Floater

A nurse remarked to me recently, "Mr Surname has been particularly appreciate of his floater over the last few days."  Eh?

For those of you not in the know, a floater is a hot meat pie floundering in a mire of mushy peas, strongly associated with winter and football.  Mr Surname must have been ringing in the festive season in style.

But no - not that type of floater.  Surely he wasn't referring to a leftover bit of poop that resolutely refuses to flush?  Why would you be appreciative of that?

Or perhaps the floater he meant was the body of a drowned person, bobbing gently under the buoyancy of its internal gases.  Something to appreciate, surely, if only because of a schadenfreudesque relief - "There but for the grace of God go I..."

Aaaah - I have it!  He was referring to the perception of irregularities in the vitreous humor of his own eyeball.  He spends his days staring at the sky marvelling at the drifting, dancing angels always just beyond his reach.

Again - no.  The floater in question was a dose of oxazepam, an anxiolytic, available to be taken at any time as Mr Surname saw fit.  That would certainly make a trip to the football much more bearable.

Plot summary for generic espionage/action flick

Man is surprised to find that people keep trying to kill him.
Man executes a series of astonishing manoeuvres on a motorcycle.
Other man comes crashing through a large window with a big gun and tries to kill the first man without success and is himself killed right back.
Man speaks to other man wearing a suit over a telephone.
Man wearing suit says "Goddammit!" and slams the phone down.
First man sails away on a boat.

Movies is hell

As a recent commenter to my post Reading Is Hell pointed out, movie watching also suffers from the travails of internship, from the slings and arrows of outrageous offspring. We have been to the cinema twice in the last two months, which is remarkable because before that it had been more than two years since we'd been to the movies.

Apart from our non-existent cinematequing, we've been subsisting on offsite backup copies of movies provided by my Smaller Half's brother who obtains them in a manner unknown to us but which almost certainly involves the paying of royalties to any and all copyright holders in accordance with international treaties, arrrrr.

This has been quite good, except my poor old computer struggles a bit with the concept so every 15 minutes I have to pause the movie and persuade my computer not to reboot itself. Also, some films have such a low sound level that the dialogue is frequently interrupted by one or the other of us saying, "What? What did he say? He's going to buy a duck?" Fortunately these two disruptions are complementary so whilst I am fixing the computer we attempt to mutually reconstruct the dialogue.

Also fortunately, in our impoverished mental state, our viewing tastes veer more towards The Avengers and less towards Gosford Park. It's much easier to figure out that the Hulk probably screamed out, "RAAAAH! HULK SMASH!" than it is to decipher the intricate household intrigues of the Edwardian aristocracy, so the audio issues aren't as much of, well, an issue.

We finally did make it to the cinema. The first time, we ruthlessly bunged the Hatchling into the care of the brutal misanthropes at her childcare centre (note: this is obviously a lie. Her childcare centre is fantastic.) and took off into town. We saw an incredible film. The people in it had faces as large as a house. Their voices boomed out like thunder. Not once did the screen try to reboot itself. I think it might have had Richard Gere in it as well but I'm unsure of that.

The second time, we ruthlessly bunged the Hatchling into the care of the brutal misanthropes who are my Smaller Half's brother and mother (note: The childcare centre really is fantastic.) and took off into town. This worked a lot better than when my own brutal, misanthropic mother visited and said, "I really should offer to babysit so you can go to the movies but I'm not going to." Sad trombone.

We went to see the new Bond flick, Skyfall. As mentioned previously on this blob, I was unreasonably gobsmacked by the opening credits, largely because they were colourful and moved around a lot, as movies have tended to in general since the 1950s. Still, regardless of the objective merit of the film, it was a relatively novel experience for me, if I may be permitted to use such a bookish adjective in relation to a movie. So I think in 2014 I might go to the movies again, if they still exist.

I didn't have any instant coffee though. The choc-top is eternal.

Mental state examination

Appearance: Caucasian male, medium height and build, looks of stated age, short brown hair unbrushed, unshaven. Dressed in semi formal office clothes, clothes clean though rumpled.

Behaviour: calm demeanour, good eye contact though prone to reverie, no abnormal movements, gait symmetrical. Cooperative with interview.

Conversation: normal rate, tone, volume, rhythm of speech. Brief answers verbally, more expansive in writing. Some tangentiality and loosening of associations. Occasional inappropriate humour. Themes of anger, being misunderstood, narcissism.

Affect: reactive, engaged. Claims subjective inner turmoil.

Perception: apparently normal. No attendance to internal stimuli.

Cognition: not formally assessed. Grossly intact.

Intelligence: above average though possibly not as high as he asserts.

Insight: good though limited in the context of accepting and integrating criticism.

Judgment: impaired by innate laziness.

