Friday, April 30, 2010

Happy birthday Willie


Happy birthday Willie Nelson!  Seventy seven years old today.  I know that some of my readers don't care for you, but I guess that's balanced out by the fact that you don't care too much for them either.

Here are the lessons that I've learned from you Willie - lessons that have made me the man I am today:
  • It's okay to cry, and if you do, make it spectacular.
  • Sometimes it's best to just walk away.  But never forget.
  • Country people are better than city people.  And they carry more guns.
  • If someone disappoints you, they will probably continue to disappoint you, so maybe you should just shoot them and be done with it. 
  • But you can't hang a man for killing a woman that's trying to steal his horse.
  • It's best to leave reggae to the experts.

Thursday, April 29, 2010

Agony Aunt 2

Dear PTR,


I need your advice!  I'm a terrible procrastinator, so I often find myself with plenty of time on my hands while the urgent stuff piles up, looming over me like a reef break.  But since I took your previous advice and enrolled in a medical degree, I find that I don't have any friends, hobbies, nearby relatives or private interests.  Clearly I can't spend time actually studying - that would be preposterous.  So what can I do?

Ideally I'd like an activity where I can unleash my boundless creativity.  Something involving writing would be great, since nothing tangible is created so my procrastination will have nothing to sink its hooks into.  In the past people have laughed at things I've said, so it would be good if I could come up with a way of just spewing out all this garbage that comes into my head during the day without regard to social niceties.  Sure, maybe a few people will give me some kind of feedback, but wouldn't it be great if I had ultimate control over that too so I could simply remove any response that didn't stoke my flaming ego.

I am also very opinionated and like ranting and raving about things of which I am ignorant.  Considering alternate points of view is too hard, so some kind of way of expressing myself at great length in a pompous and pious tone would be nice.  Oh, and I am a deeply sensitive person, so from time to time I would like to show people a picture I have taken of a sunset or a cloud or a little baby duckling snuggling up to a tiger.  In fact, I would probably just steal the picture from some other website and publish it without attribution, but I'm still sensitive, right?

Perhaps I could also find some way of telling stories about the things I do which show how funny, clever, brave and self-deprecating I am.   It would also be nice if I could indulge myself by being ironic a lot.

Any suggestions?
(signed)
Idealistic in Adelaide


Dear Idealistic in Adelaide,

You should start a blog immediately.

Sincerely,
PTR

Wednesday, April 28, 2010

Agony Aunt

Dear PTR,


I desperately need your advice!  I'm bored with my current job and need help deciding what to do next. 


My current job is extremely boring and predictable - I want something with a little more excitement.  For example, I enjoy getting confusing and contradictory feedback on my performance depending on the whimsy and caprice of whoever happens to be in the room at the time.  In particular, I like being taught six different ways to do the same thing, with each new teacher emphasizing how terribly mistaken the previous teachers were.  I also like to be given ambiguous tasks in language which is easily misinterpreted.  When I fail to complete the task adequately because my telepathic powers failed that day and I was unable to read minds, I would like to be scolded for being timid or unreliable.


I don't have many friends, and I don't like the ones I do have, so it would be convenient it this new job could suck up as much time as possible and, if possible, destroy my social life by making my schedule irregular and unpredictable and by otherwise making me feel extremely guilty if I do attempt to enjoy myself.  In fact, the guilt thing is very important - my ideal career would be one in which success is difficult if not impossible to measure, thus leaving me a neurotic mess as I have no idea when enough is enough.  Needless to say, the added benefits of my new job being completely unpaid would add a certain je ne sais quoi.


In order to remind me that it's a job and not a hobby, it would also be good if many of the people in this new job were unpleasant, egotistical, arrogant, abrasive, selfish, or just plain mean.  Naturally, a majority of people will not be like this at all, but it would be nice if the awful people were SO awful that they SEEM like the majority.


Please let me know if you have any suggestions.
(signed)
Idealistic of Adelaide


Dear Idealistic of Adelaide,

You should enrol in a medical degree immediately.  Good luck!

Sincerely,
PTR

Tuesday, April 27, 2010

A proposal regarding nature

We should plant seeds in our hair, letting the foliage grow long and luscious with the onset of spring.  A hard cut-back in summer when the rains come would encourage denser growth.  In autumn our hair would turn a beautiful collage of auburn, russet, amber and claret.  The dry twigs would catch the snow in winter, insulating us beneath its muffled cushion.

