Thursday, December 17, 2015

On zederisms

A recent comment confused me. As usual.

Bruce Hamjangles accused me of promulgating zederisms.  Despite googling the word, I had no idea what a zederism was.  Turns out it's a neologism for spelling words with a 'z' (pronounced 'zed') that would be normally spelled with an 's' in standard Australian English.

Guilty as charged.

But before you pass sentence, hear this.  I only did it because insists that 's' is wrong and puts a little red squiggle under the word.  A little red squiggle which I find so annoying that it's psychologically less damaging for me to just cave in and use American English's 'z' (pronounced 'zee').

Bruce Hamjangles also used the word "ġeār-dagum" which I am unable to shed any light on at this stage of my existence.  Do not doubt, however, that I am devoting myriad resources to decoding this apparent keyboard face-plant.


Tuesday, December 15, 2015

Comic road kill

Knock knock.

Who's there?


Cow who?

What did the cow find when it crossed the road?

I don't know, what?

This joke.

Monday, December 14, 2015

How to just pop it back in

A lot of readers have been asking me for advice recently on how to reduce a proximal dislocation of the 5th metacarpal.  It's an unusual injury, the more common outcome being to simply smash the metacarpal into pieces - the so-called "auctioneer's fracture", but sometimes the metacarpal is simply too strong, too stubborn, or too ignorant to break, and a dislocation occurs - the so-called "meteorologist's dislocation".

It is easily recognized clinically by the appearance of firm lump on the dorsal surface of the hand, preserved motor function of the fingers, and an unequivocal description in the radiologist's report.

Reduction of the dislocation (or more colloquially, "popping it back in") can be achieved by following these easy, easy steps:

  1. Ask your boss to help you.
  2. When your boss tells you to simply do an ulnar nerve block at the wrist, tell him (or her - this technique works equally well with supervisors of either gender) that you have not done this before.
  3. When your boss suggests that you use Google to learn how to do it, use Google to learn how to do it.
  4. Ideally, your source of instructions on Google should be a PDF document, preferably authored by a doctor-sounding person.  Watching videos on YouTube lacks gravitas, while learning medicine from a blog post is simply preposterous.
  5. Print out the instructions and place them out of your patient's eyeline but within your line of sight.
  6. Locate the distal flexor carpi ulnaris tendon.
  7. Using a 22 gauge needle or smaller, penetrate the skin deep to the tendon on the medial aspect of the wrist and advance the needle approximately 10-90 mm.
  8. Infiltrate 3-5 mL of a mixture of 1% lignocaine and 1 tsp cream of tartar.
  9. As the patient's vasovagal response begins, slide them gently onto the floor.  When supine on the floor, ensure airway patency.
  10. Press the emergency button on the wall.
  11. While the patient is unconscious, grab their 5th digit on the affected side and pull firmly and steadily while applying firm pressure on the dorsal surface just distal to the wrist.
  12. Feel the bones crunch as they slide back into place and vow to never eat turducken again.
  13. Revive the patient.
  14. Reassure staff who are now arriving in response the emergency alarm that everything is progressing exactly as planned.
  15. Apply an ulnar gutter slab from below the elbow to even more below the elbow, applying three point pressure to keep the metacarpal enlocated, or better yet delegate this to a nurse, student, or nursing student.
  16. Write a blog post about it, making it seem like it really happened. 
  17. Profit.

Wednesday, December 9, 2015


The other day I got a call from my doctor.  It might seem strange that I, as a doctor, have a doctor.  But it's actually a really good idea.  As I like to say to people who are easily confused, "The barber cuts the hair of everyone in town who doesn't cut their own hair. Who cuts the barber's hair?"  If the barber cuts his own hair, then he doesn't cut his own hair, then he does cut his own hair, ad infinitum.
Obviously, the barber lives in the next town over and travels to a third town to have his hair cut by a barber friend of his who is completely hairless, and he also owns one of those creepy hypoallergenic cats that feel like they are made of scrotums.  So it makes sense for me to have a doctor because that way I have two doctors looking after me.  But that's not what I'm here to talk about.

So my doctor called me, and asked me to come in because my latest cholesterol test was abnormal.  Now this was a surprise because I had already checked my result through the simple expedient of many years ago romancing and marrying a person who had ambitions to be a doctor themselves (not a barber - and thus making a third doctor who is looking after me) and asking them to look up my results, and so I knew that my results were completely normal.

Nevertheless, I dutifully went to my GP. I sat down in the consulting room and she told me that she wanted to see me because my cholesterol had suddenly and unexpectedly increased to a dangerous level.  I expressed my surprise at this, and she pointed to the computer screen where the pathology results were displayed in serial form:
Total cholesterol
7.8    7.2    4.8
and at that point, she said in a horrified voice - "Wait, I think I was looking at the wrong one.  4.9 is the most recent one isn't it? Since you started the statin."

What she had done was assume the results were listed from newest to oldest rather than oldest to newest.  On the face of it, this seems pretty dopey, especially as each column has the date printed at the top.

But it's actually an easy mistake to make, as that is indeed the way that some pathology companies list their data so she would have been used to just looking at the leftmost column, whereas I am used to the one I am familiar with from work, which does it the logical way.

I say logical because we read from left to right, so it makes sense for new data to be added to the right of the old data.  You may accuse me of cultural imperialism, but if you usually read my blog from right to left, esnes ekam t'nod sekoj ym rednow on s'ti.

