Not quite Heinlein

"A human being should be able to spin silk, roll a dung ball with his legs, lift fifty times his own weight, leap one hundred times his own height, continue to mate whilst having his head devoured, walk on water, spray noxious chemicals from his hind-parts, drink eight times his own weight in blood, hover in mid-air. Specialization is for insects." - PTR

Psychiatry for toddlers

This week I've been working as a locum in the emergency department, with the psychiatry team.  Here is the transcript of a conversation I just had with the Hatchling about it:

Hatchling

Dada, did you work today?

PTR

Yes, I did.

Hatchling

Were there lots of people and animals?

PTR

There were lots of people, yes, but no animals.

Hatchling

Were you friendly?

PTR

I was.  That's what my job is all about. When people are feeling really sad, they come to the hospital and I am friendly and nice to them, and then they aren't so sad anymore.

Hatchling

Did you give them a cuddle?

PTR

No, I just talk.  The only people I give cuddles to are you and Mama.

Hatchling

Thank you Dada.

In reality, of course, it's not quite so simple.  Psychosis, attempted suicide, substance abuse, people with really tragic histories of childhood abuse, pain, and deprivation.  But I think the details can wait until the Hatchling is a bit older than 3.  Until then I'll just continue counting my lucky stars and trying to be the best Dada I can be.  And being as friendly as I can to people who need a friend.

A list of anniversary gifts

Meanwhile, the Smaller Half and I have recently celebrated our 9th wedding anniversary.  "Celebrated" having a specific meaning, of course, when you have a small child and busy jobs - we caught up for a late lunch and shared a sandwich.  Hooray!

My brother observed that the 9th anniversary is traditionally associated with gifts of willow and pottery, and that perhaps there was some relationship with the Australian cricket team having just won the Ashes.  I thought that this was a surprising coincidence.  He thought that there was perhaps a causative relationship. So I started to look into some of our previous anniversaries to see if any other momentous events may have been due to our tying of the nuptial knot.  First, I needed a definitive list of the traditional gifts associated with each year of marriage.

Much to my surprise, I discovered that every man and his dog seems to enjoy inventing and propagating such lists.  There are "modern updated lists" which claim, for example, that the 4th anniversary should be marked with the gift of kitchen appliances.  There are "spiritual lists" which claim that the 6th anniversary is the quartz anniversary.  There are "nerd lists" which insist that the 10th anniversary is the "flight simulator" anniversary.  These were not what I wanted.

Eventually I managed to track down, in the local library, a moldering crumbly parchment. It is dated from the middle of the 14th century, and has been tucked away, hidden for centuries, in the 23rd edition of the Guinness Book Of Records, which had been mis-shelved in the poetry section.  It records, in the wavering hand of the Capuccin monk Bernadetto Ristretto, the definitive list of anniversary gifts, and was penned as part of the church's planned statement opposing marriage between unrelated couples, the intention being to glorify and uphold the status quo.  And it goef a little fomething like thif:

1. Paper. Preffed ye from reedf growne on the bankf of the briny ocean.
2. A booke of marvelouf and interefting geometrey.
3. A dicke in a boxe.
4. Tranfuranic metalf, formed into a chain or locket that doth glow.
5. A fmall puppey or kitten, calleth Fpot or Fufie, refpectively.
6. A big hatte, fufficient to hide therein a dram of wine.
7. Anti-hiftaminef for the relief of the feafonal rhinitif.
8. A hogfhead of wine, fufficient to hide therein a big hatte.
9. A pockette-fized notebook for the tranfcribing of one'f numerouf paffwordf.
10. The Blue Whale and feveral dayf krill for the feeding of.
11. A particularly bouncey balle, for fport.
12. Thingf of the color red.
13. A native of the Indief for one'f perfonal amufement and care.
14. A jar of fartf.
15. A gifte voucher for a night in one of thofe noveltie "Ice Hotelf".
16. A choir of flender boyf to fing the greateft hitf of Ftatuf Quo.
17. To have a new font named for you, oh verily.
18. A glaff of horfe milke, with the haire extracted with all due diligence and care.
19. A confervative legiflature.
20. The Duke Of Yorke, with pantf of courfe..
21. A copy of thif lift.

... and so on.  It was a useful list, and certainly much more interesting than the typical nonsense that gets foisted on unsuspecting couples every anniversary.  It's such a shame that such a valuable piece of tradition and history has been lost for so long, and I am very excited about having the opportunity to bring it to the attention of the world.

I suggest that the next time your anniversary rolls around, or that of your parents or siblings, you consult this list for gift ideas.  Just imagine how surprised they will be!

Vital signs

Hatchling

I take your tenchaba. 

[Sticks a finger in my ear] 

PTR

What is it? 

Hatchling

One o'clock!

Party pooper

Hatchling

Look at that boy.

Smaller Half

That's not a boy. That's a man. He has a condition called achondroplasia. Can you say "achondroplasia"?

Hatchling

Aycondopaza

Smaller Half

Oh my god, she can say "achondroplasia"!

PTR

Yes, because you just told her to.

Some day

[The scene - watching an animated nursery rhyme ending in a teddy bear going to school]

Hatchling

Teddy bear go to school?

PTR

Yes, one day you'll go to school too.

Hatchling

I go to school some day, when I am tall.

Zen master in action

Smaller Half

Which is your favourite, the swing or the slippery-slide? 

Hatchling

Red?

Get me Pam or Bev

Clinic. Oh how I hate thee.

Now that I am a fully registered non-intern-type actual doctor, I have to run a clinic.  It could be worse - it's only one morning every fortnight.  But it is nuts.  I am in fact a reasonably good doctor, despite my gross inexperience.  Thanks to my eidetic memory, burly forearms, and devil-may-care smile, I am quite good at preventing people from dying whilst in my care unless they have an actual life-threatening illness.  But clinic isn't about avoiding killing people until you can handball them on to the next shift.  It's about actually trying to get things done.  Mysterious things.

You sit in a tiny little room seeing patients who need expert advice on their medical issues.  Patients you have never seen before and will probably never see again, who have problems you've never heard of, and have no idea how to appropriately manage.  You may think this sounds foolish, wasteful, dangerous, stressful, or even ludicrous.  You are correct.

What happens is that people go to see their GP and say, "When I wake up in the morning I can smell ferrets".  And the GP says, "Hmmm", and then says, "I'm going to refer you to a colleague of mine who specializes in this type of thing, as it can be quite serious". And the GP writes a letter to the clinic saying, "Thank you for seeing Mr John Patient regarding him waking up in the morning and smelling ferrets, for your advice and ongoing management etc".