The squirrels would nest in our hair, marry and have families.  They would forage for nuts and store them deep in our pockets.  We would be old men of the forest.

We would use our chests and legs to plow through the snow, the underbrush, the thickets, the woes, the heartaches, the rains, the mud, the tears.  No machines for us.  We'd feel the cold more but care less.  We'd bask in the sun and wash in the rain.

The squirrels, my friends.  Think of the squirrels.  The squirrels can save us.

Friday, April 23, 2010

The whirlybird cometh

Sitting here in my little student room at the clinic this afternoon, I realized that I could hear a helicopter, getting louder and louder and LOUDER.  "There must be a retrieval happening!", I thought, "And those buggers didn't even tell me!"   

Normally if someone is being retrieved by chopper back to the city they'll have been brought in first by ambulance, then they'd be stabilized here by the doctors while someone jumped on the phone back to the big hospital to give them the picture and arrange the retrieval, then the chopper has to start up and fly down here.  It'd be an hour at best I reckon before it arrives.  So I was a bit irked that in all the excitement nobody had bothered to let me know what was going on.  I hadn't even heard an ambulance turn up.

So I grabbed my stethoscope in case there's any stethoscoping to be done and strolled nonchalantly out the back of the clinic.  Strolling nonchalantly is a good way to make people think you know what you're doing, so I do it all the time.  Otherwise I'd be as giddy as a schoolgirl.  But out the back of the clinic there doesn't seem to be anything going on.  The same old guy is still lying there on the drip that I should have put into him but for some strange reason the duty doctor got very possessive of and did it himself before telling me that I probably could have done it, and he's certainly not needing retrieval.  But where were all the staff?

The back door was open and the helicopter noise was even louder, much louder than it usually is when the chopper lands.  It normally lands across the road on the football field.  Which must be exciting if there's a footy game going on.  Possibly a good way for the retrieval team to guarantee that they won't be going home empty handed - just generate some fresh trauma on the way in. 

I stepped out the back door and saw why the noise was so loud.  This was not a medical retrieval - there was a flippin' great big Navy helicopter hovering over the building next door.  Wow.  Those things are huge.  They might look small up in the sky, but they look large when they are hovering 10 meters above the ground, slowly coming down in a little children's playground with tall trees on each side and a hundred gawping villagers standing so close it looks like they're in danger of losing their wigs.

A couple of the doctors and nurses were standing out behind the clinic already, watching the chopper come down.  They looked like they wanted to go closer and watch, but obviously there were sick people who needed looking after in the clinic.  I, on the other hand, have no responsibilities at all, and furthermore I was now as giddy as a schoolgirl.  Helicopters are awesome.  We all wanted to be helicopter pilots when we were young, right?  Plus this one had a big open side door that you could probably shoot big guns out of.  Maybe like that minigun in Predator.  We all wanted to shoot big guns out of a helicopter when we were young, right?

So in the hope of seeing the helicopter suddenly and mercilessly machine-gun the growing crowd, I trotted off away from the clinic to get a closer view.  As I stopped to snap a few blurry photos on my phone, I realized that the doctors and nurses were coming too.  So much for the sick people, there's a helicopter!  Wheeee!

Perhaps fortunately, there was no machine-gunning, nor did any squads of special forces soldiers with handlebar moustachios and aviator sunglasses rappel out of it to the ground.  It seems that there is to be no bloody coup this week.  I'm assuming that it's down here for ANZAC Day on Sunday.  I hope not.  It doesn't seem right to commemorate the deaths and maimings of thousands of people by strutting around showing off your death-machines and maiming-guns.  I know that probably sounds hypocritical coming from someone who just two paragraphs ago was hoping that his townsfolk would be senselessly mass-murdered for his passing entertainment, but who ever said the interwebs was for stuff that makes sense?

Sigh - back to the books.

Thursday, April 22, 2010

Old school

I had a thoroughly enjoyable afternoon sitting in with a visiting specialist.  He's a geriatrician, meaning he deals with old folks.  So my eyebrows twitched when the second patient walked in and she was 22.  After that patient left I said to him, "If I may ask a stupid question, aren't you a geriatrician?", and he laughed at me and explained that he also works as a general physician, so he also gets to deal with all the "what the heck is going on here?" patients.

