I've got your deposit right here

My Smaller Half and I want to buy a house.  But we've hit a snag - we have no money.

Apparently a few years ago there was a big stink-up because some chumps in the USA borrowed more money than they could ever afford to pay back, plunging the world into a screaming spiral of horror and causing a number of billionaire sociopaths on Wall St to temporarily lose their jobs.  As a result, Australia's pinko government rammed laws through parliament infringing my democratic right to borrow more money than I could ever afford to pay back, thus grossly offending my inflated sense of entitlement.  This country is stuffed!

After ringing 4 banks and 3 other non-banks (by which I mean non-bank financial institutions rather than other non-banks such as ice-cream vans or Belgian pederasts) I resigned myself to having to live in penury for another 3 months until those juicy payslips giving me substantially less than I used to earn in my old job start rolling in.  But then I got put onto a mortgage broker in town who turns out to have all sorts of tricky tricks up his sleeve, so maybe we're still in with a chance.  Actually it's not so much that he has tricky tricks, it's more that he seems to motivated by wanting to succeed, whereas the loan processors at the banks and non-banks seem to be motivated mostly by malice and spite.

We had a two hour meeting with him on Friday where he sussed us out and did some brainstorming of possible ways around the road blocks.  It was really interesting to watch a professional from another field work.  It reminded me of nothing so much as a good doctor taking a really thorough medical history.

For example, it's important to know what medications people are on (for both doctors and banks, but I'm talking about doctors now).  So you ask them, and they tell you.  And then you typically ask them about a whole bunch of medications that most people don't think of as medications, like the contraceptive pill, asthma inhalers, anti-inflammatories and other analgesics, insulin, and so on.  It's easy to start thinking that people are pretty dumb for not telling you this the first time.

But lo, yesterday the shoe was upon the other foot.  He asked me if I had any debt.  No, I said, quite proud of myself.  Any credit cards?  Oh, yes, sure.  Any HECS debt?  Oh, yes, that too.  Oops.

And, just like a doctor, sometimes he used words and jargon that I didn't understand.  It's incredible how many times I've seen doctors walk up to a patient, dump a mouthful of polysyllabic Graeco-Latin blah-blah on them, then consider the job done.  It's excruciating to witness, and now I know how difficult it is to get it to stop when it's done to you.

It's really hard to ask questions about what something means when you can't remember what the thing was even called.  I'm sure he was horrified when I got my Third Party Mandated Lending Policy Exception mixed up with my Conditional Approval Pending Party People Mandate.  Or something.  It'd be like confusing your cardiorenal syndrome with your velocardiofacial syndrome.

I reacted by just calling the different things "The First Thing" and "The Second Thing" and so on.  I must try that on Monday morning when I turn up to my first surgical ward round of the year.  I'm sure it'll be looked upon kindly.

Praise me

I was feeling generous and expansive, so I was talking up my Esteemed Colleague who is going to be replacing me after tomorrow in this unit.  The registrar obviously found me unconvincing in my universally positive comments, so he asked me if there was anything bad about him. 

"Why yes," I said, "He compulsively makes inappropriate jokes."

"Oh," said the registrar, "He sounds just like you."

Nutri-brain

Registrar

So once the mRNA is produced, what happens then?

PTR

I have the word "ribosome" in my head.  But maybe that's just something in my breakfast cereal.

As it turns out, ribosome was the word I was after.  The other word that I was afraid I was confusing it with was "riboflavin", a.k.a. vitamin B2, which is essential to life because it makes your pee yellow.  All those nutri-grain ads on the idiot box when I was a kid nearly derailed my medical career.

My vulnerability to the all-pervasive cereal advertising industry in lieu of any kind of actual medical training is regrettable.  But still, I can walk the walk and talk the chalk or something like that when I have to.  Check out this picture from a talk I gave earlier this year on tuberous sclerosis:

It's complex but I think it captures the essence of what I was trying to say, which is that I had no freakin' idea of what is really going on but it's probably too complex to matter in an informal talk.

Not really

Checkout Person
That'll be $87.76

Smaller Half
The register only says $28.76

Checkout Person
Oh, you know what I mean.

I wasn't aware until now that I was an apologist for sexual predators

Nurse

There is a well-known case here in this city of a psychiatrist who had sexual relations with no fewer than five of his patients.

