My child is a genius

PTR

Oooh!

Hatchling

Igg-yeah!

PTR

Igg-yeah!

Hatchling

He he he!

PTR

Igg-yeah!

Hatchling

He he he!

Smaller Half

Igg-yeah!

Hatchling

He he he!

PTR

Igg-yeah!

Parent hood

I went, nay - was dragged - to a "Baby And Pregnacy Expo" recently.  The horror...

I was anticipating that it would not be my cup of tea but the reality of it left me stunned and reeling.  The place was jam-packed with hyper-aggressive Mumzillas smashing each other aside with their prams as they careened randomly from booth to booth desperately accumulating free handouts and leaflets and buying discounted samples of products they never realized they needed until they saw how cheap they were and how adorable they made someone else's baby look.

Not that I'm claiming immunity from the madness.  I bought a little plastic ball for a dollar that turns itself inside-out when you throw it up and down.  Sweet!  And I do have Dadzilla tendencies.  I overheard a few people remark on how cute the Hatchling is, so I started looking around and man, there are some ugly babies out there.  Not too surprising when you check out the parents but still, why does nature not give them a few months of grace?

The expo was targetted at three groups of people:

1. Parents
2. Expectant parents
3. Pre-conception parents

This neatly embraces most of humanity except for childless post-menopausal women and guys who're shooting blanks.  Clever.  Nevertheless, despite the carpet-bombing-style marketing, the products there were all aimed with laser-like precision at the Neurotic Mother demographic.  There is apparently nothing so prosaic that it can't be re-packaged and sold at a premium to parents desperate to give their child the best in life.

Toys that optimally stimulate the cerebral cortex!  Puree jam-packed with essential amino acids!  Nappies made from organic farmed bamboo and lovingly crafted by Zen pandas!

But the strangest thing (to moi) was the nappy cake.  I recoiled in disgust at the name, but it's not a cake make to look like a nappy.  It's nappies made to look like a cake.  Nappies stacked up like a wedding cake and wrapped and decorated to look like a cake.  Words truly fail me.

Olfactional heavies

While I was ironing my shirt last night I noticed a strange odour rising from the ironing board.  On closer investigation I discovered that the end of the board was redolent with the smell of feline urine.  It seems that leaning the ironing board up in the laundry where the cat likes to pee on the floor may been an unwise decision.

I sniffed my shirt thoroughly since nobody really wants to turn up to work smelling like urine, but I was about 65% sure that I couldn't smell it, and hey - 65% is good enough for a credit in the subject "Not Smelling Like The Crazy Cat-Lady 101".  Besides, the Hatchling vomits, pees or poos on me most days and if I start to care too much about that kind of thing we'll have three times as much washing to do, so I just let it slide.

If anybody queries me about funny smells, I'm pointing the finger at the patients.

A New Hope

It's a new day, it's a new ward, it's a new life for me - and I'm feelin' good.  This is my first actual ward placement since I was in Nowheresville last year and so far this year I haven't been ward-based.  So it was a bit of a shock to the system to pull an 8am to 5.30pm day.  It's been a while!  There was a lot going on that I had not much idea about, so it was good to be able to take some bloods and a quick history and examination to admit someone just to make myself feel competent.

The highlight of my day was undoubtedly being trash talked about my appearance by one of the patients who looked as though he slept in a hedge.

Dishevelled Man

Don't you know how to use a comb?

PTR

Ha, ha, I do need a haircut.

Dishevelled Man

If you get one there won't be much left.

Zing!  My Esteemed Colleague was kind enough to guffaw loudly at the Dishevelled Man's attempt at humour.  How kind of him.

Play misty for me

The last few days when I've got into my car in the morning there's been a bit of mist on the windscreen.  No big deal, it's been raining a lot and it's cold and clammy.  Like a clam.  It always cleared up pretty quickly once I put the demister on.

Come to think of it, there's been a bit of a musty smell too.  It blows away soon enough when you crank up the air though.

But this morning I could have sworn that I was getting a wet bum as I drove around.  I stopped and felt the seat.  It was a bit damp.  Hmm.  The back seat was even more damp.  Aaah, perhaps something to do with the inch of rainwater on the floor in the back of my car. 