Rapport: superficially established.

Impression: ?tormented artist
?selfish prick
?dysthymia
?intern burnout.

Plan: 1. Ship him off to another hospital and let them sort him out.
2. Put him in the scuppers with a hosepipe on him.
3. Encourage writing: entertaining at times.

Nostalgia

I remember seeing the film se7en in the cinema when it came out. Apart from the pretentious alphanumeric title and the repulsive tortureporn vibe, the thing that struck me most were the credits. They were like a rock video. Jittery, buzzing, energetic, packed with attitude. And the best part of the film as it turns out.

When the first Daniel Craig 007 film came out, those credits were the best I'd ever seen. They were hypnotic. A shifting maze of colour and movement and danger. Which was no small feat given they came after arguably the best Bond prologue ever.

I thought they couldn't be beaten. But the most recent Bond film's opening titles left me gaping. The blood in the water. The skeletal teeth turning into tombstones. The underground/drowning/death/shadow thing was some heavy shit, man. I wanted to go and see the film again just so I could see the title sequence. So I looked it up on YouTube and you know what? They were clever but not all that, sister. Too clever. Too many references to the film itself. Too cerebral. Disappointing.

But you know the best opening credits OF ALL TIME??? A children's program called In The Night Garden. The visuals and the music fuse to form a perfect image so beautiful that every time I see the show I nearly cry. The boat recedes over the waves, the stars burn bright in the sky, and as the string melody swells, the stars burst into flower and we are pushing our way through the blossoms and into the Night Garden.

It captures for me perfectly that feeling when I was a child of being lost in a dream and half knowing it, half not. Of feeling the bed roll and sway as you float up towards the ceiling. It's the music of a lost age.

I can't remember if I've mentioned before that the word "nostalgia" derives from concept of a painful memory, but now has come to mean a longing for a thing long gone. These credits trigger memories I never had. They are the best ever. And it's on TV every night at 6.30 pm.

Tune in, turn back, drop off.

The stone

So here I am - stuck at the hospital on a lovely day with not much to do.  I'm on cover.  "Cover" means you're stuck here all day on a weekend dealing with whatever random stuff the regular doctors forgot to do or didn't foresee or simply couldn't be bothered doing.  Today is bizarrely un-busy for me.  Hence the flurry of blobbing activity, which I've cunningly scheduled to be published daily over the next week or so.

All that is by way of getting to what I want to talk about which is superstition.  When I'm on cover I get hugely superstitious.  All of my superstitions are aimed at avoiding having my pager go off.  Over the last year I've developed a decent set of tips for avoiding being paged.

1. Do not go onto the ward, through the ward, or near the ward unless you absolutely have to.  If they see you there or smell you out, they will page you.
2. Do not read a book.  Opening a book is a sign that you're getting comfortable, and they will notice and page you.
3. Do not watch TV.  Watching TV is practically begging someone to page you.
4. Do not sit down into a comfortable soft chair and wriggle back and forth a bit then curl your feet up underneath yourself.  They will page you.
5. Do not attempt to eat any food which gets substantially grosser if you try to re-heat it later on, such as cheese on toast.  As soon as you've got it ready to eat, you'll be paged.
6. Do not ever send anyone a text message saying, "Today is AWESOME!  There's NOTHING to do!" - you know how this ends.
7. Do not attempt to do any of your own work, such as chewing through your backlog of discharge summaries or doing MMSEs on your own patients.  This will generate a singularity in the pager continuum that will suck you in for the rest of your shift.
8. Don't arrange to catch up with someone you know and love for lunch or coffee.  Your pager will go off so often that you may not even see them except as a rapidly receding silhouette in the sunset.

"But PTR", I hear you ask, "What can I do when I'm on cover and want to avoid making the pager gods angry?"  A good question, mosquito.  The answer is to be found in nature.  You must be like the stone, which weathers all that the world can throw against it.  The stone does not read books, or sit in comfy chairs, or meet up with friends for coffee.  The stone does not try to catch up on discharge summaries or eat a delicious lunch. 

No.  You must be like the stone.  You must lie low, very still, in the dirt.  Let the ants crawl over your face.  Let the rain run into your shoes.  Let the frost rime your beard.

Do this and you will be like the stone, whose pager never, ever goes off.  Be like the stone.

Reading is hell

In between lurching from day to day as a hospital intern, raising a small child, and smothering my rage so as not to commit chargeable offences on this blog, I've not had time for much reading.  I used to get through a book every fortnight or so on average, even during med school when I probably should have been reading rather more about sick people than I actually did.

As a result I haven't updated the Bookshelf page of this blog for quite some time.  I'm sure that the more literary minded of you have been salivating at the thought of an update, and I'm equally sure that only one or two of you have ever actually noticed the Bookshelf page of this blog. 