PTR

That's terrible.

Nurse

No, it's not.

PTR

?

Nurse

It's unacceptable.

Extreme child care

Most mornings, I drop the Hatching at child care then come in here to the hospital.  Yesterday morning, it was the child care workers who dropped the Hatchling - literally. 

I got a phone call around 10am, it was the child care boss.  My first thought was that she was ringing me up to rouse on me for not paying our bills.  This is a splendid example of a conditioned stimulus.  The first thing she said to me though was, "The Hatchling is fine.  There's been a bit of an incident."  Good first line - I guess lots of parents would assume that disaster had struck as soon as the child care centre calls them at work, so it's sensible to defuse things immediately.

But "an incident"?  That's too vague.  I suppose she said it was "a bit of an incident" so I wasn't thinking of sieges and hostage-taking so much as perhaps she's had her finger bitten or something.

Anyway, it turns out that two other kids mugged one of the child care workers while she holding the Hatchling, with the result that the Hatchling plummeted earthwards.  Fortunately she landed on the child care worker so there wasn't much of an impact.  Nevertheless I scurried up the hill to go give the Hatchling a cuddle.

As soon as I walked in the door the poor woman who'd dropped her burst into tears and started begging for forgiveness.  "YOU BITCH, I'LL SEE YOU IN COURT, YOU'LL NEVER WORK IN THIS TOWN AGAIN!", I screamed, spittle flying from my lips.  No wait, that was the feedback I gave my supervisor a few rotations back.  What I actually said yesterday was, "It's okay, she's not hurt, accidents happen, you must have got a real scare but it's all okay now."  That made her cry even more. 

Once the staff realized that I wasn't going to burn the place down in righteous fury they all got kind of manic with relief.  They launched into a detailed account of how it happened, where it happened, who was standing where, what similar incidents had occurred in the past, re-enacting how people had rolled around on the floor in desperation trying to catch the babies that were raining from the ceiling, and generally creating a ruckus.  It was quite a scene so I beat a hasty retreat, shouting reassuring words to them as I went.

I reckon they probably have a policy that if anything bad happens to any of the kids, they call the dad first.  Dad turns up, nobody is missing any limbs, so he jiggles the kid a bit and takes off again.  Saves time for everyone.

Bark, Flinders Ranges

Clouds in my coffee

In the middle of my day I found myself lost in a bureaucratic meeting.  People were talking words that I knew but their meaning was obscure to me.  There was discussion of leveraging client actualities, of service overlap, and of negative expression of emotion prior to an upcoming facility transfer.

So I wrote some poems in the haiku style instead.

There's a cardboard box in our doctors' office that has the coffee supplies in it.  On the sides are written poems in the haiku style about or inspired by coffee.  Coffee haikus - I hear you think - what a bunch of hipsters. And truly, there is no defence against such an accusation.  The ones I wrote are pretty damn good though...

A warm cup to hold
To take the place of a hand.
Welcome to the tribe.

Black? White? Some sugar?
Do you embrace or mask the
Bitterness of life?

The top 10 songs in which you can substitute "fart" for "heart"

1. My Fart Will Go On - Celine Dion
2. Unchain My Fart - Ray Charles
3. Two Strong Farts - John Farnham
4. What Becomes Of The Brokenfarted? - Jimmy Ruffin
5. Achy Breaky Fart - Billy Ray Cyrus
6. Good Farted Woman - Waylon Jennings & Willie Nelson
7. Fart Of Glass - Blondie
8. Fartbreak Hotel - Elvis Presley
9. Listen To Your Fart - Roxette
10. Sgt Pepper's Lonely Farts Club Band - The Beatles

Not thinking about elephants

Psychiatrist

Well, what would you like to talk about in today's tutorial?

Registrar

Oh, anything at all, as long as it isn't the Oedipus Complex again.

Psychiatrist

It's interesting, isn't it, how the Oedipus Complex often brings out these types of very strong reactions from people.  It just makes you think that Freud must really have been on to something.  I know you don't want to talk about it but there are some fascinating things to consider such as how...

[One hour and fifteen minutes pass]

... ending in the destruction of civil society and the slow rebuilding up again which is, of course, the tragedy of man's inability to process or work through the Oedipus Complex.