And you turn up at clinic and there is a file sitting on your desk with the GP's letter in it, which you read and think - what the fuck?  So you bring the patient into your room and ask him every question you can think of that seems relevant - no, I don't own a ferret - no, I don't ever smell anything else - yes, I'm allergic to strawberries - no, I don't have diabetes or epilepsy.  And after twenty minutes of this you are none the wiser, and resign yourself to asking the consultant.

Yes, the Big Boss is sitting in a tiny little room next door, seeing his own patients just like you are but presumably not thinking, what the fuck? quite so often as you.  So you knock on his door, stick your head in and say, "excuse me Dr Hardhat", which of course he answers by saying, "Just wait" because he's trying to see a patient.  So you hang around the corridor for 15 minutes waiting for him to finish.  Hopefully the patient isn't using your computer to look at anything too dodgy on the internet, like homeopathy sites or pictures of Tony Abbott.

Finally your moment arrives.  "Dr Hardhat, I have a man next door who wakes up in the morning and smells ferrets."  "Good God! What's his record number?" "I don't know, I'll just go get it."

So you go and get the patient's record number and the consultant proceeds to look at the patient's blood results, CT scans, home address, previous admission records, all at high speed and in apparently random order.  And all the while he is asking you surreal questions that you don't know the answer to because nobody in their right mind would have thought to ask them unless they were already a ferret-sniffing specialist.

"Is he left-handed? Has he ever had radioactive iodine? Did he work as a paprika-splitter prior to the signing of the Ottawa Charter? Is his wife from Brazil? Does he have intact proprioception of the nasal septum?"

The only good thing about this is that he doesn't actually wait for you to answer any of these questions.  Then he turns to you and says, "Well, we're just going to have to do a transplantational conscious venothrombofistulinstagramatron.  Put him on my list for Wednesday."  And then he leaves to get the next patient. And you think, not for the first time, what the fuck?

So you go back to the patient and inform them solemnly that having considered their situation, that you think they need an urgent transplantational conscious venothrombofistulinstagramatron.  And the patient says yes, okay.  Because they were out of their depth way back when they saw the GP and now they're just going with the flow.

And you're sitting in this office desperately riffling through every drawer in the desk trying to see if you can find a form to book one of these damn things before you die of hunger.  And you can't, so you leave the room, looking in despair at the growing pile of patient files on the trolley outside your door.  And you see the consultant coming back with a patient so as he passes you ask him how to book that thing he wanted.  And he says, "Just call Pam".  And you think, who the fuck is Pam?

So you call the hospital switchboard and ask to speak to Pam, and they ask which Pam, and you say Pam who works for the ferret-sniffers, and they say ok, but the phone just rings and rings and rings, and the patient is staring at you as the sweat runs down your forehead.  And you call switchboard back and ask them for Pam's other number but they just keep putting you through to the same extension which rings and rings and rings.  And you can see out the window that there is an orderly driving a little electric cart back and forth across the parking lot moving bins full of dirty laundry, and you're thinking you chose the wrong career.

And eventually while you are staring blankly at the wall in front of you trying not to meet the patient's gaze in case he sees The Fear In You while the phone rings and rings and rings in your ear, you realize that you are staring at a piece of paper typed in the 1980's and thumbtacked to a corkboard which says, in faded archaic monospaced font, "VENOTHROMBOFISTULINSTAGRAMATRON BOOKINGS - PAM 81702".

So you dial 81702 and Pam picks up the phone and you ask for a spot on Dr Hardhat's list for next Wednesday and she says conscious or sedated, and you say conscious and she tells you to call Bev instead and hangs up but at least you know Pam's number so you call back and ask for Bev's number and eventually after much bewildering misadventure much in the vein of the preceding tale, you get through to Bev and book an appointment.  So you give the patient the appointment time and breathe a sigh of relief.
 
Then you tell the patient that you're sorry he parked in a 15-minute spot but you don't have any authority over the parking inspectors.  And you don't know how long the test will take next Wednesday but it would be best to probably sell the car and catch a cab instead.  And yes, his gangrenous foot is no doubt troubling him but you think it would be best dealt with by his GP.  And you push the patient out the door, take the next file from the stack, and start all over again.

My Smaller Half, as drawn by The Hatchling

Hottest 2013

Triple J, Australia's official government mouthpiece for youth radio, is holding a poll to find your favourite music.  You have twenty days to vote for your twenty favourite songs from the past twenty years.

Fair enough.  But it doesn't go far enough.

So for the next 2013 days, I want you to vote for your top 2013 pieces of music from the past 2013 years.  Votes close in six years or so.

Go!

Problem list

[scene: standing with my registrar looking at a new patient's medical record in the emergency department] 

PTR

It says MBA 2005. What's that? 

Registrar

It could be MVA (motor vehicle accident) - B is next to V on the keyboard. Or maybe a motorbike accident. 

PTR

Oh I wouldn't have thought of that.

Registrar

Or else he did a Masters of Business Administration. But I wouldn't expect that to show up on his problem list.

PTR

I don't know - some of my degrees would fit pretty well on my problem list.

Registrar

How many degrees have you got? 

PTR

That's also on the problem list.

Suburban dictionary

Matticus Finch recently left a wonderful list of words for me to use in future requests for radiography. Unfortunately I didn't know what most of the words meant. And if I, the Elderly Boy Genius, am flummoxed and bamboozled, what hope is there for you Readers, the mere dross of humanity?

To assist you, to educate you, to lift you up from the gutter, I have prepared some definitions of those words. I urge you, nay - instruct you - to use them every day until they enter common parlance in your everyday milieu, or somebody punches you in the face. Either way, mankind will be better off.

Avaunt - A jaunty cry given when vaulting over a privet hedge, garden setting, or pile of croquet mallets. "With a lusty avaunt, he disappeared over the gunwhales and was not seen again."

Anon - A infeasibly small quantity of an exotic ingredient required to make a particular recipe, which is only obtainable in amounts large enough to make several thousand serves. "Then, add 2 anons of strawberry seeds."

Ordure - An instruction that is especially burdensome to fulfill. "He ordured me to clean every toilet on the ward."

Eftsoons - The easterly tropical storms seldom seen these days in Adelaide. "We re-planted the garden in anticipation of a good eftsoon drenching, but everything just dried up and died."

Marmoreal - Of, or pertaining to, the marmot, which may or may not be a type of groundhog. "Your new haircut is somewhat marmoreal."

Thole - (derogatory) the anus. "Get back to work or I'll kick you in your thole."