Anyway, the reason it was a lovely afternoon isn't because I learned a lot (I learned a little bit) but because he was a very chatty guy and we spent a long time talking between patients.  We talked about amateur radio equipment and licensing (he's an enthusiast, I'm an engineer), the cultural differences between "my" university hospital and "his" guys across town, I explained wargames to him, he talked about how much medicine has changed since he started back in the Paleolithic era when they didn't even know that you weren't supposed to eat rocks and so on. 

Despite our good chats, when he asked me, "So what textbooks do you use?", there was no way I was going to say, "Wikipedia", since up to that point we were getting on well.  So I quickly listed the names of some of the textbooks that I saw on the shelf that time I went into the library to see if there was a toilet in there (there isn't), and he seemed happy with that.  Fortunately it went on to a conversation about the different ways that you can use books and I was able to explain my pet theory that a book is useful either for learning from or as a reference text but never both, and he was gracious enough to agree with me.

He even tried to convince me to do my internship across town with the opposition.  I was expecting him to try to argue that the training is better, it's more rigorous, and all that competitive blather.  But his argument was that it's the biggest hospital so it's a great way to meet girls.  I assume he hadn't noticed the wedding ring on my finger, or else thought that someone as devastatingly handsome as me must be a caddish bounder and I thus require a steady stream of women to sate my flawed ego.  Because that's what people always think.

A few weeks back, a different doctor told me about how on his first day of med school he walked up to a big group of fellow students and introduced himself, and they told him to "fuck off" because he wasn't from their very special and privileged old school.  And today this nice geriatrician was telling me how 17 boys from his class got into medicine because they got such a great education at their very special and privileged old school.  Presumably he's mellowed since the Paleolithic era...

Wednesday, April 21, 2010

Crisis

First, let me say that I know perfectly well that the plural of "crisis" is "crises", pronounced "cry-seez".  But let's face it - you sound like a knob if you say that.  So I'm going to say "crisises", pronounced "cry-siss-ez".  Okay?  Just live with it.

Also, I know that the Chinese word for "crisis" consists of two characters - one represents "bear", while the other represents "being bitten in the face".  So there's no point posting a comment to that effect.  We've all done those management courses where you learn that kind of guff. 

If you look up the word crisis in a medical textbook, you'll find that there are lots of different types of crisises.  For example, there's the Addisonian crisis, where your adrenal glands just aren't doing their thing.  Or the oculogyric crisis, where your eyes roll uncontrollably whenever someone uses long Greek words that you don't know the meaning of.  Or the cholinergic crisis induced by nerve gas, where you poop your pants but can't do anything about it because you're lying dead on the floor.  Or even the carcinoid crisis which can cause a deficiency of tryptophan, an essential precursor of serotonin, which is best remedied by eating chocolate-coated corn chips.

But the one crisis you won't find, despite it being intimately familiar to all medical students, is the academic crisis.  The academic crisis can be triggered by a wide range of different stimuli yet the symptoms are always the same.  The sufferer will:
  • exhibit a prodromal attitude of apparent relaxation and whimsy in relation to their learning,
  • progress to a stern self-admonishment that "I will start tonight!", often accompanied by sincere promises to bewildered partners and friends,
  • become tense, agitated, and uncommunicative,
  • pace back and forth in front of their usual place of study yet be unable/unwilling to actually begin work,
  • acquire a fixed delusion that other medical students do not suffer these same crisises,
  • decide to "just start on topic X", then suddenly switch to topic Y, then topic Z etc, at an ever-accelerating rate,
  • conclude that they should try to learn everything at once and actually attempt to do so,
  • insist that "this time it's different", despite the fact that the same thing happened just last week,
  • eventually realize that they are learning nothing so they might as well do nothing, and settle in front of the TV with a big bowl of chocolate-coated corn chips.
The duration of the academic crisis is inversely related to its intensity.  Indeed, some sufferers endure an ongoing chronic nagging crisis for years at a time, characterized mainly by low-level guilt.  Truly serious cases can go for months without an attack, then suffer continual short crisises which are so intense that they are quickly followed by a cholinergic crisis, leaving them dead on the floor with poopy pants.

If you know a medical student and see them undergoing an academic crisis, your immediate priority is self-preservation.  Stand well clear in case they unexpectedly explode.  Under no circumstances should you attempt to minimize their distress.  What they are going through is part of the circle of life.  From time to time, the tree of medicine must be refreshed with the blood of students.

