Young people

My Smaller Half and I went to a food and wine festival this afternoon.  I like these types of things because they give me a great pretext for strolling around eating lots of different types of meat in bread.  Today I ate a duck sausage in a baguette, a steak in a bun, and a chorizo on a stick.  Okay, the stick wasn't bread, and nor was the iced coffee, the calamari or the mushroom pasta but I was forced to put the chorizo on a stick in the meat in bread category due to a new mathematical theory that I have discovered.  Put simply:

lots ≥ 3

Brilliant, eh?  I call it the theory of minimally bounded multitudes.  It will revolutionize warfare.

Anyway, I'd been walking around for a while feeling really uncomfortable, as if a million voices cried out at once and were suddenly silenced.  It was creepy.  And eventually I figured out that it was because we were surrounded by freaks.  Everything about them was freaky.  Their clothes.  Their hair.  Their body shapes.  The way they spoke.  The way they moved.  These freaks are called "young people".

The reason I was freaked out by these so-called "young people" is because I am constantly surrounded by old people.  In my clinic all the doctors are older than me.  98% of the patients are much older than me.  And in the last month I have embarked on exactly two (2) social activities, both of which were almost exclusively attended by old people: a concert by the ACO, and the Adelaide Writers' Festival.  I don't think I've seen a person born after the Korean War since last year.

Here are some of the characteristics of young people that I discovered today while observing them with fresh eyes:

• the males all have freakishly muscular arms, like my legs but not as hairy,
• the females are all freakishly tall, like endocrine time-bombs,
• they are all freakishly dressed, looking like clones of two-bit dumbo celebrities,
• they all wear freaky looking sunglasses that aren't from the Cancer Council like mine are,
• they all seem to have freakishly high levels of disposable income to spend on booze and bad clothes,
• they all look freakishly young despite clearly being old enough to drink,
• they travel in freakishly large gangs, unlike me and my Smaller Half,
• they all speak freakishly loudly and also they all speak at the same time,
• none of them have walking frames.

These pimped-out, pumped-up, packs of pampered princes and princesses just blew my mind.  Have things really changed that much since I threw my life in the bin less than three years ago to seclude myself in the stygian solitude of study?

Am I now ... OLD????

I'll let the unruly mob decide - vote now in the new poll on the right →

Spambots

Alas, due to morons posting spam links in the comments section of my blog, I will be moderating all blog comments from now on.  Rest assured that I won't be using my executive privilege for purpose other than killing spam. 

Standing opposite

Realizations can wash over you at strange times.  I recently sat in with a GP obstetrician* who was running a clinic for women who were 36 weeks pregnant or more.  And if you know as little about pregnancy as I do, that's pretty darn pregnant.  At least two-thirds of the women, in response to the doctor's first question asking them how they are doing, said "I'm pretty over it".

I found it an exciting afternoon because it was the first time I've been able to lay hands on some pregnant tummies and squoosh the baby around.  You do this to figure out which direction the baby is facing and whether it's head up or down, and how far down if it is down.  At first I felt like I was going to pop some of them tummies, they were so tight.  But I watched the GP and she was quite firm with her hands so I was too and she seemed to approve.  "Does this hurt?", I asked at one point.  "Yes!", she replied through gritted teeth, "but carry on".

We ended up running it like a contest.  I got to do all my measurements first and then we compared them to what the doctor got afterwards.  At first I was a bit all over the shop but by the end I was getting consistently quite close to her which was reassuring.

The realization that I had is that my sense of humour is often negative, challenging or provocative.  I don't know if it comes across that way here in the blog - I suspect it doesn't because mostly I am me-talking and hence it's more the self-deprecation that comes out.  Anyway, let me explain...

I was really enjoying the afternoon.  I was learning heaps, the doctor was really nice, and as I am a robot that has been genetically programmed to want to nurture pregnant women, I wanted them to feel relaxed and happy too.  In most circumstances I'll have a bit of a chat and a laugh with the patients.  But all the jokes I was thinking of were things that someone who is about to have a baby really doesn't want to hear.  Things about big heads or tummies popping or doctors being late and so forth.  Douglas Adams described this situation perfectly in The Meaning Of Liff with his definition for the word Wigan:

"If, when talking to someone you know has only one leg, you're trying to treat then perfectly casually and normally, but find to your horror that your conversion is liberally studded with references to (a) Long John Silver, (b) Hopalong Cassidy, (c) The Hokey Cokey, (d) 'putting your foot in it', (e) 'the last leg of the UEFA competition', you are said to have committed a wigan."