Betimes - Indicative of an indeterminate length of time that has expired since one began playing the one-armed bandits. "I've wet my pants and there's a new Prime Minister betimes."

Somatic - Partially automated. "My car won't go into fourth gear so it's somatic at best."

Betwixt - The loneliness felt when eating an entire chocolate bar whose key advertising feature is the ability to be easily broken and shared between friends. "I hurriedly gobbled the whole thing up then sat there in front of the vending machine feeling betwixt for the next half hour."

Evisceration - The act of forcibly removing someone from their place of residence. "If full restitution for unpaid rent is not made by the first of next month, evisceration proceedings will commence."

Forsooth - A dental abscess. "I han't hum in do work doday coth I hab a forsooth."

Howbeit - Grammatical term for the long compound words in languages such as German. "Did you hear about Jeff? He dislocated his jaw on a particularly nasty howbeit!"

Lazarus Pit

I was playing with the Hatchling today in a public space when a small child came up to me. She was about 5. She peered closely at me and asked, "Is this your little sister?"

I explained that actually I was the Hatchling's dad. She looked kind of crestfallen then wandered off.

I thought it was quite funny that she couldn't distinguish between the various categories of Big Guy by sight. I would have thought that being 37 years older than the Hatchling (yes you read that right) would have qualified me for potential grandfather status but clearly the years of aggressive exfoliation, Botox and hair dye have paid dividends.

This makes a refreshing change for me. Recently I've been drawing a lot of "you look like a wreck" comments. These have all been at work though, and given that I've been working 12 hour days seven straight and not getting much sleep (due to the Hatchling's preference for waking up by shouting "Dadda! Where are you?" after I've not got home until after 1 a.m.) I suspect that exhaustion rather than simple decay is the culprit.

The fact that I was building a tower out of little wooden blocks when I was mistaken for someone 25 years my junior also is telling. Clearly when I'm enjoying myself I looked rather more relaxed than when I'm having to wade through the mire of half-baked referrals from the Emergency Department.

Not that I'm bitter about it.

Because because because because beCAUSE

Pretty pleased with myself today.  I used the word "thereof" on a form requesting a CT-scan of a patient's chest.  Being born in the late 20th century, I'm not 100% certain that I actually used in a grammatically correct way.  It was along the lines of, "Patient has diagnosis of condition X but no radiological evidence thereof".

Sweet action.

I wasn't planning in advance to write it like that. I'm pretty tired and the sentence just kind of came out of my pen in an awkward manner which "thereof" seemed to resolve in an elegant flourish.

Despite my uncertainty about correct usage, I'm a fan of these archaic-slash-legalistic adverbs. (Confession: I had to google "thereof" just now to determine that it is an adverb. Hey, it's late and I've been at work for 11 hours now. Shuddup.) So I think I might start using more of them in day to day settings. 

Words that I might try to use more often include, but are not limited to:

• hereunto
• heretofore
• aforementioned (I think I've already used this in an admission note)
• whereupon (ditto)

Did you notice how sneakily I qualified that list?  I "might try" but am "not limited to" them. In other words, I'll do whatever the hell I like.

Sweet action.

Double edged

On our fridge we have a little round magnet inscribed with a quote from Goethe, who was a real smart German guy. Or possibly Swiss or American or even Dutch. Anyway, smart enough to get stuff he said written onto fridge magnets.

It says, "Nothing is worth more than this day"

When I get up in the morning and I'm stumbling my way into the kitchen this is a gentle reminder to be mindful, to savour the world as it is, and to fully engage with reality. Makes me feel like the goddamn Dalai Lama.

But on a bad day, when I look at it, my brain interprets it literally and the message I get is: "This day is worth less than nothing."

I wonder if depression is more common in mathematically minded people?

Birds and ships

The birds are singing in your eyes today,

Sweet flowers blossom in your smile,

The wind and sun are in the words you say,

Where might your lonesome lover be? 

Birds may be singing in my eyes this day,

Sweet flowers blossom when I smile,

But my soul is stormy and my heart blows wild,

My sweetheart rides a ship on the sea. 

- Woody Guthrie

Work it

As a parent, it's important to me that you understand that my daughter, the Hatchling, is the cutest, most adorable person in the world. Fact.

Yesterday evening she spent about an hour walking around the house "photographing" us and her toys. Her camera was in fact a large rectangular piece of Lego. She would come up to us and say, "pictures?", in her best air-hostess voice. She would then hold the Lego up in front of her eyes for several seconds and say, "smile!", before turning the Lego around and offering us a view of the beautiful picture she had just taken.

She took quite a few shots of us before moving on to her toys. They were photographed in situ, individually, before she realised the exciting artistic possibilities open to her, and she began arranging the toys in little tableaux, usually with the toys having their arms thrown casually over one another's shoulders as if they were just coming home from a night at the pub.

She was halfway through one particularly detailed shoot when she stopped, peered closely at the piece of Lego, and must have decided that it made a better airplane than camera, because she started saying, "zoom zoom zoom!", and flew it around the room several times.

That didn't last long though because it then became apparent that Baby (her doll, who has no hair) needed her hair brushed, and the airplane/camera was the perfect tool for the job. She was quite vigorous in her brushing and because I'd missed the plane-brush transition I thought that she was brutally beating Baby with an airplane. As a result she got a little lecture from me about how its very important to be kind and gentle to babies and thus beating them with vehicles of any kind was really not on.

She looked pretty baffled, but had the patience to explain to me that the plane was in fact a brush. So it was all okay. But I think my intervention kind of ruined it for her because the camera/plane/brush went back to being a camera shortly thereafter and remained so for the rest of the evening.

Smile!

True love

You are the cheese to my sky
You are the horizon to my eggs
You are the bacon to my sneakers
You are the laces to my peanut butter
You are the jelly to my face
You are the smile to my mashed potatoes
You are the gravy to my bath
You are the bubbles to my cookie
You are the milk to my pen
You are the ink to my french fries
You are the ketchup to my ocean
You are the water to my cupcake
You are the icing on my macaroni

Bip the clown

PTR

Have you had any vomiting?

Mr Nesby

No, no, what is this? I no understand this.

PTR

Oh. Um. Throw up?  Bleurgh!  Bleurgh!

[Mimes vomiting]

Mr Nesby

Oh! No, no, none of this.

PTR

Have you had any diarrhoea?

Mr Nesby

I no understand.

PTR

Never mind.

Witzelsucht

Nurse

What's the plan for bed 2?

Doctor

I'm just looking at her x-ray.

...

There's no fracture, she can go home.