The only treatment for the crisis is group therapy.  Get a bunch of students together in a room with a cake and hope that one of them confesses to a recent attack.  This may take a while, as they have extraordinarily strong and deceptive ego defence mechanisms, but eventually someone will crack.  When they do, there will be a moment of solemn silence and then everyone else will sigh and say, "I thought I was the only one who did that".

It's not a cure, but it will stave off the next attack for a week or so.

Tuesday, April 20, 2010

This


This is what I'm saying.  This is what I'm typing.  This is what I was typing.  This is what I typed.  This is what you're reading.  This is what you're thinking.   This is a blog post.  This is my blog.  This is a website.  This is the internet.  This is the screen of your computer.  This is the screen of my computer.  This is a sentence.  This is a collection of letters.  This is a space.  This is English.  This no es el Español.  This is my big idea.  This is not a game.  This is a symbolic reference to the object of the current context.  This is Spinal Tap.  This is the way it's got to be.  This is the end.

Monday, April 19, 2010

Deaf cat

We noticed that our cat had been quite deaf recently.  Of course, cats will routinely ignore their owners/servants so it's fair to ask how we noticed.  The big thing was that when we made the "food noise", she did not even twitch.  I'm a bit embarrassed to admit that there is a food noise that we make for the cat, but since we inherited/stole her from some friends who instructed us to make the food noise when we were going to feed her, my excuse is that you can't teach an old cat new tricks so it's not our fault.

In my family, we always summonsed our cats by whistling the Gilbert and Sullivan song, "Titwillow", whilst dressed as Japanese courtiers.  If the cat was sufficiently amused, it would saunter over to see what you had to offer.  But here we were with a new old cat that only responded to a different food noise, a kind of nauseating kissy noise, that we morphed into a clicky, lipsmacky noise if only to save our own sanity.

(The cat also responded, by the way, to the noise of a vaccuum cleaner.  It would respond by running around the room like a motorcycle wall of death rider before flinging itself into a cupboard, whether the door was open or not.  But that's not what this story is about.)

Anyway, we'd noticed that the cat was going a little deaf.  Every time I go deaf it's because the top 3 inches of the Simpson Desert have found their way into my ear canal so I take myself off to the doctor to have them syringed.  Having your ears syringed is one of the great pleasures of life.  You go in deaf, tired, frustrated, hoarse from shouting and with a sore neck from looking around wondering if people are speaking to you or not.  You come out hearing the rustle of sparrows' feathers from blocks away, able to follow every voice in a party.  It's like being born again.

But let me tell you, that is nothing compared to the pleasure of syringing someone else's ears.  I really get into it.  Sometimes you're there for a while and you start to doubt whether anything will ever come out.  But then, oh my!  Out comes great clods of brain-earth, the muck and mud fills your bowl and you go back for more like a gold miner whose every swing of the pickaxe digs deeper into a glistening vein of ore.  It's magic.  Earlier this year before a life support and resuscitation tutorial the doctors asked if we'd done anything exciting yet at our practices.  Other people had delivered babies, amputated limbs, surgically constructed monstrous creatures out of man and beast, but I stood proudly and announced that I'd syringed a lot of ears.  The doctor looked at me like I was feebleminded.  And perhaps I was.

So because the cat was deaf it occurred to me that she might have her ears all full of wax.  I'd have tried syringing them myself, but ever since I required months of painful rehab to recover from the wounds she gave me when I tried to make her take a tablet, I've been averse to performing medical procedures on my cat.  I did get out my tuning fork and attempt to diagnose conductive or sensorineural hearing loss (as explained in a previous post) but my cat was being obdurate and refused to cooperate.  So we took her to the vet, thinking that we'd prefer to look stupid than sentence our cat to a lifetime of trivially-cured deafness.  Which of course meant that we ended up looking stupid.

The first thing the vet did was to clap her hands and stamp her feet like a flamenco dancer and tell us that the cat could hear after all, on the grounds that it looked terrified and was trying to flee.  As were we.  It was a small room, and quite echoey in the manner of clinical rooms, and those hand claps were painfully loud.  She must have seen the fear in our eyes and mistaken it for the dull stupor of the insanely rich, because she began offering us all sorts of very expensive options for investigating our deaf cat that she had just told us could hear.

For example, to rule out the slim possibility that the cat's middle ear was being obstructed by a slow-growing tumour, we could fly our cat to Sydney and have an MRI done for only a thousand dollars.  So we passed on that since, as she had already pointed out, the cat could hear, and for a thousand dollars I could buy probably a billion grains of rice.  Regarding the cat's kidneys, which are slowly deteriorating, as things do when you're the equivalent of 126 years old, we were able to escape with urine and blood tests (of the cat).

