strong when you're flat on your back and half unconscious."

About

Okay, three posts in one day.  I am officially procrastinating now.  But I wanted to draw your attention to something important.  Previously a reader expressed a desire for a statement of my vision.  I couldn't come up with anything for a long time but today something crystallized and I was able to summarize in a few short pithy sentences what this blog is all about.  It's now immortalized as an "About this blog" page.  Read it today.  Or even tomorrow.  But not yesterday, oh no my friend.  That wouldn't be playing by the rules.

Battle lines

Cry havoc and let slip the tubas of war!

It's been a long time since I reported from the front line in the War On Innumeracy.  But last Friday we had a marathon 7 hours straight of respiratory medicine from a Distinguished Physician, so of course after the first 3 hours my brain filled up and went to the happy place where all it does is trawl through my life looking for bloggable material. 

I was snapped back to reality when the Distinguished Physician said, "The terrible thing about asbestos and smoking in terms of your lung cancer risk is that they amplify each others' effects, making them synergistic.  For example, if asbestos made your risk ten times higher and smoking made your risk six times higher, then smoking and asbestos together make your risk sixty times higher."

Well, sorry to break it to you Dr Smart-Guy, but what you just described would mean that smoking and asbestos are independent risks rather than synergistic ones.  Did I stand up and blaze away at him with the Holy Machine-Gun Of Mathematics?  No, I kept my mouth shut, for two reasons:

1. In the War On Innumeracy I'm deep undercover.  So deep that sometimes I'm unsure if I'm fighting for the right side any more.
2. He's probably going to be marking us in the OSCE at the end of the year and the last thing I need is for him to write me off as that smart-arsed bastard who corrected his arithmetic the moment I walk through the door.

Still, I expect more of you, Gentle Reader.  If someone abuses mathematical jargon in your presence today, let them have it with both metaphorical barrels!

Insomnia

Every now and then I have trouble getting to sleep.  Usually it's because I slept in really really late that day so I was only actually awake for 12 hours or so before going to bed again.  Sometimes it's because my mind is racing with something interesting or challenging or upsetting or disturbing that happened during the day.  And sometimes it's because the Secret Cat is stomping all over my face trying to make herself comfortable.  Regardless of aetiology, it's annoying.

So I've developed a great method for focusing my consciousness and getting myself off to sleep.  It seems to work well, for me at least.  If you have insomnia why not try it and let me know if it works for you?  Here's how it works:

1.  Visualize a sphere floating in front of you, about the size of a tennis ball at arm's length.  The ball is smooth and matte and shining against a dark background.
2. Now change the colour of the sphere from however it first started.  The colour you want depends on your current emotional state.  If you are angry, make it red.  If you are agitated, make it purple.  If you are sad, make it blue.  If you are happy, make it green.  And so on.  The colour doesn't really matter, the point of it is to identify your current emotional state and make the sphere an appropriate (for you) associated colour.
3. Just focus on the sphere now it is that colour.  It will probably try to change to a different colour or maybe even a different shape but just gently nudge it back to what it should be.
4. Now, visualize the sphere gradually changing colour to a pale silvery grey, over the course of several seconds.  Hold it there.  Feel your mind relax.
5. Repeat the previous steps in order about ten thousand times until either you're asleep or the goddamn sun comes up and it's time to get out of bed.

 If I get a positive response to this maybe I'll record some CDs of the instructions and sell them in hippy shops.

Doctor Who?

Once again I find myself surprised by the results of one of my polls!  I really expected that there would be heaps of votes for Tom Baker and maybe Peter Davison, since they were the reigning Doctors of my youth and that otherwise there'd be a little spike for Christopher Eccleston, who brought some much needed credibility back during his short time on the throne.  But no...

The most popular Doctor is Jon Pertwee!  To my mind, that means there's a bloc of readers slightly older than me who watched the good Mr Pertwee as the Doctor before their memory of him would be forever blighted by his portrayal of Worzel Gummidge, the scarecrow who comes to life in a Calvin-&-Hobbes-esque fashion.  Whereas I was young enough to only catch Pertwee's Doctor in repeats and so he'd lost street cred with me already.  Having said that, one of the most genuinely scary Dr Who stories ever was, for me, Planet Of The Spiders, with Jon Pertwee as the Doctor.  Tellingly though, it was his last, with the irrepressible Tom Baker taking over after this.

I don't know what to make of the people who voted for Colin Baker, Sylvester McCoy or Paul McGann.  I stopped watching during that time so when I did see these actors they just looked like twits in silly costumes.  Eccleston was where the Doctor first started to creep back into my consciousness, as his role coincided in my my mind with him getting a fair bit of critical attention for some of his other more dramatic roles.  Perhaps that was why he was so short-lived.  And perhaps people felt that he didn't stick with it long enough to be credited with their vote.  Pure speculation of course, but it is interesting to see how fast actors move on from the role these days compared to the Golden Age of Tom Baker who hung around for seven years.

As for David Tennant, the putative second-best Doctor ever, I just don't know.  I still don't watch the show so I have no opinion at all on either him or the losers readers who voted for him.  Perhaps he has great virtues, chief among them being that he doesn't have a head shaped like a besser block like the current Doctor does.  Perhaps he got the votes purely for ushering in a new Silver Age of Doctor Who.

Do any of my Gentle Readers care to illuminate me as to why they voted the way they did?

p.s. New poll up.  Vote now or I'll make an ill-defined threat.