Weapon of choice

The results from my world famous "Choose a weapon" poll are in!  This is how you folks voted:

• Dagger - 3
• Rope - 0
• Candlestick - 4
• Revolver - 3
• Spanner - 2
• Lead pipe - 6

Presumably you all recognised that the weapons listed were those from the boardgame "Cluedo", a.k.a. "Clue".  I put the poll up because it always seemed to me that the possible murder weapons were kind of stupid and I was wondering if other people agreed.  It seems not.

A dagger or knife I can understand.  I wouldn't choose that myself though - very messy instead, with much shrieking.  Eeeeee!!!!  But available nevertheless.  A revolver would be my choice.  Quick, effective.  Hard to get hold of one unless you're a cowboy.  Another tool of the cowboy, rope, has always seemed a bit infeasible to me as a tool of murder.  I suppose you could try to trick somebody into hanging themselves as if it was some kind of life-size Punch & Judy show.  Or maybe you should try to tie someone to an anvil that you throw off a cliff like in a Roadrunner cartoon.  I guess if that option had said "Rope and Anvil" it would have got more than zero votes.

Candlestick, spanner and lead pipe collectively got 12 votes, which really surprised me.  Bludgeoning someone to death seems particularly brutal.  I for one will take care to be more courteous to my commenters from now on.  I did not know you were such hard cases.

The candlestick seems the only really plausible one of those three though.  There are plenty of candlesticks in those old manor houses.  And people are always falling violently against them.  Again and again.  And again.  Whereas a spanner seems inappropriate.  Too workmanlike.  There was no room marked "The Shed" on the Cluedo board.  I think it should be taken out of the game and replaced with a 9-iron.  Likewise for the lead pipe.  Not only do you end up doing time for murder, your carpets get wrecked by the water damage.  The lead pipe should be replaced with a bust of Thucycides or some such aristomocratic item.  It would add more realism to the game.  But then, perhaps teaching youngsters effective ways to murder people isn't such a good idea.  Oh wait, what am I thinking?  Playstation.

Thanks for voting everyone.  It was very educational.  I learned that my readers are primarily vicious working class thugs.  Just like me.

p.s. New poll up now!  Vote now or be temporarily disenchanted with your lack of initiative.

Question of the day

Tomorrow night I will be having dinner at an Italian restaurant with a bunch of paediatricians.  Do you think they would get angry if I ordered veal?

Poppers

Something that I think is pretty strange about South Australians is the way they refer to Poppers as Fruit Boxes.  In case you have no idea what's going on here, I'm talking about the little cardboard cartons filled with fruit juice.  Where I come from we call them Poppers because that was the dominant brand.  Here they call them something else, but for the same reason.  Confusing. 

It was even more confusing when my Smaller Half and I were walking through the red light district of Paris a while back and saw a lot of signs advertising "poppers" and "zingers".  Turns out they were not talking about beverages or chicken burgers.

Anyway, it annoys me that the name Fruit Box is so literal.  Do you think László Bíró would be the man he is today if he'd called his invention Ink Tube?  No.

So I was sitting here just now slurping on a Fruit Box.

PTR 

Slurrrrrp.  Slurrrrrp.  Slurrrrrrrrp.

Smaller Half

For God's sake - breathe!

PTR

I can't breathe - this is how you get the juice out.

Chalk up another victory for Science! 

Hot-Can? Hot stuff!

Yesterday while I was cooling my heels in the local general store I chanced upon the Hot-Can - a self-heating can of coffee, also available in chocolate and, in a stroke of genius, mocha.  At first I was skeptical.  A self-heating can, eh?  Perhaps you simply need a microwave oven?  No, upon perusing the label it seems that the can really does have a built-in heating unit.  I simply had to try it.

I purchased the Cafe Latte flavour of the Hot-Can and took it home to show my Smaller Half.  She was underwhelmed and somewhat bemused at my excitement.  She suggested that perhaps I should try the Hot-Can outside in case it exploded.  This did concern me a bit.  When I went on a school camping trip when I was young, somebody pitched an unopened tin of baked beans into the camp-fire where it heated up until the end blew off and the can took flight.  We all gasped at the explosion, then laughed in relief that nobody had had their skull staved in by a supersonic bean tin, then cried out in pain as hot baked beans rained from the starry night sky upon our heads.  I didn't really want to re-create this with the Hot-Can.