Regardless of your level of interest, I'm going to bang on about reading for a bit, for a couple of reasons.  First, I'm sitting here in front of a computer on a cover shift with not much happening so far, so I've got the itchy fingers, and second, I've noticed some interesting trends in my reading.

Normally my reading tastes run to:

• literary fiction
• vintage sci-fi
• historical non-fiction
• scientific non-fiction

Now what I've noticed is that when my stress levels ramp up, the literary fiction is the first thing to go.  All that cortisol must shut down my frontal lobes.  After a while the scientific non-fiction goes too, followed soon after by the historical non-fiction as my brain withers and dies under the relentless assault of my unhinged amygdala.  All that's left is vintage sci-fi, and even that warps and mutates into a desire to read really awful genre fantasy.  Ugh.

But given long enough, even the bad genre fantasy goes away, and historical fiction rears its head again - but in a very specific way.  I get magnetically drawn to personal memoirs of people who've had really really traumatic experiences, mostly to do with getting shot at.

I think the protective mechanism at work here is an underlying desire to put my life in perspective.  Sure, I may have to attend multiple Code Blues in the middle of the night but at least I don't have to see the tortured corpse of my best friend as in Flags Of Our Fathers.  I may feel burdened by being called to assess yet another asymptomatic hypotension, but that's preferable to having to pretend to be dead while my pockets are looted by the enemy and bullets are fired into the heads of my injured comrades around me, as in We Were Soldiers Once, And Young.  And sometimes I rile at the selfishness and insensitivity of my seniors at work - but at least I'm not being systematically hunted down and exterminated by the State, as in The Pianist.

The good news is that phase of my life seems to be over.  I've recently been able to start reading scientific non-fiction again, with Oliver Sacks' Seeing Voices - a book about Deafness, Sign and language.  Prior to that I read Naval Warfare In The Age Of Sail and learned to distinguish a sloop from a brig.  Soon I might be able to crack open that Anna Funder book I've been sitting on since April.

Here's hoping!

Funny blog content

The other day during the nursing handover we were astonished to discover that one of our patients has been doing his own FBC - full blood count.

He gets all the blood taking equipment ready, puts on the tourniquet, finds a good vein, draws the blood, makes a slide and examines it under a microscope, counting the different numbers of cells in a random selection of high-power field views, and then analyses the rest of the sample to get a haemoglobin level and all the other palaver.  Pretty amazing.  But then I guess he has a fair bit of time of his hands, being a patient with nothing else to do.

Sadly, it was all in my mind.  He does indeed do his own FBC - but it's the fluid balance chart.  He merely keeps track of his fluid input and urine output volumes.  I preferred my version.

Call me nick

The Hatchling is going through what must be a developmental milestone of sorts: she finds it highly amusing to call me by my first name.  I remember when I was a kid I had one or two friends who would call their parents by their first names and to be honest, I found it creepy and a little bit frightening.  Somehow it breaks the child out of the "child" role and they become instead some kind of mutant evil genius in a child's body. 

So I always make a point of correcting the Hatchling - "No, Dada" - which of course is a trigger for her to turn it into a game.  Even stranger is when she copies my Smaller Half and calls me "Honey".  That's just wrong.

I realized the other day when the three of us were sitting in the cafeteria at work that I could turn the tables on her and see if she identifies with any of the nicknames I tend to give her.

So I asked her: "Where's sweetie-pie?" - she pointed to herself, pleased.

"Where's gorgeous?" - she pointed to herself.

"Where's beautiful?" - herself again.

Hmm, let's see what happens if I use something she hasn't heard before, I thought.
"Where's boombalada?" - being a generic nickname for a fat person that I remember from my childhood - and she turned around and pointed at the unfortunate person at the next table, causing me to almost bust an internal sphincter trying to not laugh.

Cheese blues

Gorgonzola is an unfortunately named cheese - the Gorgons being the snake-haired monstrous sisters of Greek mythology.  The idea of getting milk out of them just puts me right off.

Modern genius

Despite the Hatchling's shortcomings in classical mechanics and abstract algebra, she is doing well in fields.  Botany, for example.  She has been hampered somewhat by being unable to pronounce the word "flower" - producing something more akin to "fla-fa", but nevertheless her theoretical knowledge is excellent.

Just the other day when I was eating a plate of nasi lemak, she pointed at the red-skinned roasted peanuts on my plate and said, "Bean! Bean!".  Now it would easy to patronisingly assume that she had mistaken the red peanuts for kidney beans, which she had in fact eaten just several days earlier.  I, however, knew that she knew that peanuts are not true nuts but are actually a variety of legume, or bean.

Well played, little Hatchling, well played.