I concede that it is possible that my experience was a true wigan in that it was simply the perverse effect of my own sensitivity to the topic that produced it.  But I've been listening to myself for the last few days and I've noticed that most of my jokes involve either absurdly contradicting what someone is saying, mocking them through exaggeration, or other such contrariness.  As such, I believe that what I experienced was a false wigan and that it was simply me becoming aware for the first time of my own tendencies due to my sensible awareness of another person's sensitivity.

It kind of freaked me out at first and I started to wonder if perhaps I was in fact some kind of jerk and should start to take more of an interest in surgery.  I certainly have a bloated ego and a European car already so I think it's a road I could travel all too easily.  But then I re-examined my life as Socrates would urge and realized that I'm a clumsy geek who does chess puzzles and Scrabble online and realized that surgery is not for me - I'm such a nerd I'll probably be an immunologist.  Wa-hay!

* Fact of the day: the word "obstetric" actually means "midwife".  Use this information to irritate obstetricians.

Hemingway - a new hope

I've been alerted to the fact that, in a strange case of life imitating art (or to put it more accurately, life being vastly more astonishing than this shithouse blog - who'd have thought?), it seems that Ernest Hemingway's daughter Gloria was born Gregory and underwent gender reassignment surgery.  I'm not making this up - http://en.wikipedia.org/wiki/Gloria_Hemingway

I feel really awful now for making up stupid jokes about Hemingway which coincidentally touched on the life of a family who seem to have gone through a whole bunch of hard times.  As a result, I am cancelling my planned post about how Ernest's son Jack returned from the dead as a brain-eating zombie after being infected with zombie plague by Hemingway's zombie housekeeper, and how Hemingway not only covered up the ensuing carnage but also wrote a semi-autobiographical novel based on the incident called The Son Also Rises. 

For me to publish that now would seem tasteless and exploitative in the extreme.

Toughen down

Here's a good lesson: rather than just sticking a Band-Aid on the knee of the old bloke who's just taken a tumble down the steps and insists that his knee is fine apart from the scratch, why not actually examine his knee?  That way you'll stop him trying to walk away on his knee and crashing to the ground again when his knee gives way from the soft tissue injury that caused him to fall down the first time.

I actually did do a cursory examination of his knee but failed because when I said, "Tell me if this hurts", he thought I was saying, "If this hurts you are a big sissy and I will laugh at you", so he denied any discomfort.  The second time I examined his knee I had to make him yelp before he would admit anything was wrong.

State of the anion

I won't deny that I've been feeling pretty negative recently.  But I think things are starting to turn around thanks to a week of chatting to my Smaller Half about it and some deep thought.

The first Breakthrough Revelation (tm) I had was that it's pointless to compare my own experiences with those of my classmates.  Other people in my year are in totally different environments ranging from major tertiary hospitals to tiny rural GP clinics.  Even my Esteemed Colleague in the same practice as me is already diverging from me in terms of her exposure to patients simply because of the vagaries of our timetables.  It's really good to hear what my Esteemed Colleagues at more remote sites are up to (for example here and here) because it all gets added into the big slush fund of life experience.  But it's foolish of me to worry that I'm not getting enough of this or that, or that my day to day routine might be organized differently.  This may be obvious to you.  But to me, in thr throes of trying to feel at home in a new environment, it's been something I've struggled with.

The second Breakthrough Revelation (tm) is that there's book work and there's hands work.  And they don't necessarily have much to do with each other.  And since I can do my book work anywhere where there's a book, I'm better off using my time in the clinic or hospital to do hands work.  Stuff like bunging in drips or ripping them out.  Taking histories.  Doing ECGs.  Wiping blood off the floor.  You don't need to be too smart to do it, but doing it means that I'm getting all up in the grille of the patients and the doctors, so they talk to me and I learn stuff and next time around they might even let me have a go myself.  Once more, obvious stuff, but I've always been a slow learner.