Fortunately, our fears were ill-placed.  Hot-Can makes a safe and reliable product.  To activate, you simply push in the bottom of the can and shake it gently for 20 seconds, then rest the can upright for 3 minutes on a heat-proof surface such as your thigh.  The small thermonuclear device in the bottom of the can goes super-critical, a chain reaction of cascading neutrons heats up the unsuspecting liquid above, and when you open up the can out comes delicious glowing Cafe Latte with a delicate sprinkle of Higgs bosons.

There is even a temperature activated colour patch on the side.  Initially black, it gradually colours red or green to signify either, "Whoa dude, your Hot-Can is too hot!  Just chillax a little before slamming this one down!", or "Aaah!  This Hot-Can is just right for you Brosef!  Don't wait - refresherate yourself immediately!"

The packaging itself is brilliant. The can itself appears to be a standard aluminium can, but it is wrapped in a matte black layer of bullet-proof polypropylene so you don't burn your lips.  This is the kind of self-heating beverage that Batman would be proud to buckle onto his utility belt.

In summary, the Hot-Can is the coolest thing on the shelves this year.  But don't be idle!  The same scientists who invented the self-heating Hot-Can have more products on the way, like the Self-Dropping Ice-Cream for kids, the Self-Writing Blog for idiots, and the Self-Pooping Pants for medical students. Keep your eyes peeled!

And I would have gotten away with it if it wasn't for you pesky kids

This is a pretty nerdy story here, so unless you have some kind of bizarre interest in medicine and/or pharmacology, don't bother - just go to bed and see if I post something tomorrow.

So I was talking to a patient recently and going through her medications.  She mentioned she was taking Endone, which is an opioid analgesic.  I asked why and she said it was for her chronic back pain and it was helping a bit.  But the real benefit was that since she started taking it, she only had to get out of bed once each night to go to the toilet.

This really confused me.  I sat there for the rest of the consult feeling baffled as to why an opioid might stop you urinating.  Perhaps she really meant that she was constipated?  Perhaps it's something to do with anxiety from the pain causing her blood pressure to rise and hence her glomerular filtration rate goes up?  Perhaps I actually have no idea at all about the effects of opioids?

Afterwards I started looking through her file and yes, sure enough, she's on Endep.  Wait - Endep?  Not Endone?  Argh, she definitely said Endep and that's what I wrote down and that's what is in the notes, even though for some reason I was thinking of Endone. 

What's Endep again?  It's a tricyclic antidepressant that is useful for treating chronic neurogenic pain.  It also has anticholinergic effects that can cause urinary retention and reduce urge incontinence.  Boy, what a crazy mix-up!

Great story huh?

A literary proposal

In 1969, French author Georges Perec published his book La Disparition (in English "The Disappearance", though an English translation would later be published under the title The Void) which entirely omitted the letter E, which is the most common letter in both French and English.

In 2001, Canadian poet Christian Bök published his book Eunoia containing five chapters, one for each of the five vowels.  Each chapter used no vowels other than the single one the chapter was named for.  Thus, the A chapter contained no vowels other than A.

Now it is 2010 and a new literary power has arrived - me.  I have contrived to write an entire book using only the letter E.  It is a horror story and will chill your heart just as surely as it amazes your mind.  To generate publicity and find a publisher, may I present a short extract which I think conveys the flavour of the whole:

"Eeeeeee! EEEEEEE!!!  Eeeeeeeeee!  Eeeeeeeee!  EeeeeEEEEEE!!!!  EEEEEEEEEE!  Eeeeee!  Eeeeeeeeeee!  Eeeeeee!!!!  Eeeeeeeee!!!  EEEEEEEEEEEEE!!!!"

For trade enquiries please contact my agent.

Identity crisis

One of the really frustrating things about this year for me is that I don't really have one doctor who I consider to be my main teacher.  Sure, there is the guy who is supposed to sign all my forms but I don't actually see that much of him.  Which makes it a bit of a farce when he's supposed to give me feedback on my performance.  He certainly is generous with his opinions, but as far as I can tell they have only a tenuous connection to reality so I don't give them too much credence.  For example, last time he wrote on my feedback form (the one that goes to the university) that I was "sometimes in attendance".  Yes, I often don't turn up when the clinic is closed at night, or in my holidays, so I can see that I am lacking in commitment.  Not that I'm bitter about that.