Nurse

She can't go home.  The pain means she can't mobilize.

PTR

Does she live in a mobile home?

Ba-doom-TISH!

Best foot forward

I went to see a patient recently - while I was trying to examine him he started to peel off the sticky dots with metal buttons that serve as ECG leads.  I thought I'd give him a hand, just to try to build up some patient rapport, that kind of thing.  But as I reached down to the V3 lead he drooled on me, on my bare skin on the hairy part of my wrist.  Ew!

But wait, there's more.

Later on I was walked around and I noticed that my right shoe was going click, click, click.  Must be a drawing pin in the bottom of my shoe, I thought.  On inspection though I found that I had a big sticky ECG dot on the sole of my shoe.

So there I am, adopting the "I've just stepped in dog poo" posture while I'm trying to peel this thing off my shoe in the nurses station, when around the corner comes a nurse, who stops and raises an inquisitive eyebrow.

I paused dramatically and said, "I think I've been going too hard with my chest compressions".

Boom-TISH!

See no evil

I'm encouraged by the recently released stat that more than 100 people every year mistake superglue for eyedrops and glue their eyes shut.  Most obviously, I will clearly never be out of work as a doctor while humans are capable of such blunders.  Also, the more people walking around with their eyes glued shut, the less frequently I will have to iron my shirts or shave or brush my hair or blow my nose.  Perhaps if more people put superglue into their nostrils I could save a bunch of money on deodorant as well.  And if they put it into their ears I could buy more Bieber albums.

But the tragic corollary of this story is that there are probably at least 100 people per year whose model airplanes are falling apart because they were assembled using eyedrops instead of superglue.  It's a hidden epidemic.  Nobody turns up at the Emergency Department complaining that the wings fell off their Lancaster.  Nobody over twelve anyway.

But I'm sure that the long term health effects will be felt for decades.  I remember when I was five I had a yellow model Pontiac Firebird.  I was foolishly playing with it in the yard, thinking that it would be as robust as an actual toy car, when the front left wheel broke off.  My blood pressure shot through the roof and I could feel the seeds of atherosclerosis growing within me.

"I'll give you atherosclerosis in your head if you don't stop crying by the time I count to three!", said my Aged Mother.  But the damage was already done.

There must be many other disastrous incidents where people accidentally use their medications improperly.  People in the midst of renovating their bathrooms filling their mouths with polyfilla thinking that it is mouthwash.  In fact the Hatchling was onto something the other day when she was watching me shave - "Dada put toothpaste on face!", she said in astonishment, being unfamiliar with the concept of me shaving since it usually happens when she's asleep.

Have any of you ever made this type of mistake?  Glued your eyelids shut?  Swallowed Julia Gillard's contact lenses?  Given a patient a transfusion of passata arrabiata?  Accidentally transplanted the heart of baboon into a human?  It must be more common than we admit.

Crazy mixup #6

Finally (no! I hear you cry out in anguish), one last poor unfortunate came to my hospital with a tummy like a bowling ball. Once more unto the breach, my registrar found me and patient engaged in a stimulating discussion of the mystical philosophy of Martin Buber.

"What are you doing?" shrieked my registrar, "I asked you do do an ascitic tap!"

"Oh!" said I, "I thought you said a Hasidic tap."

I think we're done here now.

Crazy mixup #5

Just like before, only this my registrar came into the cubicle to find me blissing out to the Grateful Dead on my iPod.

"What are you doing?" shrieked my registrar, "I asked you do do an ascitic tap!"

"Oh!" said I, "I thought you said an acidic tap."

Crazy mixup #4

Blah blah blah an unnecessarily complex setup story involving somebody with free fluid in the peritoneal space, which ends with my registrar finding me lying in the patient's cubicle, my only visible movement being the feeble drumming of one of my fingers upon the floor.

"What are you doing?" shrieked my registrar, "I asked you do do an ascitic tap!"

"Oh!" said I, "I thought you said an asthenic tap."

Crazy mixup #3

So this elderly man came into the Emergency Department with a bloated abdomen.  To cut a long story short, vis-a-vis the diagnostic process involving the necessity of analysing a sample of the fluid within his abdomen, my registrar walked into the cubicle a bit later on to find me in the process of cracking open a big barrel of wine, only to find it had gone sour.

"What are you doing?" shrieked my registrar, "I asked you do do an ascitic tap!"

"Oh!" said I, "I thought you said an acetic tap."

Crazy mixup #2

A little old lady turned up at the Emergency Department not long ago with a grossly distended and tense abdomen.  We were pretty sure that her underlying problem was severe right heart failure but the fly in the ointment was that she did have hereditary angioedema.  I was halfway through working her up when my registrar walked into the cubicle to find me doing a beautiful soft-shoe shuffle in front of a bemused patient.

"What are you doing?" shrieked my registrar, "I asked you do do an ascitic tap!"

"Oh!" said I, "I thought you said an asthetic tap."

Crazy mixup

I admitted a guy to hospital a little while back.  He had liver failure and severe abdominal distension, probably due to his alcoholism but possibility of an intrabdominal malignancy couldn't yet be excluded.  A little while later my registrar walked into the cubicle to find me whipping the patient's stomach with a leather thong and making him wear a hair shirt.

"What are you doing?" shrieked my registrar, "I asked you do do an ascitic tap!"

"Oh!" said I, "I thought you said an ascetic tap."

Hooray for rationalisation

Day off - yay!

Compulsory grand round and tutorial - booo!

Decide to skip them - yaay!

Realise that I've also missed a scheduled meeting with my supervisor - booo!

Rationalise it by pretending that the meeting was just to tell me that I had to attend these things and not skip them - yaay!

The frogurt is also cursed - booo!

I did it for you

youTube.com is an amazing site.  Not only does it contain hilarious videos of cats, it also enables you to see children falling off bicycles.  Before youTube I used to have to fling cats at children on bicycles, but no longer.  It's win/Win/WIN!  Part of its genius is the name - it starts with "you" so it makes everyone feels like it's relevant.  The principle could be used to start up a bunch of other websites which I think could end up being just as big.  Here's a partial list - feel free to register and develop them yourself - I just don't have the time to give them all that they deserve.

youThyroid.com - This site would be handy for people to upload pictures of their goitres or of their Mel Brooks googly eyes.  They could trade stories about their pretibial mixoedema, and swap tips on how to use the internet effectively despite a severe tremor and a heart rate of 160.

youVolaemia.com - This site would be dedicated to enabling people to share hints, tips and tricks to do with their fluid balance.  How to best assess your jugular venous pressure.  The controversy over mucus membranes.  Skin turgor and the elderly.  The osmolality conspiracy.

youRopeanUnion.com - A fan site for European communalists of all stripes!

youClideanGeometry.com - Do your external angles sum to 360 degrees?  This could be the site for you!  Or perhaps that's just hyperbole.

youKaryote.com - Too long have plants and fungi been excluded from the internet.  This site would serve as a portal for all organisms with nuclei.

youPhemism.com - This site would have a lot of the you-know-what, eh!  Eh!  Especially for you-know-who!

youLersNameIsPronouncedOilerNotYoulerSoThisJokeDoesntWork.com - A site for looking up the names of dead mathematicians and the mispronunciations thereof.