Urine tests are less invasive for the cat, although there is a fair amount of squeezing involved.  But the advantage of getting the blood tests done as well is that they have to shave a little patch of fur off the cat's neck to get access to the vein.  When you scratch this little spot a few days later, it must feel pretty funny, because the cat's back leg involuntarily comes up and starts to kick, as if the cat were no more than a stupid dog.  Great stuff.

The other great thing about getting the tests done is that when the vet calls later on and gives you a generic answer like, "Her kidneys are slowly deteriorating", you can say, "Oh, so the urea and creatinine were up from last time?  Was there any proteinuria?", and the vet knows that what you're really saying is, "I know your game and you can't lure me into your silly expensive tests and treatments, so there!", and you can hang up the phone afterwards with great relish, knowing that you won this round.

Hopefully the cat doesn't have one of these tumours in its ear or I'm going to feel really guilty.

Friday, April 16, 2010

Dangermouse

I spent the day with a psychiatrist yesterday.  It was great.  I enjoy psychiatry a lot.  I don't really enjoy psych consults with GPs very much since they typically run like this: "Still feeling okay?", "Not so great", "Okay, try taking the tablets 3 times per day instead of twice and come back in a month", "Okay, see you then".  Not very inspiring stuff.

Psychiatrists get to spend longer with their patients because, presumably, the patients have a more serious need of them.  Its the conversations in these long consults that I like, when the patient isn't just trying to avoid getting pushed out the door.

But the most exciting bit about yesterday was that there was a mouse loose in the consulting room.  Halfway through one of the appointments, I noticed that the mental health nurse was twitching her foot in a funny way and staring at the floor.  I thought I might have to ask her switch seats with the patient, but it turns out she had spotted the mouse right by the patient's chair and was trying to persuade it to go back behind the desk without alerting anyone by doing this little minimalistic haka.  It didn't work.  The mouse came charging out right through us all, heading for the door.

The patient screamed.  We all jumped.  The mouse realized it was trapped because the door was shut.  I leaped up, announcing that I could catch it because I was from the country.  (I get that from my mother - the belief that any eccentric behaviour will be tolerated if you loudly announce that you're from the country.)  Of course, I failed to catch the mouse but succeeded in making myself look like an idiot.  The mouse ran back bahind the desk and vanished.  We all had a laugh and carried on.

The mouse made two other appearances in the afternoon.  The first time it bolted for the open door, running over the psychiatrist's shoe to get there, and then disappeared down the hall towards the lunch room.  About an hour later, once it had had some lunch I suppose, it sprinted back into our room and ran between my feet, under my chair and back behind the desk.  The patient we had then really jumped but the psychiatrist and I were quite relaxed about it by that stage, and laughed it off with an insouciant wave of our hands, as if it happens all the time. 

I noticed that each time after the mouse appeared, the patient was more relaxed and open with the psychiatrist.  There were more fearful glances over their shoulder towards where the mouse was seen last, of course, but it didn't seem to inhibit the consult.  Perhaps they had the right idea in the olden days by sending people out to asylums in the country where they could reconnect with nature.  Yes, most if not all of the therapies were a bit inappropriate and ineffective, not to mention downright dangerous or harmful.  But I think the prescription of a mouse to chase around the house might be just the thing to really pep people up and give them the change they've been looking for.  Who'd like to be a co-author?

Thursday, April 15, 2010

Awesomeness knocks

No time to post properly, but check out this comment someone left recently.  It's epic!  As I noted in my response, I can't figure out if it is a madman raving incoherently, or a mathematician ... errr, raving incoherently.

And they spelled Kolmogorov wrong, but let he who is without sin cast the first stone.

Tuesday, April 13, 2010

Love your neighbour?