The third Breakthrough Revelation (tm) is that for once I have to be prepared to be a pest.  This year is the only third year I've got, so my usual reticence to be forward is out.  If they think I'm being a pain they can tell me.  Until then, I've got stuff to learn.  So step aside Mr Starchpants, I'm taking over.

The final Breakthrough Revelation (tm) is that I perform at my best when I've had a shitload of coffee.  Okay, so maybe my suturing gets a little shaky.  But my brain is running a million miles an hour and I'm already thinking six patients ahead so let's get this show on the road! 

Bring it on!

Hemingway again

Another little known fact about Hemingway is that he wrote all of his novels longhand using a pencil clenched between his toes. 

The reason he wrote with his feet is that he was a double amputee.  He was very self-conscious of this.  Whenever he left his house he always wore prosthetic upper limbs jammed deep in his pockets so that he wouldn't have to shake hands with anybody.  His refusal to show his disability by taking notes with his feet during his career as a journalist served to develop his memory and ear for dialogue. Hemingway scholars credit this for the origin of his laconic style and direct delivery that would in his later years win him the Nobel Prize for literature.

He sustained the injury in a mortar attack during his time as an ambulance driver in the Great War that I mentioned in my previous post.  He was evacuated to a Red Cross hospital in Milan where doctors were obliged to perform the amputations to prevent gangrene.  Although Hemingway knew that the surgery had saved his life, he remained bitter about it for the rest of his days.  His trials and tribulations in the war and his subsequent experiences in hospital were later to serve as fodder for his novel, A Farewell To Arms.

Hemingway

It's a little-known fact that Ernest Hemingway began his life as a woman.  Born as Edith Mary Hemingway, she struggled to accept her gender as she always identified as a man.  Upon her return from nursing work on the Italian front in World War I, she began living as a man and styling herself Ernest, affecting a range of overtly macho behaviours, perhaps to distract from her feminine looks.  It was in Spain as a correspondent covering the civil war that Hemingway finally obtained the gender reassignment surgery that she craved.  This experience formed the basis of her semi-autobiographical novel, For Womb The Bell Tolls.

Lost those flat cake blues

Had a great great great great tutorial today from a GP obstetrician with an infectious case of enthusiasm.  I've been pretty down on obs until now, for a pretty pathetic reason.  I've been getting really irked at people who are enthusiastic about obstetrics because they tend to behave like Star Trek fanboyz. 

"Oooh, the placenta is so beautiful!" - that kind of thing.  It shouldn't bother me, but it does.  It's something to do with my total ignorance of obstetrics and those people's patronizing and holier-than-thou attitude towards people like me who are totally ignorant of obstetrics.

All it took today was a teacher who was willing to explain things in simple terms and be encouraging and be understanding of my inability to convert weeks into months or to remember anything to do with fetal development.  When she pushed that plastic doll through that rubber pelvis I had little tears of joy in my eyes!

Oh, and I figured something out which has been confusing me for a while.  Placenta praevia is when the placenta obstructs the uterine outlet.  Placenta primavera is when the placenta is served with brightly coloured fresh spring vegetables.  No wonder I've been getting funny looks in the hospital.

The Girl With The Dragon Tattoo

Just finished reading The Girl With The Dragon Tattoo by Stieg Larsson.  It was a Swedish bestseller followed by two sequels, then the author dropped dead just before all three became world-wide bestsellers in English.  So I feel kind of bad saying what I'm about to say.

I think this book sucks.  I think it's sleazy and exploitative.  It presents itself as speaking out on behalf of women who are the subject of violence and abuse, while simultaneously gleefully presenting gruesome details of how these (fictional) women were raped, mutilated and murdered, presumably in order to advance the plot but in my opinion being present for nothing but titillation.

The main male character seems to be some kind of fantasy alter-ego of the author.  He's a brilliant investigative journalist who manages to sleep with all the major female characters thanks to their convenient habit of finding him irresistible and flinging themselves at him.  The main female character seems to be some kind of adolescent wet-dream.  She's a brilliant computer hacker who has a sketchily-depicted case of Asperger's that allows the author to skip over all the gooshy emotional stuff and jump straight into the sack or whatever other action scene is desirable.  Oh, and she rides a motorbike and has heaps of tatts and piercings.  Rad.