Just give three

Nurse

You've charted 450 mg of clindamycin for this patient.

PTR

Yes.

Nurse

Well we only have 150 mg tablets.  How are we supposed to do that?

PTR

...

Got bicycle clips?

Fat in food is like salt. It's yummy and healthy and generally great. But its also something that you tend to become accustomed to having present at a certain level and major deviations from this can cause distress.

We had some friends in a previous life, when I was a woodsman in Depression-era Illinois, who would invite us round for dinner every now and then. We would secretly dread it because their fat barometer was set way below ours.

We generally like fatty foods. This is because my Smaller Half is Chinese and as for me, I am a greedy bastard. So we tend to load up on butter and oil when we cook. Perhaps the bed sheets do accumulate a yellowish tinge over time but we aren't too out of control.

Anyway, these friends were on a mission to cut down on fat. They would buy the leanest piece of pork they could then roast it at 4000 degrees on a rack so every molecule of fat was drained or destroyed. Then just before serving it on a delicious bed of shredded sandpaper they'd give it a light dusting with, well, dust, to really dry it up.

Not really our style.

Tonight we were eating out with friends and I ordered some roasted pork belly, an extremely fatty cut at the best of times. When it came it was quivering on the plate. There were pieces of meat the size of my hand which seemed to be nothing but fat.

Even I quailed somewhat. But not wanting to waste good food, I found that if you had equal parts fat and rice that it was great. Fatty and smooth and flavoursome and packed full of vitamin F. I really enjoyed it, somewhat to the horror of my friend opposite who is a cardiologist and knew that I should know better.

But nature has a way of interfering with mankind's fun. Just like drinking gallons of water is fun until you get cerebral oedema and die, just like bungee jumping is fun until your retinas detach and you get atlanto-axial dislocation and your skull falls off - there's only so much belly pork you can eat before your liver and pancreas stop playing along and you develop anal leakage. Not so fun now eh?

So the next time you try to show off by eating your own body weight in lard, remember my tragic tale and think to yourself, what do I value more: the smooth moist fatty feeling in my mouth or the smooth moist fatty feeling in my pants? Because you may end up with both.

Shortbrain

Initialisations, abbreviations and acronyms.  Medicine, like any complex field, is full of 'em. Some of them are similar but mean very different things.  And some of them are doctor's own personal shorthand and don't mean much to anyone else.  So if you're ever unfortunate enough to work in, visit, or be a patient in a hospital, be very careful when you start flinging them around or you may end up with more than you bargained for.

Last year I was talking to the family of a person who had had a stroke.  They were filling me on the patient's medical conditions.  I went and told my registrar that the patient had a family history of IHD, PVD and EPOG.

EPOG? asked my registrar.

Yes, I said.  The family told me that the patient's son had EPOG.

My reg laughed and said, EPOG is Enduring Power of Guardianship.  Difficult to treat.

What kind of sick do you has?

At the moment my job is kind of strange.  I do nothing but admit people to hospital.  I make some decisions about the immediate treatment and investigations but after that they aren't my responsibility any more.

It's bad in that I have to make an effort to follow the patients after that to find out whether or not I got things completely wrong (more on that another time).  But it's good in that I get a nice look at a representative cross-section of all the people who are getting sick and coming in to hospital, so I learn a fair bit.

For example, yesterday I admitted:

• a little old lady who got a urinary tract infection (UTI) and fell down,
• a little old lady who got a UTI and fell down,
• a little old lady who got pneumonia and fell down,
• a little old man who got a UTI and fell down,
• a little old man who got both a UTI and pneumonia (but he didn't fall down), and
• a little old lady who fell down.

I'm not convinced that this is preparing me well for the physician's exam in 2 years time, but I suspect it is good background for my Plan B of being a GP.  Also, I've decided that when I get old (ie: in about 5 years time) I'm just going to munch down on trimethoprim and amoxicillin for breakfast every day, just in case.

A prescriber's guide to cephalosporins

Antibiotics - they're confusing.  Especially the cephalosporins (Greek for "mushroom-head", or maybe not) which all have very similar names but quite different properties.  I keep having to look them up to make sure I get it right, so I decided to put together this quick guide to the main cephalosporins in use today in Australia's public hospitals.

Cefazolin - a first generation cephalosporin.  Acts by disrupting synthesis of the cell-wall of Gram positive bacteria.  Limited efficacy against Gram negative bacteria.

Ceftriaxone - a third generation cephalosporin.  Like other 3rd gens, has narrowed efficacy against Gram positive species, broader spectrum activity against Gram negatives, and has hi-speed Wi-Fi, BlueTooth, and data network connectivity.

Cefameme - protoypical Gen Y cephalosporin.  Has little activity or efficacy against, like, anything.  Known to be useless but still frequently indulged due to its vocal complaints of unfairness.

Cefalopithecus - the original ancestral cephalosporin, known only by recovery of several fragmented tablets in the Rift Valley, Kenya.  Acts by carrying a pointed stick and a flat rock.  Known to be effective against nuts, grubs, and berries but with little action against cave bears and hence seldom used.

Cefapene - only prescribed by dickheads.

Cefexazaxxayaxx - a potent 9th generation cephalosporin, with both broad and narrow-spectrum activity against Gram positive, Gram negative, anaerobes, fungi, cave bears, and students, depending on which magic words you speak as you take it.  Versatile, powerful, safe, and packaged in an attractive tangerine box of 13, its only side effect is to cause the patient to excrete delicious creamy chocolate instead of stool.  Never yet successfully prescribed in Australia due to the overly fashionable and difficult-to-spell name chosen by the marketing department of Pharma-Jim, the company that discovered it.

Little less conversation

We've been hearing possums in our roof.  So we called the real estate gangsters and told them there were possums in our roof.  They told us to send an email to them telling them that there were possums in the roof, so we sent them an email telling them that there were possums in the roof.  They sent a Man, who knocked on our front door and told us that, having looked at our yard, he reckoned we probably had possums in our roof.  He climbed up into the roof-space and poked around for a while, then came down and told us that we have possums in our roof.  He then sat on our couch and wrote a report to the real estate gangsters telling them that we have possums in our roof.  Then he left.