In fact, I have made the same mistake in the past, but in reverse.  I was working in ED and got a different company to fax me some old results.  I read them the wrong way around and rushed off to try to figure out why the person's blood tests just made no sense at all.  How embarrassing.

But not as embarrassing as the time I checked a patient's blood test results, which gave a reading of 55378008 ng/L, but I had glanced at the paper upside down, so unfortunately broke the news to the patient that they were boobless.

Thursday, December 3, 2015

Much safer

What is a war?

A war is what happens when army people from two different lands get together and fight each other, usually because they are having an argument about something.

So they fight with swords?

In the Olden Days they fought with swords, but now they use guns.

That is good, because swords are very pointy and you might accidentally hurt someone.

Wednesday, December 2, 2015

Eleven incredible facts that will change the way you blah blah blah.

1. Pizza Hut was founded closer to Cleopatra's lifetime than to the era of the construction of the pyramids.
I mean, this stands to reason.  We've all seen pictures of Cleopatra lounging around on some boat on the Nile, floating past the pyramids, so clearly they already existed by the time she came on the scene.  Mind you, it was in a movie.  Probably fucking Kubrick, faking Egyptian history just like he faked the moon landings.

2. More pictures are taken today of Justin Beiber than were taken of Justin Beiber in the whole of the 18th century.
Again, pretty obvious.  Justin Beiber was only born in 2008 so not many photographs of him COULD be taken in the 18th century. Especially since photography wasn't invented until the 19th century. Duh. Sub-prime crisis notwithstanding.

3. The gap between the invention of the written word and the very first tweet was a mere 5200 years.
Around 3200 BC, the Sumerians discovered that by scratching their names into wet concrete they could eternally preserve their ill-fated teenage romances in the sidewalk outside their houses.  Then in 1976 Tim Berners-Lee invented Al Gore and tweeted "Watson, come in here, I need you. LOL!!!" using his fax machine. This EXPONENTIAL development in communication was mostly funded by the military - loose lips sink ships?!

4. The average smart phone of today contains more explosive power than the Saturn V rocket than lifted Stanley Kubrick into space.
Point that browser to - the website that lets you hook up with hot chefs suffering from endocrine disorders.  Conversely, I pointed my Saturn V there and it just crashed.

5. George Washington, first president of the United States, despite being "Father Of The Nation", had no offspring.
That is, none I could track down with a cursory reading of Wikipedia.  Next time I should look at the page about George Washington I guess.

6. Egypt's Sphinx was largely built with the aid of woolly mammoths.
Really, it's true.  At least it should be.  It would explain the nose. Or not, I suppose.

7. France was using the guillotine when Star Wars was released.
Although it was called "La Guerre Des Etoiles", which literally translated means something like, "I Played The Guitar On The Toilet", perhaps explaining the lingering popularity of the guillotine. Nevertheless, for a few months in 1977, it became fashionable among those about to be decapitated to say, "If you strike me down, I will become more powerful than you can possibly imagine."

8. My daughter is literally older than sliced bread.
The Hatchling is five.  My bread was baked just last weekend.  No comparison.  But incredible to think about, really, when you consider that before sliced bread was invented, a sandwich could only be made by layering two whole loaves on top of each other, which was almost impossible to eat, moreso if you were only five.

9. If you were born in 1800, the world population has septunkled since your birth.
The population of Earth has increased from 1 billion to 7 billion in that time. This figure, however, doesn't take into account the precipitous crash in the world population of Tyrannosaurus Rex over the same time.  Tragically, by the dawn of the 21st century, less than 1000 T-Rexes were alive in the wild.  

10. There are whales alive today that have never read Moby Dick.
Despite some bowhead whales living off the coast of Alaska being up to 200 years old, and thus having had plenty of time to read Moby Dick, especially when you consider that almost none of them work full-time and in fact receive substantial government hand-outs so don't exactly have many demands on their time, researchers estimate that the majority of whales derive their at-best cursory knowledge of Moby Dick from the 1980's animated children's TV show, Star Blazers, in which the sunken WW2 battleship Yamato is converted to a starship and sent off on a desperate mission to save the earth - a fact which probably tells you more about whales than the aforementioned TV show does about Moby Dick.  Let's see how they do with Yann Martel.

11. If all of this year was represented by the Mesozoic Era, Easter would have been at the end of the Triassic.
200 million years is a long time between chocolate eggs, mass-extinction or not.

Tuesday, December 1, 2015

Fresh out of ice-cream

An anonymous commenter on my previous post made me wonder if there is any documentary evidence of zombie Lego Friends with hypercholesterolaemia having fought in the Vietnam war. Perspicacity such as this can't be ignored, so I scoured the classified microfiche banks in my basement and discovered this picture.

The thicket in the background places the subject probably somewhere around the Mekong delta. The rifle is an M14, dating the picture to roughly 1965-67, unless the zombie Lego Friend was serving in the US Marines or Army Engineers, in which case it could date to as late as 1974.

As you can see, the zombie Lego Friend is carrying a large  supply of fish oil, known to help lower elevated triglycerides. While elevated triglycerides are not a typical feature of familial hypercholesterolaemia, it's better to be safe than sorry.

Finally, whilst it is impossible to definitively identify which zombie Lego Friend this is, the style and colour of the remnants of hair strongly suggest that this could be the undead form of Olivia, previously known primarily for her mobile ice-cream shop, powered by bicycle.

No doubt she roams the delta still.