By the way, if you're in the midst of writing a novel just for me - I don't consider that computers have much of a role to play in interesting storytelling.  "She then downloaded a special program that let her crack the bad guy's passwords and find out all the secret stuff that she needed to know."  Wow.  I wish I'd thought of that little plot twist.

As you can tell, I feel let down and disappointed.  I expected this book to be something that it's not.  Maybe I'm judging it too harshly because of that.  But if you haven't read it, I wouldn't bust a gut trying.  Having said that, its a world-wide bestseller and has gotten rave reviews.  Maybe rape and mutilation is more popular than I think.

Milkgate

This is an outrage!  I had to buy a carton of milk today at the clinic because there was none in the fridge.  And since the nearest shop was a bakery, I had to pay bakery prices.  So I'm $1.80 out of pocket.  Admittedly I have drunk nine thousand dollars worth of free coffee already this year, but I think that's my right - nay, my responsibility to myself and my patients.

I'm going to get Barnaby Joyce onto the case.  Sigh - Barnaby... is there nothing he can't do?

Penny

If I had a penny for every visit to this blog I'd have fifty-one dollars and sixty-three cents.

Dining out

My basic rule in restaurants is to never order something I could make for myself at home.  Not that you see Fried Spam On Rice all that often in restaurants, but it's the principle of the thing rather than the whatever, if you know what I mean.  This means that I tend to be lured into ordering dishes that I don't fully comprehend because I don't know what some of the key ingredients are, or perhaps the method of cooking is alien to me.

We went out to our Chinese New Year slash Valentines slash Birthday dinner tonight and I came sooooo close to ordering something I didn't particularly like the sound of, simply because it came with something called "labna and ponzu".  Call me ignorant, but they didn't have much labna and ponzu on the streets of Struggletown where I grew up.  Can anyone tell me what they are without using a search engine?  I could be wrong, but perhaps they are the main characters in a novel by Michael Chabon.  In which case I should have ordered that dish after all.

I ended up getting a curried snapper and fried oysters on babaganoush, which was deluxe.  My Smaller Half had zucchini flowers and smoked duck, which was also deluxe, even though the zucchini flowers mystically transmogrified into mushrooms by the time they arrived at the table.  Such are the perils of gourmet dining!

Chinese New Year

"I wish we weren't married", I said to my Smaller Half this afternoon.  She was pretty surprised and asked what I was talking about.  I explained that since tomorrow was Valentine's Day, her birthday, and Chinese New Year all wrapped up in one, just imagine how exciting it would have been if I proposed as well!  We agreed that I should have thought of that five years ago and checked ahead on the calendar to arrange it.

Hope you all have a great Chinese New Year.  I hope that your Chinese Christmas was good too.

Sleep

How interesting to see the results of the last poll I put up, concerning how much sleep you get on a typical night.  Responses were very evenly spread between the low of less than five hours and the high of more than eight hours.  I usually get just over six, which you probably could have deduced from the way it was bang in the middle of the responses I offered you in the poll.

People who can get by on less than five hours amaze me.  If I did that I'd be a shambling wreck.  Missing sleep makes me very tired and irritable, which does worry me a bit when I think forward to the first few years of my postgrad training when I'll be very busy and tired most of the time.  Try not to get sick for a few years after January 2012, that's my advice.  Apparently Napoleon and Kevin Rudd both get/got by on very little sleep.  Both of them are raving lunatics of course, but I suppose that's the price you pay for being the greatest leader of your era.  Kim Jong-Il probably stays up watching Rage on the weekend too.  Just imagine if they got him on as a guest programmer.

It's probably a common fantasy to imagine how great life would be if you didn't need to sleep.  You'd have plenty of time to get all of that stuff done that you somehow don't ever quite get around to in your regular waking hours.  If I could stay up all night all the time I'd learn to play the banjo.  Although I'd probably need a soundproof room to practise in unless my Smaller Half was also awake all night.  Actually I'd probably need a soundproof room regardless.  I would also write a book about some amazing thing or other (I'd have plenty of time for ideas, okay?), become a master potter, practise touching my toes a lot, and crouch on the roof of my house in the dark so I could ambush those damn possums and fling them over the fence to teach them a lesson.  But as I say, those are common fantasies.