Bugger.

What kind of doctor?

Last year in the hell that was GP-land, I was frequently asked, "So what kind of doctor do you want to be?" by patients.  This year I've been doing anaesthetics which means that patients don't ask me that question any more.  Instead, they ask me questions like, "You're not really going to stick that needle in me, are you?"

Nevertheless, the question about my future career path is still being asked, but this time by the doctors themselves.  It's important to have a good answer to this question because doctors will make snap judgements about you on the basis of what you say.  If you're female and you are interested in paediatrics, for example, they will sigh as if to say, "yeah typical".  If you're male and you are interested in orthopaedic surgery you will get the same response.

So in order to avoid getting these "You're such a cliche" responses, I present for your consideration PTR's Foolproof Instrument For Randomly Generating Unusual Sounding Medical Specialties (tm).

The procedure is as follows:

1. Take the last two digits of your phone number.
2. If either of them is 0, use 10 instead.
3. Take the penultimate number and find the corresponding item from List A below.
4. Take the ultimate number and the corresponding item from list B below.
5. Combine the two terms to come up with your future career plans!
6. If the last two digits of your phone number are the same, keep taking preceeding digits until you get a different one, otherwise people will look at you funny.

List A:

1. Rheumo-
2. Psycho-
3. Neuro-
4. Pharmaco-
5. Ortho-
6. Hepato-
7. Cardio-
8. Paediatric
9. Emergency
10. Geriatric

List B:

1. Rheumatology
2. Psychiatry
3. Neurology
4. Pharmacology
   
5. Orthopedics
6. Hepatology
7. Cardiology
8. Paediatrics
9. Emergency
10. Geriatrics

Example:
The last two digits of my phone number are 22.  This would make me a Psycho-psychiatrist.  This is unfortunately pretty stupid sounding, so I'd go back one digit and get an 8, which would make me interested in Paediatric Psychiatry.  That sounds pretty cool.

What kind of doctor do you want to be?

Proof that slugs can't read good

LD50

In my experience, when you poison someone you usually intend for them to die.  If you would rather that person did not die, it would make sense for you to not administer the poison in the first place.  This is why the concept of LD50 - the dose of a poison at which half the subjects will cark it - makes no sense to me.  If I'm going to go to the trouble of trying to bump someone off I don't want there to be any doubt about the outcome.  Fifty percent odds are unacceptable.  A measure such as LD99 would be more useful.

The reason I bring this up is because in anaesthetics there is a commonly used measure of anaesthetic potency called MAC.  It is defined similarly to LD50.  At the MAC dosage, half of all subjects won't leap off the operating table when you cut them open.  What a stupid measure.  I would prefer that none of my patients leap off the table.  Yet all the monitors and equipment and doctors and research papers talk about MAC.  ( I won't even get into how outraged I was when I found out that MAC stands for "minimum alveolar concentration" even though it's actually a median value.  The War On Innumeracy is long since lost on this front.)

I went looking for information about what the inter-person variability is for MAC.  In other words, how much anaesthetic would you have to give to ensure that everyone went under? It turns out that this information is surprisingly hard to track down.  Eventually I found a paper giving the 95% bands for MAC for one specific anaesthetic gas (desflurane) when used on - wait for it - llamas and alpacas.  Great.

Well it turns out that this paper is more useful than I thought because MAC is pretty much the same for all mammals.  For all animals, actually, just in case your pet starfish needs a hysterectomy some time soon.  Which makes me wonder why somebody bothered to do the experiments on llamas in the first place, noisy stinking beasts that they are.  Why not just assume that MAC in llamas is the same as in every single other species ever examined?

I suppose the researchers were hoping that somehow llamas and alpacas would end up being radically different from every other living being on earth and that this, combined with their intimate knowledge of llamoid physiology would enable them to deduce how the heck it is that anaesthetics actually work. Which would be nice because nobody really knows yet.

Think about that.  Nobody knows how anaesthetics really work.  For all we know they may work by destroying you and replacing you with a sinister mind-clone.  Controlled by sunflowers.