So because I bounce randomly from doctor to doctor I find that I'm constantly having to bung on a bit of an act in order to avoid being scolded or patronized.  One doctor rebuked me for not knowing how to use the software to prescribe things for people, despite the fact that I won't be legally allowed to do so for several years yet.  Meanwhile another doctor brushes aside my questions about the Pharmaceutical Benefits Scheme because I won't need to know it in my next set of exams.  And one doctor sends me off to look things up in my books after every consultation, while another tells me off if he sees me opening a book during work hours because I should be using that time to harass patients. I still haven't managed to figure out some of the doctors.  I do what I think they want me to do but by mid-morning they turn to me and announce that it's just not working out and would I mind if they threw me out so they can continue alone.

The reception and admin staff are nice to me, but unfortunately I'm hopeless with names and I've only just figured out what some of them are called.  So I've spent the year merrily shouting out hello to the ones I do know and scurrying past the others with a quick, "Hey there!".

The only people that I feel that I can actually interact sensibly with are the patients!  Thank heavens for them.  Although why people insist on asking me if I'm going to specialize in something...  I wish I had a better answer than, "I'm just trying to get through this year."

[p.s. new poll up - vote now or your underarm skin will sag]

Trying

Doctor

Come in Mrs MacGillicuddy!  This is PTR, our medical student.  He's the only medical student I've ever known who wears a suit.

PTR

I'm not wearing a suit, I'm just wearing a jacket because it's cold in here.

Doctor

Just as well you're not wearing a tie.  Are you very tired?

PTR

I suppose so.  No more than usual though.

Doctor 

You look glassy-eyed.  You can go home if you want to.

PTR

No, I'll try to tough it out.  But this afternoon I have to take my cat to the veterinary ophthalmologist.

Doctor

Ha ha ha!  Why?

PTR

It has hypertensive retinopathy.

Doctor

How do you treat that?

PTR

Amlodipine

Doctor

No, what you need is the Green Dream.

PTR

That's a terrible thing to say!

Mrs MacGillicuddy

Good morning!

I chose umber

Excellent!  The voting just closed in my world-famous "Choose a colour" poll.  Twenty votes were cast.  And oh so interesting are the results.

Five of you chose Sienna.  You are all ageing hippies who chose that because there used to be a girl called Sienna working at co-op who you were too shy to talk to.  You're now with Beverly.  Move on.

Seven of you chose Umber.  You are all ageing nerds who chose that because when you were an eleven year old dungeon crawler you saw the Umber Hulk in the Monster Manual and that's always what you'll think of.  

Four of you chose Taupe.  You are all ageing hipsters who think that by embracing the bland you're being strangely ironic and countercultural.  You're not.

Three of you chose Mushroom.  You are all ageing ageing secretaries who get frowned at by your boss for wearing anything not beige, and mushroom is as daring as you can be.

One of you chose Salmon.  You're a ... grizzly bear.  Hence the big pause.

Scrubs

I went to a hospital that I'd never been to for a theatre session today.  It went really well, the surgeon was happy to answer my questions ("Let me ask you about my cat" - he looked surprised) and so was the anaesthetist, and they both asked me questions that I could kind of figure out the answers to with a bit of prompting from them and guesswork from me.  There was no afternoon tea, but the anaesthetist was due back in town by 6.30pm so we had to cut some corneas - haha, just a little ophthalmology joke there!

The one thing that was a bit substandard was the scrubs.  (Scrubs are the pyjama-like garments worn by doctors and nurses in operating theatres.  Contrary to American television, it's not usual to stroll around the wards in them unless you want to look like a plonker.)  Down here on the coast the scrubs are nice thick cotton, worn soft by hundreds of laundry cycles, and they are a lovely royal blue that really suits my complexion.  But today in this other hospital the scrubs were thin, pale blue, and enormous.

Being thin is bad.  Operating theatres are cold.  And nobody wants to see the outline of my underwear (as far as I know).

Pale blue is bad.  It's a sickly colour, not like the robust masculinity of royal blue.  It makes me look a bit jaundiced.