Now I know how patients in hospital feel about doctors.  Except nobody ever died from having possums in their roof.

Autonomy

PTR

There's a small chance your collapse might have been because of your heart.  We'd like you to come into hospital so we can monitor your heart for 24 hours.  What do you think of that?

Little Old Lady

What choice do I have?

PTR

In the end the decision is always up to you.

Little Old Lady's Daughter

Oh no it's not.  You're staying here in hospital.

Little Old Lady

You see?

Music hath charms

About two years ago I ran a poll on the eve of the birth of the Hatchling, asking if we should have a girl or a boy.  Well, now the truth is dawned on me - we had a Yokel.

For about 18 months I thought we had a little girl.  Whenever we took her anywhere in the car she would shout out "Baa-baa song! Baa-baa song!" until we put her favourite nursery rhymes on to play.  If I ever tried to put on the radio or play something more, shall we say, sophisticated, she would say, "No Dada music.  Baa-baa song!" - all of which is consistent with my initial diagnosis of Little Girl Syndrome.

Then about 6 months ago I found that if I sang to her in my best Johnny Cash voice that she quite liked it - at least for a song or two.  Danny Boy was her favourite, but she also liked Folsom Prison Blues and Ring Of Fire.  At that stage I was thinking that perhaps she was actually a Redneck.  Not that there's anything wrong with that.

This morning, though, I was playing bluegrass by Bela Fleck and Earl Scruggs in the car while driving her off to child-care, and she was loving it.  She was slapping her knees with both hands, and laughing.  When I asked her if she liked the music she said it was "Funny!", which is her all-purpose term of approval.  She also pointed at the sky and said, "Yee-hah!", which is something she picked up from the song She'll Be Coming Round The Mountain.  It was a real hoedown in the back seat of my car.  And that was when I knew - she's a Yokel.

Just like Dada :)

Lincoln

My Smaller Half and I went to see Spielberg's new film "Lincoln" the other day. It was good. It was like a two and a half hour episode of The West Wing, but without Alison Janney, which was a shame. Still, I recommend it to you if you're interested in a film which is mostly dialogue about politics. It might be worthwhile reviewing your American civil war history before you go though. I made the mistake of reviewing my Spanish civil war history instead, which wasn't as useful as I'd hoped.  Being largely ignorant of US history and geography made the film more baffling than it would have been to my american doppelganger, but on the other hand perhaps that allowed me to concentrate on other aspects of the film such as the relationship between Lincoln and his wife, and their housekeeper.

 

However, there were two things about it that were difficult for me:

• Abraham Lincoln's voice was uncannily like Grandpa Simpson.
• The soundtrack was eerily similar to that of Forrest Gump.

 I kept expecting old Abe to burst into a rendition of "On the road again" before collapsing into a narcoleptic stupor. But it didn't happen.  And the film is not well set-up for a sequel in which this could happen because *SPOILER ALERT* Lincoln is assassinated at the end of it.  Who knew?

Code lupp

There are a bunch of emergency codes in the hospital that for some reason are named for colours. If you're ever around a hospital you may hear them being announced over the loudspeaker system. So here's a list of what those codes are which may help you know what's going on in the hospital.

Code blue - medical emergency. If you hear a code blue called for your own bed number, sit up very straight and open your eyes or somebody will stick a very large needle into you.

Code black - behavioural emergency. Somebody's gone off their rocker and is going to be wrestled to the ground by security and bombed out of their skull with drugs by the doctors. This can be done to patients, visitors, staff, basically anyone who flips out. If you get a code black called against you, rush to a phone and call a code black squared against the person who called it on you. Who says you can't tip the butcher back?

Code brown - if called by a doctor, it means it's time to go and have a coffee. If called by a nurse, it means that someone's pooed their pants. So make sure you know the situation before eagerly volunteering to be involved.

Code red - fire. Or smoke. Or a funny smell, like burnt cheese. Or the battery has gone flat in the smoke alarm. Or one of the surgeons got too enthusiastic with the cauteriser while reaming out somebody's prostate. Either way, someone's gonna get their door chopped down by a burly firefighter. Meow!

Code yellow - it's the middle of the night and you really really need to eat one of those small pieces of cheese that you get on airplanes, but the box in the RMO lounge has been pillaged and is empty even though it was refilled yesterday. Throw out a hospital wide code yellow and everyone will check the fridges in the nearby ward kitchens and respond if there is any cheese present.

Code purple - is used signify that:

• the Artist Formerly Known As The Artist Formerly Known As Prince has been admitted to hospital, and is putting on an impromptu performance in his isolation room. Be there now!
• a patient has severe testicular torsion requiring urgent manual intervention. Be there now!
• both of the above. Run for the hills!

Code white - useful for alerting one of your colleagues, who has worn a suit jacket to work today because they are meeting with their mentor/stalker/sugar daddy, that their shoulders are covered in dandruff and need a brisk brushing. Best not announced over the PA system, but rather whispered discretely into the ear of the victim. Or into someone else's ear if you'd rather the victim was oblivious for the time being but you want to share the joy.

Code orange - there's a Dutch man who insists on bliintzinge his floogeboorts for some individueel slaapcomfoort. At least that's what we hope is happening. If not this could get upgraded to a code black quite rapidly.

Code green - extreme nasal congestion. All hands on deck!

With this list we've covered the basic of emergency situations in hospitals. You should be prepared for anything. And I just wanted to say, "good luck, and we're all counting on you."

Some terminology explained

I've noticed that my family, my friends, and pretty much everyone who isn't actually a doctor themselves tend to become confused by the medical lexicon. Not the endless names of drugs, diseases, and anatomical bits n pieces, but the terminology used to refer to other doctors and their jobs or levels and what not. So I thought I'd publish this little list of explanations that may help people decipher what I'm banging on about.

Intern - you're an intern for a year after you finish medical school. This is reckoned to be the most stressful year of work, apart from the others. Your responsibilities are basically to do everything that is too boring, too dirty, too repetitive, too inconvenient or too "easy" for your superiors to do. You're also the first point of contact for nurses, which is even worse than it sounds, as they have to call you whether they want to or not.

RMO - Resident Medical Officer. You're an RMO for between zero and forever years depending on local circumstances and your progression through a training program, or not. An RMO occupies a pleasant mid-ground between the intern and the registrar. They know enough medicine to not be freaked out on a day to day basis, and they have both a subordinate to delegate to and a superior to be guided by.