The local paper's front page last week just about blew my mind.  Most of the story was of the "regrettable but unsurprising" variety, but the twist at the end was a real kicker.  Here's how it went:
  • Local church (major denomination) got a new minister last year.
  • Unspecified rumours started to circulate regarding new minister and his private life.
  • Minister decides that unsubstantiated rumours are bad and declares to church council that he is gay.
  • Church council holds vote on whether to sack him or not.
  • Church has two local districts.  One votes overwhelmingly to dismiss him, the other votes overwhelmingly to retain him.  Overall vote is to dismiss, minister is sacked.
  • People from the district that voted to dismiss him speak to (ex-)minister saying that they had been advised to vote against him by council members.
    Now this is all kind of standard church politics, right?  I don't think it's fair or moral or in the spirit of Christianity but since, for some bizarre reason, churches are exempt from anti-discrimination laws, that's kind of the end of the story.  Except...
    • The head of the church council (the one that told people to vote the minister out, remember?) tells the newspaper that he has no problem with the two church districts having voted so differently, since "we value diversity".
      Riiiiight....

      Monday, April 12, 2010

      Undead bluegrass

      On a last-minute impulse, prompted by a Facebook link posted by one of my Esteemed Colleagues, my Smaller Half and I went to see Béla Fleck play on Friday night.  The first half of the concert was him playing solo banjo.  The second half was him playing banjo with the songbird of Mali, Oumou Sangaré, and the rest of her band.  Unfortunately the mixing levels weren't so great for the second half, but the first half was spellbinding.  He played several pieces which were built on Ugandan folk songs, a Beatles medley which was much better than you'd expect from that description, several pieces which were almost wilfully dissonant, and a few more traditional bluegrass-style rushes.

      After the concert I lined up to talk to him and get him to sign some CDs.  As our turn arrived and we stepped up to greet him, two older folks barged in from left field and started talking to him.  At first I was outraged but then as I listened I became fascinated.  They weren't speaking English, they were speaking the native language of Hungary, which is called Draculan.  They said, "Zhebrov ghubrashnji mirro mirro mirro mirro zhabrajov muahaha haha haaahhh" and flung their red silk capes dramatically around their shoulders while the lightning flashed through the windows and the bats darted around us

      Béla listened to them patiently, smiled, and said, "Oh I'm sorry, I'm not Hungarian."

      The Hungarians looked surprised and asked him where his name Béla came from.  He explained that he was named after Béla Bartók, the composer.  The Hungarians looked disappointed and moved away.

      It made me wonder whether being named after a famous composer was part of what made him become a musician.  I can imagine that it was partly having parents who loved music enough to name him after a composer and partly the constant reminder of having to "explain" your name to people that meant that music became part of his identity.

      I wonder how things would have worked out if his parents had told him that he'd been named after Béla Lugosi, the iconic movie representation of Dracula.  Perhaps he would have grown up to become an actor.  Or a wampyre.  I think this idea should be explored further with a randomised trial of nominative determinism.  We should allocate unusual given names to randomly selected pairs of parents and instruct each pair to give a different explanation of who the child was named after, and track the children over time to see if they follow their respective namesakes.

      Any volunteers?

      Friday, April 9, 2010

      Unimpressed

      Patient
      I've had lots of PEs.  There are three types.  The first type, you get it and it goes away eventually and that's fine.  The second type, you end up in hospital.  The third type, you're dead.

      PTR
      So yours have mostly been the first two types then?
      Some people laugh at this kind of remark.  But usually not the person who is having the actual problem.  The sooner I learn to moderate my sense of humour, the better.

      Thursday, April 8, 2010

      Amongst our pharmacotherapies are such diverse elements as...

      Last week I was consulting with a GP and it wasn't going well.  Every time she asked me a question I was unable to answer.  It's not that I was physically unable to speak - it's more that although I knew that I had at some previous time learned the relevant information, I wasn't able to extract it from the swampy morass that is my memory.

      After the fourth or fifth time that I showed almost complete ignorance of the names, effects, side-effects, indications, contradications or dosages of a range of remarkably common drugs, she decided to offer me advice.  The conversation between me and the GP, who I will refer to as Dr Ximénez for reasons that should soon become apparent, ran as follows:

      Dr Ximénez 
      What you should do is just choose one particular drug from each major class of drugs and make sure you know that one back to front. That will make it much simpler, rather than trying to learn everything at once. For example, instead of trying to learn about lots of statins, just learn about simvastatin.

      PTR
      I see, that's a great suggestion. Thanks very much!

      Dr Ximénez
      Oh, and you should probably learn about atorvastatin as well, since that's quite popular and has additional benefits on triglycerides.

      PTR
      Right, so simvastatin and atorvastatin only.

      Dr Ximénez
      And Crestor too, you'd better learn about Crestor.

      PTR
      Okay, Crestor too.

      Dr Ximénez
      Ezetrol is also a good one to know something about.