Enormous scrubs are bad.  Down here I take size XL, mostly because of the extra leg length and the extra room for my rippling biceps, Lefty and Righty.  I put on this pair of thin, pale, XL scrubs today and I looked like some kind of anaemic hip-hopper.  The shirt came down to my knees and I had to do a Harry Highpants up under my armpits to stop the pants dragging on the floor.

At that very moment the surgeon came into the change-room and was subjected to my complaints about the size, texture and colour of their scrubs.  He seemed very impressed with my taste and style to be honest.  Those are things that you just can't teach, apparently.  He's on the board of his surgical college and it seems they are seeking persons with just my blend of aristocratic splendour and the common touch to be the next generation of enlightened surgeons bringing their magic to the masses.  Now my name is right up there on their lists.

Case history

BB is a 17 year old Burmese female who presented with almost complete loss of vision.  Due to language difficulties taking a direct history was not possible but some collateral information was obtained from her carers.  They had been away for three weeks and during that time placed her in care. Upon their return they noticed that she was disoriented, distressed and her pupils were midriatic and unresponsive to light.

BB has a past history of mild kidney disease affecting her distal tubules causing her pass large volumes of dilute urine.  Her continence remains good.  She eats a low protein, low potassium diet prepared specially for her to preserve remaining kidney function.  Her carers believe that she may have an obstetric history including some births but are not certain of this.  Her hearing has been deteriorating over the last 6 months and she is now almost completely deaf.  Otherwise her history is unremarkable save for chronic coryza.

On examination BB was attractive, well-groomed and of lean body habitus.  Her carers report her appetite as good though she has been losing weight over the last 6 months.  She was anxious and difficult to settle.  She was afebrile, well hydrated, and mildly tachycardic.  Her intraocular pressure was estimated to be normal though not formally measured.  Her lenses were clear, but observation of the retinas was difficult due to her non-cooperative nature.  BB was referred to a ophthalmologist the following week.

On examination by the ophthalmologist, BB's retinas were detached with significant areas of haemorrage and scarring.  Her blood pressure was difficult to measure precisely, again due to her lack of cooperation, but was certainly above 200 systolic.  A diagnosis of hypertension, either primary or secondary to kidney failure, was given.

BB was prescribed amlodipine 1.25 mg/day and asked back for review in a month.  Some degree of vision recovery is expected if the retinas can re-attach, although the scarring is irreversible.  The ophthalmologist's view was that she was otherwise in excellent health for such an old cat and her prognosis was good.

Not drowning, waving

One of the things I like about living in the country is the way people wave to each other from their cars.  It's not a frenzied back and forth motion from the wrist or elbow that you might see people do when farewelling grandmothers at airports.  Nor is it the profane gesture frequently seen on city streets.  It's a simple extension of the four fingers from their resting place atop the steering wheel, and often just the index finger will do.

When I was small enough to only just see out the front window of the car, I often saw people wave to my Aged Mother as we were driving.  This would happen all the time at the bridge out of town on the way home, which was single laned and hence required cars travelling in one direction to give way.  The non-yielding driver would always raise a laconic finger as they whizzed by, to be matched by a similar slow twitch from the yielding driver.

"Why did they do that?  Is that person your friend?", I would ask.  My mother would explain that they were waving to say thank you for giving way.  I still see people doing it now from time to time - a simple gesture of thanks for obeying the road rules.  Considering how rare it is for other drivers to even acknowledge your existence unless you enrage them, I treasure these moments.  It makes me feel human.

And I've noticed something good: although not many people wave anymore, and it's mostly the old-timers who do, if I wave to another driver they'll almost always wave back.  I've decided to vastly increase the amount of waving I do in order to bring civility back to our roads.  Any time that someone could have crashed their car right into mine but didn't, they'll get a wave.

I think it'll be the next big thing.  Except in the US, where you get shot for that kind of thing.

Survey

Dear Doctor,

Sorry to disturb you from your busy consulting schedules but I would like to take 5 minutes of your time to fill out a brief questionnaire for a research project that I am undertaking in order to pad my meagre résumé.

The central research question is, "How well did your medical degree prepare you for life as a doctor, and how could we change the course to ensure that students in my generation are able to be spoon-fed all the required information so as to learn it with a minimum of effort, preferably so we don't even have to turn off our games consoles?"