Registrar - basically the most senior person in a training program who isn't yet fully qualified. In some training programs you become a registrar on day 1, so you leap from intern to reg in one step. In others you have to slog out years of work and study and pass some frightening exams before you can call yourself a reg. Either way, you are working directly to a consultant, and you are making the majority of day to day decisions about patient care yourself. Because they are training so intensely, the registrars are sometimes more knowledgable and up to date than the consultants, but propriety directs everyone to behave otherwise.

Consultant - fully qualified and a fellow of the relevant college of medicine, which are kind of like the houses in Harry Potter. For example, all cardiologists are evil schemers bent on world conquest. Consultants lob in from time to time and make seemingly ill informed changes in treatment plans which nevertheless produce miraculous results. At least that's what the registrar tells them afterwards.

Cover shift - an extra shift of work that you are assigned out of hours such as in the evening or on the weekend because there needs to be a doctor on duty. You'll usually be covering the whole hospital yourself which means that you're constantly fighting fires. Not literal fires. Unless you're covering a psych ward.

Surgeon - a surgeon does operations. Obvious.

Physician - a physician does not do operations. But they can do procedures. Which is an operation where you don't actually cut someone open. Or if you do it's only a small hole. Distinguishing physicians from surgeons is not always easy for the patient but here's the general rule: if your doctor has a personality disorder, they are a surgeon. If your doctor is completely neurotic, they are are a physician. Psychiatrists come in two flavours - completely normal pleasant people, and cannibalistic serial killers. The ratio is about 50/50.

Any other lingo that I need to spell out?

Man up or else

Valentines day. The day when mainstream men suddenly get uppity about being "told what to do". Despite the fact that compulsory presents on Christmas and birthdays didn't bother them. They resent being forced to visit a florist. Perhaps somebody will mistake them for a homosexual. Better buy sunflowers instead. They're much more hetero.

Still struggling? Consider this: what if Valentines day was also your Smaller Half's birthday? Wouldn't that up the ante a little?

Yeah? And what if Valentines day was also your wedding anniversary? Going to be so curmudgeonly now? Too much trouble to break out the plastic for some stem therapy?

Oh, and by the way, not only is it Valentines day, birthday, and wedding anniversary, it also happens to be the birthday of your only child. Pressure! Plus, it's Christmas. And Easter. And Anzac Day too. The moons, you see. A great conjunction.

But it's not that easy. You can't just give in and buy flowers. What if your Smaller Half is allergic to flowers? And not just sneezy allergic. I'm talking full on anaphylaxis within seconds of boarding a bus which days earlier was brushed up against by a passing bee. What now?

But you can't just NOT buy flowers. The flowers, although grown in practically slave conditions by helpless immigrants in Holland, provide their only means of economic support, without which they'll be expelled back to the Congo to an uncertain life, or death. The guilt, the guilt.

But wait, they aren't Dutch flower growers at all. They're Belgians. Ew. Put the blooms back on the shelf please. Sorry child slave flower growers, I'm not risking homosexual double birthday anniversary anaphylaxis just to line the pockets of some fat Belgian. Not while I've got this terrible diarrhoea.

You'll have to wait for Mothers Day.

Virtual images

I'm pretty much hooked on Instagram. Not in the sense that I'm sneaking off to surreptitiously Instagram or that I leave my baby in a hot car while I Instagram for hours. But if you take the CAGE questions for alcohol dependence I actually have a decent hit rate re Instagram.

Have you ever felt the need to Cut down on your Instagramming?
Have people Annoyed you by criticising your Instagramming?
Have you ever felt Guilty about Instagramming?
Have you ever need an Eye-opener Instagram first thing in the morning to steady your nerves?

While considering this I did feel briefly concerned. But denial is the spice of life, so I realised that it really wasn't a problem. After all, many of the finer things in life would also score quite highly on the CAGE questionnaire. Coffee, blobbing, cheese, sleep, Peppa Pig, geometry, reading, hot air ballooning and picking of the nose. How could we live life without them?

Instagram, for those you who don't use it, allows you to take or upload little photographs and gives you some basic colour filtering and highlighting tools to make them look a bit jazzier, and then you publish them to you account. It's like a blog for photos. Other users can see your photos or search for tags that you've labelled them with. You can follow other users and see their new pictures come up on your feed.

Everyone seems to use it for different things. Some people only seem to take selfies - pictures of themselves looking, allegedly, "hot". Other people seem to be obsessed with taking pictures of their food. Or their dog. Or boats. Or sunsets. Or coffee, cheese, sleep, Peppa Pig, geometry, nose picking and hot air ballooning. That's more my arena, that list.

When I first started playing with it I was mostly interested in colour and patterns, like my intermittently series of Pretty Textured Rectangles that I post here. After a while I got distracted by the small size of the photos (on my screen) and the fact that they were square, and I seem to have been conceptualising the photos as almost like tiny icons, of the computing variety. I was trying to capture the essence of the banana (for example) and nothing else.

But now, things have changed again. Now I think of the Instagram photo as like a visual haiku. For me, it's a way of capturing a tiny moment of beauty. Being mindful of the multitude of episodes in life where I catch my breath and stop for a second to dwell on something unexpected. I use Instagram to record that oasis of existence and show it to other people.

It's tempting to fall into the trap of trying to take the same type of photo over and over again. It's a visual social medium so other people can indicate that they like your pictures. And there's always part of you that wants to please other people so you'll be "liked" in some sense. So you're tempted (or at least I am) to give the crowd more of the same. Perhaps this is how the guy who takes pictures of nothing but sneakers got started.

But operating that way just makes me edgy. My fundamental principle now is that I'm taking the pictures for me. They are a visual journal of my life - not the entirety of it, but the parts of it that remind me that life goes on happening all around us and we need to notice it before it passes on, or we do.

So I'm not so different from the people who only publish selfies. Theirs of their bodies and clothes. Mine are of my thoughts and the cogs turning inside my mind to grind the grist of my perceptions into reality.

No more gaps

I kind-of promised a few posts back that I would explain how I came to have my RMO (or residency) job this year.  It's a long, fascinating story in a short and boring kind of way.  And it goes a little something like this:

I wanted to do a year of General Training this year.  General Training means you're in no specific training program.  This is because:

• I am indecisive, and can't commit to a future career,
• I am cowardly, and am too afraid to apply to a training program in case I am rejected,
• I wanted to do some more psychiatry,
• I wanted to do some anaesthetics, and
• I am lazy, and didn't want to have to do any study any time soon.