But not sleeping would be a shame because you'd miss the best bit - the hypnagogic state between wake and sleep when your brain goes on autopilot and strange things happen.  I was reading on wikipedia about August Kekulé’s discovery of the structure of benzene (you know the story - he imagined a snake biting its own tail blah blah blah).  I figured that sounded like an easy way to make incredible discoveries and become famous so I tried it myself.  And it worked!  As I dropped off to sleep I could see in front of me a strange and fantastic image: a snake biting its own tail.  And I thought to myself, "That must be what benzene is like."  So I'm the second person to discover the structure of benzene.  I'm the Buzz Aldrin of benzene.

Try it yourself tonight.  It's so easy.

ACO

We went to see the Australian Chamber Orchestra play on Tuesday night.  It was awesome.  You may think that the ACO is the kind of thing you'd do if you were a member of the snooty left elite.  Well, you're right.  I like the ACO because clearly I am better than you and I'm not afraid to let you know.

Not that I know much about classical music.  For example, one of the pieces played was a quartet by Grieg.  The only Grieg I knew was Tony Grieg and I'm pretty sure he hasn't written any string quartets.  But this piece of music went off!  If you've ever seen the film Amadeus, you may recall the music of the title credits which is I believe some kind of symphony by Mozart - the details escape me right now.  The point is, it's urgent and rushy and very NOW-ish, and even if you know two-fifths of bugger-all about music it will grab you by the throat.  This Grieg piece was like that.  It really made you sit up and take notice.

One of the best bits of live concerts is that you get to watch the players perform.  I'm a very visual person (hardly transparent at all!) so I enjoy that part of it.  I like to watch Richard Tognetti's nostrils flare when he reaches a slow lilting phrase, as if he's sniffing a glass of fine wine.  I like the way his knees bend when he powers into a big crescendo.  One of the viola players looked like she was performing at gunpoint.  Her eyes were wide open and she looked really alarmed and her mouth was stuck in a perpetual grimace of fear.  And Maxime Bibeau, the bass player, kept his forehead in a worried frown and kept casting his eyes out over the audience as if he was looking for his lost cat.

I like to watch just one finger on a musician's hand for a few minutes, watch it work furiously on the strings and then hang idle in mid-air.  The contrast between the random twitchings and jerkings of a single finger and the intensity of the composite sound from the whole orchestra that washes over you is ... well, it's quite something.

After the semi-mandatory triple curtain-call, we strolled back to the car for the long drive home.  We turned on the radio and lo and behold - the Grieg quartet was playing! The concert was being broadcast on ABC Classic FM with a half-hour delay (at least in Adelaide it was delayed - like the people - ha ha!) so we had the strange experience of listening to ourselves applaud on radio.  If only I'd thought to scream out my URL I might have got a whole lot of new readers!

Bloody hairdressers

It's me again!  Yes, my study is going well thanks.

What is it with me and hairdressers? Just got my hair cut - you know how the first thing they do is to kind of swish their fingers through your hair, just like a golfer sizing up the turf on the green?  (There's a Tiger Woods joke lurking in there but it's probably pretty unsavoury...)

This hairdresser swishes her fingers through my hair and says, "Oh yes, you've got a common problem, don't worry about it".  I won't.  Thanks.  But if I did should I worry about:

• baldness?
• greyness?
• dandruff?
• lice?
• filthy hair?
• a bad haircut?

Good thing I'm not worried about my hair.  I'm more worried about my liver.  She cut herself with the straight razor while shaving my neck and then couldn't find a band-aid so she just clutched a paper towel in her hand and dabbed at her wound in between strokes of the blade.  Hopefully I didn't catch hepatitis C.  I did notice a shark lunging at me as I left the store but it was hit by lightning and killed.

Stay on the beach

Seeing as I'm having a self-appointed "study day", this is my second post today.  If you eat your vegetables, there could be more.