To answer this question I have constructed a survey designed to make you feel superior to us as you reminisce about how things were better in "the good old days" and to subtly demean the quality of our education.  Hopefully you will be able to identify the mismatches between the curriculum we are being taught and the real experiences of working doctors, with a view to throwing out all the rubbish that I think sounds too hard to learn and reducing medicine to a shortish handbook of single-page protocols to be followed blindly so as not to crimp my lifestyle too much.

If I can cause a big enough stink with this, and suck up to enough senior doctors, my future career path is assured.  So thanks for your generosity in sharing your wisdom, intellect and education with me.  I mean us.

Question 1: Which parts of the medical course do you think could be chucked in the bin because they are nothing but a vague, hazy memory viewed through the bottom of a pint glass?

Question 2: What extra training would have eased your transition into full-time doctoring?  (This could cover technical knowledge such as the number of a good tax lawyer, practical skills such as how to get the most out of the Porsche Cayenne tiptronic transmission, communication skills such as the best way to humiliate and demoralize medical students, and administrative skills such as ... ha ha, just joking, we all know that administrators have no skills worth mentioning, right? If it's worth doing, a doctor does it!)

Question 3: Do you have any suggestions as to how these deficiences could be addressed with the minimum of further effort from myself, but the maximum publicity?

Question 4: If you play golf, would you be willing to play a round with me in the spring?  You can have as many mulligans as you like and I'll laugh at all your jokes too.

Thank you for your time and relative dimensions in space,

PTR
Medical Student Extraordinaire

Friands

Last week in conversation with my Esteemed Colleagues I was boasting proudly of my friand recipe and how it is idiot-proof (I've mentioned it before on these pages).  Well sadly, yesterday I was the idiot and the recipe was not proof against me.

I was going to make it for our group study day, as I was rostered on to provide Baked Grain Products, but in the evening I discovered that two of the eggs that I was going to use had found their way into the char kway teow we'd had for dinner, so I wouldn't be able to make the friands after all.  I was happy because of the char kway teow but also sad because of the friands.  How's that for complex emotions?  And people say I'm insensitive.

I'm just throwing off ideas like bright shiny sparks tonight!

I think someone should start selling pet foxes which have been disassembled and flat-packed like Ikea furniture for ease of shipping.  The end-user would then simply re-assemble them at home and the fun would begin!  The best part is that I have a product name all figured out: Kit-Fox.

How awesome is that?

Why fish don't get headaches

It's easy to forget, when in the midst of trying to learn all sorts of complicated sciencey stuff, that we actually don't really need to know it.  Sure, the stuff we've been learning is useful to help us learn other stuff, but in the long run I question how much of it really sinks in.

For example, a doctor recently quizzed me about why fish oil is an effective anti-inflammatory.  I said, "Hmm, it's something to do with arachadonic acid and prostaglandin synthesis but I can't quite remember."  He said, "No, it's because the fish live off smaller fish that live off plankton which eat other smaller plankton and so on, and the creatures at the bottom of the food chain synthesize a substance not unlike aspirin and it accumulates in the bodies of all those predators until it becomes concentrated in the fish oil."  Really.

In hindsight it's possible that he was pulling my leg.  It's the kind of thing that I would say to someone.  But this doctor doesn't strike me as a prank-pulling jackanapes like myself.  On the other hand, it's also unlike him to be so wildly inaccurate about something.

I'm spending tomorrow in bed to figure it out.

Great doctors

Today I figured out the secret to being a great doctor.  The trick is to run late.

I noticed that some doctors always seemed to be running late.  They'd start on time, but as the day progressed they would get further and further behind.  After I'd spent some time watching them do their thang, I realized that they wrote excellent notes on their consultations.  The reason they were able to do this is because they actually listened to what the patient's concerns were.  Gasp!

And some things that the patient were worried about, that weren't really relevant to the problem that the consult was about, were nevertheless entered into the notes as well.  It's almost as if the doctor is actually primarily concerned with helping the patient, rather than churning through a long appointment list.  Gasp!

I have dedicated myself to being a great doctor.  Fortunately I am already incredibly slow at running consults.  What a relief!  This means I am already performing at an advanced level.  Therefore my exams in 4 or 5 months are going to be a pushover.  I'm spending tomorrow in bed.