So I applied for a year of General Training at the hospital I did my internship at.  Naturally, as an outstanding and handsome young doctor I was hired and my every wish came true - not.

What happened was that four thousand other people also had the same plan and the hospital decided that they should hire a bunch of bozos so they could be closely supervised before someone got hurt - meanwhile the superior interns such as myself were thrown back on our resources since we could so obviously cope with it.  Or something like that.

So I was stuck without a job. The process in the arse end of Australia is that we get three preferences for different jobs throughout the state.  The advantage of this is that if you don't get your first preference, they know that you're a hopeless dud and they throw your application in the bin while laughing maniacally and sucking on a giant cigar.

Then after about a month of bitter self-recriminations, I got a phone call out of the blue from another hospital that I hadn't applied to.  They wanted to interview me for a job.  So I said yes, sedated all my patients, and drove to the other side of the city for the interview.

The interview went for half an hour and mostly consisted of the 3 members of the panel discussing between themselves what would be the best route for me to take in the mornings to bypass the rush-hour traffic. The other bits consisted of them hanging shit on each other, and in one case almost falling off his chair.  They asked me the expected questions, prefaced with "I'm sure you'll know the answer to this one but we have to ask", and then after I started to answer they would interrupt me and say, "Yeah yeah yeah, blah blah blah, that's great."  I was watching out of the corner of my eye as the departmental secretary filled out her evaluation form, just running down the page ticking all the boxes marked EXCEPTIONAL in a perfunctory way.  Seriously.

It was pretty clear to me that somebody had unexpectedly quit their job and they needed a replacement pronto.  Somehow they had got their hands on my resume and they liked it (I know this because we discussed some of the research I did in my prior life as Cleopatra, Queen of the Nile) and decided to offer me the job as soon as they saw I didn't have three heads and wasn't a serial killer.

Which is all great.  Except that halfway through the interview I realized (by peeking again at the evaluation form) that this wasn't an interview for General Training.  It was an interview for Physician Training.  (For Americans, this means Internal Medicine.  For non-medical people, a physician is a medical specialist like a cardiologist or a neurologist.)

Physician training is intense, scary, competitive and I had repeatedly told many people that there was no way I would do it.  So when they offered me the job, I accepted it.  I accepted it because:

• They pay me a salary.

So that's what's happened.  I got a job I didn't want by not applying for it at a hospital I didn't want to work at.  So far, all things considered, it's going pretty well!

Gamut

A sudden flashback to the recent Olympics - a FaceBook friend posts a comment there about the opening ceremony - that he had "experienced the full gamete of emotions".

And I laughed, thinking that if your gametes got involved, you obviously enjoyed it far more than I did.

Wish list

I don't enjoy birthdays much any more. I used to think it was because I was:

• getting old and forgetful,
• jealous of the kids getting all those toys when I used to just get a cessation of whippings for 24 hours,
• exhausted from all the wretched children crawling around underfoot,
• a real prick,
• all of the above.

But I had a eureka moment the other day. Not in the sense that I rebelled against the imposition of a gold miners license, but in the sense that I had a sudden moment of enlightenment.

I realized that I really miss my Aged Mother's sticky-tape dispenser.  It belonged to my Dear Old Dad too in theory, but I never saw him use sticky-tape once in my life. He was more of an Araldyte and wire kind of guy. But that's not important right now.

My Aged Mother's sticky-tape dispenser was heavy.  When you lugged it into another room to wrap up your presents, it would softly thump down onto the table, its velvety black base smothering the sound under its weight.  It was heavy enough to work with one hand while you restrained the paper with your other hand.  It's little row of serrated teeth could neatly rip the tape off, leaving the end all zigzaggy like it had been snipped with pinking shears.

But in our house, the tape roll is just flung into a drawer with all the pens and bulldog clips and rulers.  It takes you five minutes just to find the end of the roll.  Meanwhile the wrapping paper has curled up and unwrapped itself from around the present you're trying to deal with.  It's garbage. Wrapping presents is so deeply psychologically scarring now.  It's no wonder I never remember anyone's birthday anymore.

So when my Aged Mother rang me up and asked me what out of the house I would like when she dies (which is an exercise she undertakes every few months), I should have nominated the sticky-tape dispenser.

But instead, I'm just getting the llama.  Sigh.

May contain coarse language

If you're (un)lucky enough to spend much time hanging around with doctors you'll undoubtedly hear them identify themselves or one of their colleagues as a shit magnet. Shit magnet doctors are the ones whose patients suffer sudden, unpredictable, bizarre, and potentially lethal complications, while the shit magnet doctor is on duty and typically after hours when little help or advice is available from more senior colleagues.

I don't believe in shit magnets.

You see, I don't believe in luck.  It's practically the only way I'm NOT like Han Solo.  Scoundrel? Check.  Corellian? Check. Sitting next to giant Wookiee? Check.  Believes in luck? Sad trombone. 

Luck, in the sense of a person consistently attracting bad luck or good luck, makes no sense to me, and long-time readers know that I am Captain Sensible.

So what's really going on?

For a long time I believed that these "shit magnets" were actually just whingers.  People who couldn't take the heat and yet didn't want to put down the hair dryer. Got two pages at once?  "I'm such a shit magnet." Your warfarinized patient fell down? "Shit magnet".  I do not concur. It's just run of the mill medicine and everyone else is dealing with it, so why can't you? This was consistent with my observation that shit magnets were often aesthenic control freak types, not that I'm a fan of such sweeping generalizations.

But recently I started to wonder.  I've seen a few self-proclaimed shit magnets at work, and also some self-pro-claimed non-shit magnets (who, from a physics point of view, are actually also shit magnets but with the opposite shit polarity so as to repel instead of attract the shit). And what I see is this - the same bad stuff happens to both.  But the shit magnets make a big effort to do everything properly and try to get things under control.  Whereas the non-shit magnets just let things slide. Their attitude is that if the problem isn't going to kill the patient before the end of their shift, it's not really their problem. This also was consistent with my previously mentioned observation that shit magnets were aesthenic control freak types, not that I'm a fan of such sweeping generalizations, also as previously mentioned.

So what's really going on is that the non-shit magnets are simply handballing their problems on the shit magnets who then deal with them properly.  At least that's my current theory.

Anybody got any other observations or ideas?

And falling right off again

[…]

Getting back on that horse

Since my habit of writing here is so broken, I'm starting small, with just one sentence a day.

Outrageous

How can I be expected to plan out my leave for a full year ahead when I struggle to have a shirt ironed each day for work?