I'm looking through some notes I jotted down from a mad haematologist and saw something interesting in his comments about HIV and blood transfusions.  Apparently every single blood donation in Australia is subjected to a reverse-transcription polymerase chain reaction test to check if there are any fragments of HIV in it.  They do this because the regular serum antibody tests used to diagnose HIV in patients take some weeks/months to become positive after exposure.

The cost to do this is $600 million every year.  The benefit is that over a 10 year period it is estimated that there is a 50% chance that one person will be prevented from contracting HIV from a blood transfusion.  So that works out at $12 billion (that's "million" with a "b") per life, right?

That's pretty extraordinary.

I recognize that there are hefty political and psychological factors involved, especially given the problems with HIV and blood products in the past, which lead to public hysteria, vilification of gays, and the virtually assured infection with HIV of the poor old haemophiliacs.  But $12 billion per life really does seem a little excessive to me.  Worldwide charity donations after the 2004 tsunami was about $7 billion.  The tsunami killed over 200,000 people.  So that's about $30,000 per life.  Think about it, think think about it.

Anyway, the mad haematologist's assessment of the risk of contracting HIV from a blood transfusion was that it was about as likely as being torn apart by a shark while being struck by lightning.  So presumably if you stay out of the ocean you're even less likely to be eaten by a shark.  Or catch HIV.  Think about it.

Once I had a secret blog

When I first started writing this blog, it was a secret.  Not a secret because I was ashamed of it.  I just didn't want to tell people I was writing a blog and then crash and burn after 3 posts by giving up.  There's heaps of blogwrecks out there, they seem to get along okay for a week or a month, then they quietly die.  It's very sad.  They seem so forlorn, like old dusty toys on a shelf.

Once I'd been going for a month or so I told my family and some close friends.  For a while they were my only readers.  Then I put a link to it on my Facebook page.  That drew in a few more people, including some of my Esteemed Colleagues, and I believe there has been some word of mouth spread amongst them because from time to time someone I haven't ever spoken to about it asks me a question or makes a comment about something I've written here.

Each time I discover that someone else I know has read it or is reading it I go through a period of intense self-consciousness where I find myself trying to figure out how to write more of the stuff that I've already written because that must be what they want. Each time I have to re-learn that that's a bad idea.

I've only specifically mentioned it to a very small number of people, because it seems to me an intrinsically awkward interaction.  It's a bit like those people who lend you books you don't really want to read but are then obligated to at least skim through because you know that they will try to discuss it with you in the future.

I know that one person came to this blog because I mentioned in a post that I'd never had any hits from Africa, so my Generous Older Sister teed up a friend of hers living in Africa to come pay a visit.  My itch was scratched but as far as I know she hasn't come back.

My sister told another one of her friends about this blog while I was standing right with them at a party.  He busted out his iPhone and googled "prone to revelry" because he'd mis-heard me when I named it.  I think "Prone To Revelry" is actually a pretty good name and if I'd thought of it when I was starting I'd have been tempted to use it if it wasn't so wholly inaccurate as a description of me.

Various other people must have stumbled here as a result of google searches, but again I have no idea if they still come back.  My google tracking stuff showed me that a month or so ago there was someone who came back every day or so for a week, each time by googling the word "ipsiband".  As far as I know, I am the only person in the world to ever use this word, so I'm not entirely sure why he or she was searching for it.

And then there are the people who read the various stupid comments that I spray across other people's blogs and look at my profile and come to see what my blog is about.  I think most of them must be disappointed at what they find - the majority of the blogs I read are very specialized, niche, super-geeky blogs which really are nothing like mine at all.  I suspect they come to see and leave again very quickly.

This post is starting to get rambly, pointless and self-centred (a bit like this blog) so I suspect it's time to end it.  Usually I do this by quickly re-reading it, fixing the obvious typos, being surprised at how far I've wandered from the initial premise, thinking up some clever backward reference that makes it look like it was planned that was all along, and then bunging in some kind of weird semi-abstract title.

My problem today is that I'm not even sure what my initial premise was.  It's entirely possible that this whole thing is just a huge procrastinatory exercise.

Story of my life, mate.

I'm not the only smart-arse out there

Patient

I was feeling terrible but when I went to the hospital they said that one of my tablets was poisoning me!

Doctor

Poisoning you? Oh, it was probably that strychnine I put you on.