      PTR
      [quietly weeps]

      Wednesday, April 7, 2010

      Learnings from the arse-paddle of Father Time

      Here are some things I figured out recently.  Again.  Sigh...
      • Just because someone has authority over me doesn't mean they have power over me.
      • I am, for the most part, a reasonable person.  So if I think someone is a jerk, it's probably them rather than me.
      • But not necessarily.
      • It's not my responsibility to keep other people happy.  It's my responsibility to act responsibly.  They can decide for themselves how to react.

      Tuesday, April 6, 2010

      Purchasing power

      My Smaller Half and I went away for the long long weekend.  It was great to have a complete change of scene and forget all the stress and tension that has been building up for the last few weeks.  The night before we left I boldly announced to my Smaller Half that I wasn't allowed to buy any stupid random stuff, as I am prone to do in times of holiday.  I've been feeling the pinch with money and decided that spending it on things I don't need is a bad idea.  As a result I only spent money on absolute necessities such second-hand cowboy boots, a vintage blue velvet jacket, and a pre-loved copy of Art Spiegelman's In The Shadow Of No Towers.

      The cowboy boots are sweet.  They are Redwings, not too old, in dark brown, with a feathered pattern up the side and a mottled embossed pointy toe.  I'll sling up a photo in the next couple of days.  You'll be so impressed.  I wore them out on the town on Saturday night and I could feel the change.  I was certainly not easy to love, and even harder to hold.  And it's true that I'd rather give you a song than diamonds or gold.  My preference for smoky old poolrooms and clear mountain mornings was marked, as was my liking for little warm puppies and children and girls of the night. 

      The blue velvet jacket was almost accidental.  I'd been trying on an old orange velvet jacket but it wasn't working out for me.  The colour was deluxe but it was too roomy in the body and I didn't like the dual flaps up the back (a.k.a. "fart flaps").  But then my Smaller Half noticed that there was a very dark blue one hanging next to it.  I tried it on and it fitted perfectly, so I snapped it up and wore it around for the rest of the day.  Now that I have it I think I'll be able to wear it a lot, especially to those Noel Coward impersonation contests that I've been doing so well in.

      Interestingly, the mannish woman that sold me the cowboy boots was most taken with the jacket.  She used it as leverage to sell me the boots, on the grounds that the battered Skechers sneakers I was wearing didn't go with the jacket at all.  She commented that I was clearly an "eclectic dresser", which I think was her way of being rude to me but not so rude that I wouldn't buy the boots.

      And finally, I impulsively bought a second hand copy of the Spiegelman comic in hardback.  I was very pleased with it, as we'd heard Spiegelman discuss it at a writer's festival in New York and I've resisted the temptation to buy it brand new on multiple occasions.  It's very large, about A3 size with the cover being the famous black on black image of the twin towers of the World Trade Centre that Spiegelman designed for the cover of The New Yorker for the issue following 9/11:


      I discovered that walking around with an A3 black hardback comic is a great conversation starter.  In just about every shop I went into I was asked about it.  Unfortunately I discovered that it's also a great conversation killer.  The conversations would go something like this:
      Shop assistant
      What's that?

      PTR
      It's a comic by Art Spiegelman, who wrote and drew Maus.  It's about the 9/11 attacks and his personal response to the attacks themselves and also to the subsequent political response from the Bush government.

      Shop assistant
      Oh.
      And then they would turn away.  I think maybe they were overwhelmed by the sheer beauty of my blue velvet jacket being reflected in the sheen of my cowboy boots, or vice versa.  Or possibly they realized at that point that I was a pretty hardcore nerd and decided that talking to me was not on their things to do list.  There was one young woman who was really interested and said a whole lot of stuff about Germany and "die Zeit" that meant nothing to me, so I just said, "Oh" and turned my back.  When I read the introduction to the comic later on I found out that she must have read it herself.  What a freak.

      So overall, as you can, I was most parsimonious.  The stuff that I bought was Excellent Stuff that promises to further ingrain my reputation for being a nerdy, outdoorsy, salon pianist.  And that can only be a good thing.

      Thursday, April 1, 2010

      I like the caramel centre

      It's been one of those weeks, culminating in one of those days.  I flipped open a book at random this morning when I arrived and the page was titled, "Men and Penis Removal".  That was a bit of a downer.  Fortunately one of the GPs then gave me an Easter egg.

      I'm easily pleased.