[p.s. new poll up - vote now or feel my wrath]

Nine things which have adversely affected my studies

1. The World Cup.  Not only is my lack of sleep having an impact on my beauty - it has also adversely affected my studies.
2. The Secret Cat.  I've had to attend several veterinary appointments this year with the Secret Cat and unfortunately the vet knows that I'm a medical student and hence uses all sorts of complicated jargon that I don't understand.  The anxiety is adversely affecting my studies.
3. The weather.  It's been a bit chilly recently and my hands get pretty cold on the steering wheel in the morning, which may be adversely affecting my studies.
4. My computer.  It's five years old now which clearly has been adversely affecting my studies.
5. The ancient Romans.  There's far too much Latin in medicine.  I think that if it was all in plain English it wouldn't have such an adverse effect on my studies.
6. Aaron Sorkin.  Wasting my life watching re-runs of The West Wing is having an adverse effect on my studies.
7. Pyromania.  Having a wood heater means that I've been spending a lot of time rubbing my hands together with glee and laughing like a maniac which has had an adverse effect on my studies.
8. Paul McCartney and Michael Jackson's The Girl Is Mine.  I'm a lover not a fighter, and it's having an adverse effect on my studies.
9. This blog.

The hairy princess

Wasn't the 3rd place playoff between Uruguay and Germany a great match?  Plenty of plinking away at the goals with not much time wasted with that rubbish passing the ball around in the middle of the field.  In the end though, it was Germany who managed to uphold their reputation as the hairy princess of the world game with a well-earned victory.

It was almost put into extra time though when Diego Forlan pounded a free kick off the crossbar right on full-time.  He had a fantastic game, including a brilliant goal from a sideways lashing right foot which left the German keeper flat-footed.

Another player who stood out for me was Diego Godin who defended stalwartly to deny the German goal-scoring machine which had previously eliminated such fancied teams as Diego Maradona's Argentina.  I would have really liked to see Uruguay play Argentina simply to see how Godin would have handled Argentina's aggressive striker Diego Milito.  It would have been a stunning match-up.

Diego Perez also had an excellent game, feeding the ball forward to Forlan from midfield and entertaining with some free-wheeling running as well.  But he was eclipsed in my view by the brilliant young German, Diego Muller, who scored yet again to take his tally for the tournament to 5 goals.  Sadly, his teammate Diego Klose sat the game out due to a strained back and thus was unable to match Muller's feat.

Soon we'll see whether it's Spain or Netherlands who get to hoist the Cup for the first time.  SBS's commentariat seem to think that Spain are irresistible, but I'll be barracking for the Dutch.  My tip is for them to be World Champions and for midfielder Diego Sneijder to score the winning goal.  Until tomorrow, adios!

Desert island doctors

So the results are in!  Seventeen of you good folks voted in my recent poll, "If you were stranded on a desert island, what kind of doctor would you like to be with?"  Correction: seventeen votes were cast.  I know that some of you can't resist monkeying with my polls, but I persevere nevertheless.  I am so selfless.

Anyway, only one person voted for "Orthopod".  I suppose it's possible that you thought I meant "Arthropod", but in any case it's clear that orthopods aren't exactly the most popular people around.  Having said that, I met a very pleasant orthopod just last week.  He was handsome in an eerily unrealistic way that made me wonder if he was just an actor pretending to be an orthopod.  That might explain why he was so pleasant.

Two people voted for "Obstetrician".  I'm guessing that one of you is pregnant and the other one is married to an obstetrician and was hoping to curry favour with them.  Well I have seen straight through you buddy.

Three people voted for "Psychiatrist", which I think was wise.  It would get pretty boring on a desert island and in my experience psychiatrists are the best story tellers.

Four people voted for "GP", which again I think was wise of you.  General practitioners are usually pretty hefty thanks to all those free lunches from the drug reps.  When you run out of coconuts on the island, just knock the GP on the head and there'll be a good month worth of eating on them.

But the clear winner was "Anaesthetist" with seven votes.  I suspect that most of those votes were cast by medical students, who have a noted soft spot for anaesthetists because it's the anaesthetist who tries hard to be nice to students in the operating theatre, chatting away to us and giving us the odd job to do while the surgeons either ignore us completely or deliberately try to humiliate us.  Unless the surgeon is just an actor pretending to be a surgeon.