Mr Ms

Can anybody think of a way to find out what gender somebody is while taking their medical history?  It came up the other day while an Esteemed Colleague and I were looking at some medical records and we couldn't see where the person's gender was recorded.  We thought about how awkward it would be to have to ask someone their gender (believe me, I've been there when someone was asked and it was very awkward) and so started wondering if there was a way you could figure it out indirectly.

It isn't always obvious from their name.  Some people have either gender-neutral names (eg Ricky Ponting) or are from an unfamiliar cultural context (eg: Ricky Lake).

There's obviously no point in asking questions concerning preferred sexual partner(s) since that's actually not helpful at all.

It's no use to ask gender-specific questions (eg: how's your prostate? when did you have your last period?) because if you guess wrong you'll look like an idiot which is what you're trying to avoid.

Perhaps you could measure their height and weight and then hand them a double-sided set of gender-specific growth charts and ask them to plot themselves while you do some writing on your blog.

Or perhaps you could take some blood to check their thyroid function (because everyone needs their thyroid checked, right?) and secretly order a karyotype to determine their XY/XX status.

Hmm.  Seems that I might be better off just asking them directly.  Any other ideas?

Eponymous slander

PTR

Hey you know how we were talking about Asperger's Syndrome the other day?

Smaller Half

Yes?

PTR

I was reading about Hans Asperger on Wikipedia and apparently there's some conjecture that he had Asperger's himself.

Smaller Half

Yes, I read that too.

PTR

So it made me think I should name a condition after myself.  It would present as a syndrome of dashing good looks, manly charm and sparkling wit.

Smaller Half

And total apathy.

PTR

Hey!

Sex, drugs and rock & roll

One of the things that has really been tripping me up so far this year has been my lack of knowledge of commonly used therapeutic drugs.  I have a basic knowledge of the drugs which affect major body systems.  For example, I know that drugs that end in "-prazole" such omeprazole, esomeprazole and macgroodleprazole are all proton pump inhibitors that you might use for people with bad reflux*.  But what I don't know are the forty-eight other drugs that basically do the same thing, nor do I know their brand names or the dosages.  So I've been spending a fair bit of time flipping through the Australian Medicines Handbook trying to figure out what the hell people are talking about.

It doesn't help my cause when I get drugs with superficially similar names confused with each other. Today I got dexamethasone mixed up with dexamphetamine, which turned out to be a great way to ask someone a bunch of really stupid questions.  You know when people say, "There are no stupid questions"?  They're lying.

The patient was an old guy on dexamethasone, which is a corticosteroid, to soothe his inflaméd liver. (See how I made it sound all mediæval there, by writing "inflaméd" instead of "inflamed"?  It's the little touches like that that keep readers coming back. And yes, I have just figured out how to use the Windows character map.  Why do you ask?)  Anyway, I thought he was on dexamphetamine, which is what kids with ADHD go on so that their parents can steal it from them, drive all night to Surfers Paradise and crash their hire-car into the ocean.  You can imagine the hilarious hi-jinks that ensued after my foolish mistake!

After that little episode, my GP pulled out a patient's drug chart listing about 20 different medication and told me to go through them and tell him what they were for.  Apart from having to have the brand names translated, it turns out I actually knew what most of the drugs do and how they do it.  My GP said, "Oh! Well, you actually know quite a lot!" in a very surprised tone.  I would have gotten narky but I was just as surprised.

Oh, and I'd better mention sex and rock & roll before I'm done.  There we go.

* But not aripiprazole, which is an antipsychotic, so there goes that whole theory.  Bugger.

3rd time lucky?

I got to intubate two people today while in theatre.  Or perhaps more accurately, I got to pass an endotracheal tube straight past the trachea and into the oesophagus.  Whoops!  Oh well, I'm sure I'll get better over time.

Followers

In addition to the fascinating stuff I wrote just now in the previous blob that you really mustn't miss out on, I just wanted to alert you to the fact that I now have four (4) fine followers.  I don't know what "followers" really are but Blogger allows me to count them, so I do.  Hooray for me and hooray for my followers.  You can see them listed halfway down those boxes of pointless crap you never look at on the right of the screen.