Urban legends

The Candyman
Legend:  If you look at your reflection and say "Candyman" five times, he will appear and brutally murder you.
Status: False.  This is actually the plot of a 1992 slasher film.

The Handyman
Legend: If you look at your reflection and say "Handyman" five times, he will appear and unblock your drains.
Status: False.  There is no way to summon a handyman when you need one.

The Randyman
Legend: If you look at your reflection and say "Randyman" five times, a sexually aroused man will appear.
Status: True.  But only if you're a highly narcissistic adult male.

Thatch, Kuala Lumpur

Clinical audit audit audit

Introduction
Although most medical students are accustomed to producing audits, few are used to audit auditing.  Thus, this audit audit audit audits audit audits to measure their compliance with the protocol suggested by the Trans-Tasman Council of Amateur Humorists (TTCAH) and makes recommendations to improve the audit auditing process.

Method
Ethics Approval
Ethics approval was sought for the audit audit audit because of the high likelihood of two adverse events:

1. That those exposed would find it so unutterably funny that they might bust some kind of internal valve from laughing so hard.
2. That those exposed would find it so unutterably tiresome that they might lapse into a narcoleptic coma and miss their next dental appointment.

The Ethics And Human Research Committee advised that ethics approval would not be granted for such diabolically try-hard self-deprecation as contained in this sentence and thus the final audit audit audit would contain no such sentences. Otherwise they said it would be fine.

Selection of audit audits
The auditor briefly considered a range of semi-humorous methods that may have been employed to find and select audit audits before deciding that it was getting reasonably late and he wanted to get on with the main business of making stupid jokes so he would just present the selected audit audit for audit as a fait accompli with a white wine sauce and simply post a link to it.  (LINK)

Analysis of audit audits
The selected audit audit was briefly reviewed to refresh my memory and some suitable categories were invented in order to produce a few graphs that were relevant to the audit audit.  These, coincidentally, are also identified in the TTCAH protocol for audit audits as being both necessary and sufficient for a late night blog post stretching one simple idea out to several hundred words, to wit:

1. Snappy title
2. Thin veneer of respectability
3. Classical allusions that are actually totally bogus
4. Leaving the door open for a sequel just in case it works this time.

Results
The audit audit audit revealed that the audit audit had been undertaken with due regard for TTCAH processes.  This is clearly illustrated by the following charts:

 Snappy title - check!

Thin veneer of respectability - check!

Classical allusions - check!

Sequel - check!

Recommendations

1. That I go to bed soon.
2. Bacon and cheese toastie.
3. More charts.
4. Sell! Sell! Sell!
5. Shift down a gear once you hit 2000 rpm.  This is also true of driving.
6. Winning the Victoria Cross twice.
7. Banana (serving suggestion).

Clinical audit audit

Introduction
As part of the final year of the medical degree at this Fine University, students are required to complete a clinical audit.  This audit examines the adherence of the auditors to the auditing protocol and makes recommendations to improve the auditing process.

Method
Ethics approval
Since this audit was conducted only upon the auditors self and was entered into voluntarily, no ethics committee approval was sought or, therefore, granted.

Selection of audits
A retrospective selection of all audits undertaken by the auditor during the 2011 was performed.  The auditor's email account and hard drive were searched for all files containing the words "audit", "overdue", "panic" and "apathy".  This resulted in the retrieval of several thousand files which would be impractical to search by hand, so they were further searched for the tags "piece of shit".  One record was retrieved, a clinical audit recently submitted by the auditor.

Analysis of audits
The audit was examined for the following key items, drawn from the guidelines to auditing published by the International Lazy Students and Bullshit Artists Association (ILSBAA):

1. Excessive verbosity clearly intended to boost word count.
2. References farmed from unreliable online sources such as Wikipedia.
3. Formatting and structure plagiarized from example audits provided to students.
4. Meaningless recommendations.
5. Precision in statistical calculation used to distract from data collection flaws.