If anybody wants to explain their vote differently, feel free!

MCQs

We had a practise exam a few days ago.  It doesn't count for anything, it was just an opportunity for us to have a go at the type of question that will hopefully turn up at the end of the year.

There was a fair bit of stuff in there that I had to guess at but I'm feeling reasonably confident that I won't crash and burn because I am a pretty good guesser.  Guessing isn't just about closing your eyes and stabbing your pen at the page (no, that's how you get IV drips in) - guessing is a game that you play against the evil genius who sets the exams.  If you know how he thinks, you can beat him.  And thus I present PTRs Incredibly Useful Guide To Doing Well In Multiple Choice Questions When You Haven't Really Bothered To Prepare Properly (tm).

The key fact to remember is this: one of the answers is right.  Another key fact is this: another one of the answers will be clearly wrong.  And finally, the other two or three answers will be there to confuse you.  My approach is to first identify the answer which is clearly wrong.  Then, one by one, eliminate the answers which confuse you.  Whatever remains, no matter how improbable it seems, is correct.

A brief example is in order.  Here is one of the questions from the practise exam that I used my photographic memory to capture:

A fifteen year-old boy presents with sudden onset severe scrotal pain.  Your best next step in managing this problem would be:

1. My first is in anaphylaxis but not in diarrhoea, my second is in Cushing and also in Parkinson, my third is in spleen but never in lymph and my last is in both E. coli and S. aureus.
2. Inject adrenaline straight into his heart. 
3. If three and a third surgeons can insult three and a third medical students in three and a third hours, how many medical students can two surgeons insult in four hours?
4. Take a detailed biopsychosocioeconomicopoliticogeometrical history.
5. Antiquis temporibus, nati tibi similes in rupibus ventosissimis exponebantur ad necem.

What do you think the answer is?  Apply my technique, figure it out and submit your answer in a comment!

A scathing indictment of the petrochemical industry

When you find yourself in times of trouble just remember that in all likelihood you're smarter than a petrol pump.  I know I am.  Not necessarily smarter than a person who pumps petrol, that's still up for debate.  But I'm definitely smarter than the machine which pumps the petrol (known in the US of A as "gas" because it is liquid) into my car.

When I was filling up early one brisk winter's morn, I realized that the pump was just trickling the fuel into my car.  It took a minute or so just to get a dollar's worth, which these days is really only 20 mL or so (again for Americans amongst us, 20 mL is roughly five and a half drachms).  So I hung up the pump and went inside to speak to The Lady. 

"Pump one isn't going", I said. 
"Just hang it up and start again.  It's a bit cold today so it takes a while to start", she replied.

So I went out and tried again.  No luck.  So I hung it up and tried again.  No luck.  And again.  No luck.  By now it was almost lunchtime so I abandoned that pump and tried the one next to it.  Too easy this time.  The fuel gushed forth in a joyous stream.  I felt like I'd just had my prostate reamed out.  I went inside with a grin on my face but The Lady scowled at me.

"You were hanging it up too fast", she says, "It got confused".

Confused??  It should be pretty obvious that when I use the petrol pump, I want petrol.  There's not really any other option for it.  It can't give me milk or wine or blood.  It can either give me petrol or not give me petrol, and seeing as it was not giving me petrol until I arrived and attempted to instruct it otherwise, I'd have thought there was limited scope for confusion.

Maybe I'm just over-thinking this.

I need relief

While in England recently we spent the day tramping around Hampstead Heath.  We didn't intend to spend that much time there but it turns out that there aren't any signs so it's reasonably easy to get lost.  On the plus side, it meant that we stumbled onto (and into) the stately Kenwood House.  I mention this because while we were there we saw a small exhibition of jewellery where I learned that there is difference between a cameo and an intaglio.

A cameo (as you folks who subscribe to the theory of depth-first browsing would know by now, but I will nevertheless explain since the likelihood that you will ever come back to this page before the end of your lifespan is vanishingly small and hence I am almost certainly now addressing only the breadth-first browsers) is typically a small image formed by carving away the background of a portrait.  An intaglio, on the other hand (which once again, will not surprise the infinitesimal fraction of compulsive link-clickers who ever read this) is formed by carving the image away from the background.