This time last year I only had one (1) so as you can see it's growing exponentially.  If this continues I expect this blog to become self aware and destroy humanity some time early next week.  It's been good knowing you.  Hasta la vista, baby.

Stick a pin in it

In general I am unafraid of giving stupid answers to questions that I don't know the real answers too.  This is good in that it stops me from getting stressed about being asked impromptu questions by people who know much more than me and I'd like to think that it fosters a certain creative problem-solving frame of mind.  Unfortunately it is bad in that it removes the "stick" component of the "carrot and stick" theory of learning, meaning that I often fall way behind in my work because I simply don't care that I look like an idiot.

This was made clear to me this week after a couple of days of consulting.  At first the GPs were asking me quite complex questions about how I would manage this or that and what the underlying homeostatic mechanism might be for some arcane thing.  But by the end of the day they'd be patiently explaining to me that babies are made when a man and woman love each very much and lie down together and have a special grown-up hug.  So at least I learned something.

A good example of the kind of stupid answer I give was when a patient showed us a large golf-ball-sized lump in an odd place.  I asked if I could touch it and I went "ooooh!" because it was all bouncy.  The GP seemed happy that it wasn't a big deal and sent him on his way.  After the patient left the room the GP asked me, "So what did you think of that lump?" and I said, "I had an overwhelming urge to stick a pin in it" and the GP said "..." and looked at me for a few seconds before laughing nervously.

I got the impression that he was wanting me to say something of medical value, but seriously, we got taught nothing about lumps, so the primal instinct that leads you to poke beached jellyfish with a long stick took over.  And I'll bet that the guy whose lump it was had been restraining himself for years from sticking a pin in it.  I reckon the only reason he showed it to us was that he was hoping that the GP would say, "Go home and stick a pin in it.  And if that doesn't work, try a bigger pin."

You know it makes sense.

Welcome to the real world

My GP supervisor asked me to go and talk to an elderly lady whose daughter had come in with her.  When I went in there was some confusion because they thought I was a doctor.  I was introducing myself to the elderly lady (who, for the sake of brevity, I will now refer to as "the old lady" or "the mother") and explaining what was going on when she said, "I CAN'T HEAR A WORD YOU'RE SAYING".  Sigh.

The daughter explained that her mum had been having some hearing troubles and also had some short term memory issues.  The old lady could read my lips a bit, but it seemed to me that she didn't really know what was going on.  Either that or she thought I was too youthful and handsome to be a doctor and thus must be some kind of confidence trickster.  Happens to me all the time.

The GP returned and we all became embroiled in a complex conversation with the GP trying to explain some ear-drops to the old lady, me asking the daughter questions about her mother's dementia, the daughter reassuring her mum that the doctor was going to fix her ears, the GP making incidental pedagogical remarks to me, the daughter thinking he was talking to her and getting confused by all the medical language he was using, and the mother shouting out from time to time, "I CAN'T HEAR YOU.  CAN I GO HOME NOW?"

I think I deserved a jelly bean from the lolly-jar after that session but nobody offered.  Perhaps I should have just said, "I CAN'T HEAR YOU.  CAN I GO HOME NOW?"

You're always a day away

Third year is great, but I'm having a few time management issues.  I sit all day consulting with my GP supervisor, which is usually interesting, sometimes bizarre, and always educational.  By the time I get home I'm pretty zonked from the mental effort of pretending to not have forgotten everything I learned for the past two years (hot tip: say "oh yeah, that's what I meant to say!" - it's incredibly convincing).

So I sit down with my Smaller Half and we compare our days, have a cup of tea, eat some banana bread, decide that the gym really isn't going to work for us today, eat some more banana bread, go for a walk to assuage the guilt, run into some friends, stand there chatting for a while, walk home, start to tee up dinner, read various blogs and news online, eat dinner, watch some West Wing on DVD, clear up from dinner, write some stuff on my own blog (you're reading it, Einstein), then all of a sudden it's time for bed where I am only making slow progress through my recreational reading.

And I haven't had time to do any of my PBL work, nor look up any of the four thousand things I wrote in my notebook during the day so I could look them up later on.

Tomorrow!

(Edit: I'm guessing that most of you have the same problem, given my recent poll in which 93% of you agreed that you have no idea what you're doing on a daily basis.)