Pan solo

Eating alone is fraught with peril.  If you do it in your own house you run the risk of being swamped by apathy and just chowing down on a big block of cheddar or a jar of peanut butter.  If you go for take-out you'll undoubtedly end up with several kilos of chips with chicken salt.  And if you go for fine dining you'll be brutally patronized by the waiters.  This is what happened to me recently:

Waiter

Just by yourself today sir?

PTR

Yes.

Waiter

Sometimes you need a bit of quiet time, don't you sir?

PTR

That's right.

Waiter

Well don't you worry about it sir.

PTR

Thank you.

It was awful.  He used the word sir at the end of every single sentence.  That kind of thing might make you feel comfortable and relaxed if, for example, you're sitting at the table wearing a suit of armour.  But here in Australia where we're all descended from burglars and scoundrels, calling someone "sir" is a slap in the face.  It's Australian for "I am required by my employer to show you respect even though I have none to offer, so I'll call insolently call you sir instead".

And the way he commented that I needed a bit of quiet time - that made me feel like a frail little child, unable to cope with the hubbub of the real world.


What really pisses me off is that he was right.

Physiological

The anaesthetist that I was hanging around with last week was fond of using the word "physiological" to indicate approval, in the sense that the thing being approved was in some sense gentle on the patient.  For example, when we were discussing intravenous fluids, she said that she liked Hartmann's because it was "more physiological".  Later on when the patient's hand had to be immobilised and the theatre nurse popped a roll of Softban bandage into the palm before wrapping the hand up, she noted that the curvature of the wrist was "very nice and physiological".

I think that I'll start using the word "physiological" in the sense of general approval:

• "I like your new skirt, it's very physiological."
• "Stephen Fry's quiz show is so physiological."
• "Dude, you were ripping those breaks out there today, that new twinfin is physiological."

My prediction is that this is really going to catch on and be the next big net meme.

Ee ecky thump

My favourite thing in all of medicine is the praecordial thump.  It's a rarely used first response to cardiac arrest which consists of punching the patient vigorously in the chest and seeing what happens.  The reason it's rarely used is that the resuscitation guidelines say you only use it if you have witnessed the patient having the arrest and they are attached to a monitor.  Presumably this is to stop people like me running around the hospital belting the lights out of people who are having a restorative afternoon kip.

So I was in the operating theatre recently, watching them put a tube through the abdominal wall of a patient and into his stomach.  It was being done not under a general anaesthetic, but under some light sedation like you'd have for a colonoscopy along with plenty of local for his tummy.  Halfway through, the patient started to become unresponsive and tachycardic.  The anaesthetist leaned over and gave him a sternal rub.  A sternal rub is a painful grind of the knuckles along the sternum that you'd do to determine if someone is capable of responding to a stimulus.  And then the anaesthetic nurse, who was watching the monitor, said, "VF".

VF.  Ventricular fibrillation.  Cardiac arrest.  Witnessed.  Monitored.  I wound up my arm to deliver the praecordial thump. I filled my lungs to give the great kiai to project my life-saving Qi into the patient's heart.  I anchored my feet, bracing my hips to the earth so as not to be driven back through the wall of the theatre by the concussion.  "Hyyyyyyyaaaaaaa......"

And the anaesthetist calmly said, "Nah it's just an artifact from me jiggling the ECG dots on his chest."  And sure enough he was fine.

Damn it.

Parents say the darndest things

Here are some reasonable and logical arguments that nevertheless somehow fail to make an impression on 3-month-old children:

1. You're so tired, you should go to sleep.
2. I'm so tired, you should go to sleep.
3. It's really late, you should go to sleep.
4. It's really early, you should go to sleep.
5. You're so upset, you should calm down.
6. You can't possibly be hungry, you just ate.
7. Your nappy can't possibly be dirty, I just changed it.

Watch out

Did you know that Diclofenac (Voltaren) is toxic to Indian vultures?

Animal with different plants

Ingredients:
1 animal
3 different underground plants
some fruit from another plant
water

Method:
Take the fruit from the plant.  Leave it in a pot until it rots.
Kill the animal.  Put the soft parts into a big pot with the 3 different underground vegetables.
Now add the rotting fruit and the water.
Boil for 1 hour.
Season to taste.