The reason I found this interesting is that it made me immediately think of Alfred Hitchcock, who like to appear in cameos in his own film.  And I don't mean that he liked to appear in small pieces of carved ornamental jewellery, although if I was ever able to direct a film I'm pretty sure that's what I'd do.  No, he liked to appear in his films in the role of a casual bystander or passer-by, depending on his relative velocity with respect to the camera.

And I thought it was interesting that the role is referred to as a cameo, implying that the famous personality involved stands out from the (presumably) bland background provided by the actual professional actors who are involved in telling the story, thus marring the film by the cameo appearance.   Rather than allowing their face to leap forth from the screen in a cameo and bludgeon the innocent audience into insensibility with the raw power of their celebrity, I think that directors and other egotistical movie-types should make intaglio appearances in their films.

When making an intaglio appearance in a film, the celebrity would be distinguished by their absence.  Perhaps one of the actors might gesture off-screen and remark, "Why, isn't that Quentin Tarantino?", and someone else would say, "No, I don't think so", and QT himself would never actually appear.  The overall effect would be the same but to my mind it has been achieved in a thoroughly more elegant way.  Once audiences are accustomed to intaglio appearances in film, the effect could be heightened by dispensing with the references to the celebrity altogether, which has the added advantage of allowing all celebrities in the universe to make simultaneous intaglio appearances in the same film.

If anyone reading this is in the process of making a film, I am available for intaglio appearances immediately.

Boiled egg challenge

For an unknown reason I had a flash of insight the other day regarding my childhood anxiety caused by boiled eggs.  I don't know why, but maybe some of you folks will find it interesting.

Background: when I was a young tyke, four or five years old, my dad would from time to time boil an egg for me to eat for lunch on the weekend.  This would invariably end with him getting cranky with me and telling me off.  He would ask me how many eggs I wanted.  I would say "one egg please" and he would boil me an egg.  I'd eat it up, then ask him for another one.  He'd get cranky and tell me I should have asked for two eggs in the first place.  So the next time I'd say I wanted two eggs and he would cook me two eggs, but after eating one I would say that I didn't want the other and he'd get cranky at me again.

The insight I had the other day was this: I don't like eggs that have runny whites.  Transparent whites are horrible but even if the white is a little soft and yielding it gives me the shudders.  Now that I'm an adult for the most part I can cope but when I was a kid it was a big deal.

So the problem was that Dad was cooking me either one egg or two, but was cooking them for the same amount of time.  So if I'd only asked for one egg, it'd be perfectly cooked and I'd want another one.  But if he cooked me two, the water would cool down too much when he popped two eggs in the pot and they'd both end up underdone.  I'd get grossed out by the soft white in the first egg and would decline to eat the other one.  Either way, Dad got cranky.

Not surprisingly, I was unable (or perhaps more accurately, unwilling) to communicate my egg requirements clearly to my father.  But it does seem strange to me that somehow I failed to noticed the anti-correlation between the egg count and the egg quality.  All I knew was that having Dad cook me eggs for lunch was pretty much a crapshoot in terms of what you got, and you were going to get snarled at no matter what.  No wonder I never fulfilled my childhood dream of becoming an actuary!

(ps - new poll up.  Vote early, vote often!)

World Cup update

Now a quick World Cup update to follow on from the previous poll now that the round of 16 is over.  Let's see what the result were...

When asked "Who will win the World Cup?", NOBODY said "My team"!  So I guess everyone that voted is Australian huh?  That means that the three people who voted for "The team that beat my team" must have been meaning Germany.  Fair enough too.  Two people voted for "The best team" which is reasonably interpreted as meaning Brazil.  Personally I hate Brazil.  They are so damn good that it sucks the life out of the game.  It's like watching Jonah Lomu play rugby against children. 

Nobody voted for "The rank outsiders" which was at first a little surprising to me.  It's a very Australian thing to want the underdog to win.  In this case, however, the underdog was clearly North Korea, so it's not so strange that nobody was flocking to their cause.

Finally, five people thought that the World Cup would be won by "Those cheating bastards".  But I'm sad to say that Italy have already arrived home and will be playing no further part in the tournament.