Trivia of the day

Did you know that urine dipsticks for humans will often give a false positive for leucocytes when used on cat urine?

Perky

At this point in my life, people typically begin conversations with me in two ways:

1. "Your baby is so cute!"
2. "You don't look very tired!"

The first one is cool with me.  I think the Hatchling is very cute indeed and so it pleases me that other people think so too.  Sure, nobody's going to stop and say to me "Your baby is kind of weird", but if that's what they think, they can always choose another conversational gambit.  Hmmm, such as "You don't look very tired".  Maybe the Hatchling looks weirder than I thought.

Anyway, it's easy to respond to "Your baby is so cute".  I just say something along the lines of "Yay, thank you" and eat up the praise.  I am not so sure though of how to respond to "You don't look very tired".

My first instinct is to say "Thank you".  I may have mentioned before that interpreting most things that people say to you as compliments will, at the very least, keep your self-esteem ticking over and may even temporarily deflect obloquy.

"You're the worst med student I've ever seen."
"Thank you!"

But then I wonder, why is this person commenting on my appearance in this way?  They aren't saying, "You look fresh and perky!", but "You don't look very tired".  There's an undercurrent of accusation there.  Clearly I should look more tired than I do.

Are they asking me for skincare tips?  "I wear caffeinated stockings over my head at night to lift the bags under my eyes."

Are they accusing me of not pulling my weight at home?  "I sit on the couch and eat bonbons while my Smaller Half does all the running around".

Are they suspicious that I don't have a baby at all, and am just fabricating an elaborate story to cover my inability to turn off late-night home shopping on the teev?

What happens is that when I am confronted with "You don't look very tired" I feel the need to claim to be more tired than I really am in order to have some kind of parental legitimacy.  "Oh man", I say, "I obviously look better than I feel.  Rough night last night.  I didn't get to sleep until 5.57 and my alarm went off at 6.  She's been crying non-stop for weeks now and the only way to settle her down is to jog on the spot with a sack of rice over each shoulder whilst singing La Marseillaise.  In Magyar." 

Once I've told a bit of a sob story, people look at me with more respect.  Clearly I am fulfilling some of expectation of theirs.  Except people with kids of their own.

"That's nothing", they say, "When my kids were little..."

The Doc Is A Cock

I sat in the clinic
I sat there all day
With nothing to do
And nothing to say

I sat there all morning
Just watching the clock
Because when I turned up
The Doc was a cock

When he saw me arrive
His door shut in my face
That Doc didn't want me
Right there in that place

So I sat in a chair
That was there by the door
And I waited and sat
And I waited some more

That chair I was in
Felt as hard as a rock
But I couldn't just leave
Cos the Doc was a cock

I knew that he'd badmouth me
All over town
I knew that he'd fail me
Not with a frown

But with a self-satisfied
Smirk on his beard
Which was just the expression
That everyone feared

So I made myself stand up
And go back to knock
On the door of the Doc
Who was such a big cock

He opened the door
When he saw me he sneered
Then he smirked all the way
From his toes to his beard

"Oh please let me in
to your clinic" I cried
"For I've heard you have
Marvelous patients inside"

"With murmurs to hear
And lungs to percuss
And hist'ries bizarre
That they'd like to discuss"

But the Doc was a cock
He said (just to be mean)
That I was the worst student
He'd ever seen

"You have not even seen me
Your claim is a crock"
Then he laughed in my face
Cos the Doc was a cock

But then he relented
Invited me in
Brought in a patient
And said "Let's begin"

"Perhaps you can tell me
From one simple look
From the moment you saw him
Why this man is crook"

I had no idea
I would have to fly blind
So I said anything
That came into my mind

"Is it Anderson syndrome?
Or arthrogryposis?
Moya-moya disease?
Or perhaps ichthyosis?"

"I know Miller's and Larsen's
And Marfan's and Plott's and
A whole host of others
Like Saethre-Chotzen"

"Perhaps it is Patau's
Perhaps Laurence-Moon
Or Pierre-Robin syndrome
Or Mounier-Kuhn"

When I looked at the Doc
His face had gone red
And I thought I saw steam
Coming out of his head

He showed me the door
And then turned the lock
But I really don't mind
Cos the Doc was a cock

Dreams can come true

At home it's my job to leap up in the dead of night to deal with any nappy changes that need attending to and also to transport the Hatchling to and from my Smaller Half for feeding.  Sometimes I am pretty groggy when I'm staggering around with her in my arms, which is why conversations like this happen:

Smaller Half
You should talk to her when you're carrying her around.

PTR
Oh, yeah, sure.

Hi pooper-dooper, I was just having a dream that I was a superhero in the Justice League and I was running a cooking class on TV for the other super-heroes.  The Blue Beetle was there, and a bunch of other insect-like guys I didn't know.  I was teaching them how to cook prawns.  I'd made up a great song which explained it all.  It went:

And when they change colour to be all yummy
They're ready to go right into my tummy.

Smaller Half
OK, maybe don't talk to her so much.

B-sides and rarities

Apparently March 2 is Old Stuff Day, when bloggers must recycle old posts to reduce greenhouse emissions.  So without further ado, here are my favourite posts from 2008, one from each calendar month:

• The one in which I learn some guy real good using only an aeroplane seat.
• The one in which I have a personality clash with a used-car salesman.
• The one in which I carry on at length about fruit, science, politics and children's books.
• The one in which I get creative and write some poetry, or maybe not.
• The one in which I declare war on innumeracy.
• The one in which I fondly reminisce about after-dinner mints.
• The one in which I pass my first set of exams at medical school.
• The one in which I am the victim of fiendish piece of deception.
• The one in which I decry and condemn modern dining trends.
• The one in which I explore the nexus between morality and confectionery.

 They may not be your favourites but hopefully you will re-read them and agree that I certainly have made up some bullshit in my time.

What's in a name?

One of my pet peeves is the stupid names that authors choose when they are writing junky pulp sci-fi.  Junky pulp sci-fi being what it is, you may not think that there's much of an improvement to be made simply by having better names.  But the problem is that authors seem to compensate for their lack of originality and vision by loading as many weird consonants and punctuation into their characters' names as they can in order to make them seem exotic.  Which is fine, but when you're incapable of reading without moving your lips, like me, it's really tiring to have stories full of names like "Krikk'k'thlan'aaknth" and "Xoxothogg".

The opposite end of the spectrum is equally bad.  It's deflating to read of the adventures on alien worlds of Space Captain Trevor and his intrepid sidekick Brett.  A little novelty is necessary, just not too much.

So here, for your edification, I present a foolproof method for coming up with names for junky pulp sci-fi characters, using only a list of medical abbreviations and your native wits!

First, to answer your obvious question, where can you find a list of medical abbreviations?  It's simple - just enroll in a medical degree and keep a list in a notebook of all the abbreviations that people use from day to day.  But if you're too busy, here's a sample list that I'll use for examples in this blob:
MRSA, VRE, LNMP, MCHC, NKDA, all drawn from this site that happened to be thrown up by google in response to my query and that I take no responsibility for in accordance with my Iron-Clad Disclaimer(tm).

See how there are some funny letters in there for flavour?  But not so many as to induce reader fatigue?

Now all you have to do is choose your favourite vowel (you do have a favourite vowel don't you?) and put enough copies of that vowel into the abbreviation as to make it pronounceable word.  You should try to use the same vowel all the time, as that will substitute for some kind of "cultural feel", unifying all these weird names.

My current favourite vowel is O, so now our sample list of names is:
Morsa, Vore, Olnomp, Mochoc, Nokda.
Clearly this method, while foolproof, is not infallible.  Mochoc is not such a great name, but you could amend it to Chomoc. 

Using other vowels gives a different flavour, and you could, for example, use O for the people of Terra, slaving under the alien yoke of the other people whose names have I's in them:
Mirsa, Vire, Linimp, Imchic, Inkida.

So all you junky pulp sci-fi authors out there - sin no more!  Go forth and use PTR's Ingenious Exotic Name Generator To Be Used For The Generation Of Exotic Names freely and without restraint.