Results
For each audit audited, a high degree of adherence to the ILSBAA protocol was found, as shown in the charts 1 through 5 below:

Discussion
Notwithstanding the recent episode where the auditors audit was submitted late for no reason other than his inability to submit the audit on time, the auditor found that the audit was conducted largely in accordance with the ILSBAA protocol, or else in a sleep-deprived stupor, which is also an approved method of production of student audits.  Acute observers may question why confidence intervals were not calculated and quoted above, to which the audit auditor may only quote Demosthenes in the Palladium when he was stabbed in the Ides by the Emperor Octagon: "Auditor, audit thyself".  Whilst the relevance, and indeed the veracity of this quote are lost in the dawn of time, it cannot be denied that they most usefully added some sorely needed bulk to this paragraph and furthermore avoided it being a one-joke section, albeit at the expense of some rather heavy-handed surrealism.

Conclusion
It is recommended:

1. That further audits by this auditor be audited to determine adherence to the ILSBAA protocol.
2. That this audit audit be audited.
3. That the audit audit audit be audited in order to complete the third repetition really needed to hammer the point home.
4. That you send money now.
5. That you read Dune by Frank Herbert.  It's full on shit, man.

Botanic gardens, Madrid

Lost

There's a scene in one of my favourite films, Star Wars, where Indiana Jones is describing how clueless his colleague is by saying, "You know Marcus.  He once got lost in his own museum".  Well - today I got lost in my own Emergency Department.

In my defence, it was only my second day.  Plus, there are extensive renovations happening so there are temporary walls being flung up that seem to move on a daily basis, opening up mysterious corridors haunted by bull-headed freaks (sorry - by surgeons) or sealing up unwary strangers inside wall cavities to be entombed forever. 

Also, when I was given a tour yesterday I got the impression there was (currently) only an A side and a E side (don't ask me what happened to sides B,C and D.  Perhaps a mad geometer proved them to have zero length, or perhaps they got together with Type 3 renal tubular acidosis and ran away to join the circus).  But it turns out that the A side has two halves which look really similar, like the Olson twins, so I went to the wrong one and walked around it several times looking like someone on one of Escher's endless staircases.

Plus, I was tired.

It's not the first time I've gotten lost (or as I prefer to think of it, afflicted by momentary topographical ambiguity) but it was the most embarrassing.  Not only did I run into two of my Esteemed Colleagues who had to free me from where I had become wedged behind a vending machine, I had in tow an unfortunate and quite distressed woman whom I was attempting to take to her husband who was a patient.  So at first I got just a bit sheepish when I couldn't find his bed number.  Then I got to side A part 2 and located his bed, flung back the curtain with a dramatic flourish, only to find it occupied by a complete stranger.  Awkward!

I recruited the help of some bemused nurses who checked the compooters and showed me that while we'd been careening around in circles in the wrong area, my guy had been transferred to the E side, which is where we'd come from.  It didn't take me too long to find our way back but I could only do it leaving the ED and starting again as if I was arriving in the morning.

Tomorrow I'm taking in a bag of breadcrumbs.

First depressions last

Like you, I've been feeling under the hammer a bit recently, what with the Hatchling to look after, a rogue assignment rampaging through my spare time, and some pesky Hittites to suppress.  Busy busy busy.

Or so I thought.

Today I met someone who is about to complete their big scary ED exams, they are also training for some intense athletic event, they have two kids, they dress with elegance and poise, and they are a really nice person too.  They probably also play woodwind in a symphony orchestra.

People like that should be banned.

New adventures in cheese

Like you, I bought a big block of Nimbin cheese today.  No, "Nimbin cheese" is not some kind of euphemism for psychoactive substances.  (For those of you not from Australia, Nimbin has the widespread reputation, rightly or wrongly, as a hive of hippies with heaps of hemp.)  Nimbin cheese is in fact a cheese produced in Nimbin.

I was so surprised to see it right there in the stupormarket that I bought it without really thinking about it.  I don't even know what type of cheese it is.  Presumably it's a tasty cheddar or something similar.  Gets up to look in fridge ... oh my god - it's something called "Elbo style cheese". Eurgh.  I know that Elbo cheese must be a real and delicious thing, but the name is very unappealing, sounding like the consequences of a long-neglected personal hygiene regimen.

Anyway, I think that the reason I bought it was because of its colour.  Sitting there on the shelf amidst the other (non-elbo-style) cheeses it really stood out.  Yellow, dark yellow, yellow, pale yellow, green, yellow ... wait - green???

Yes, Nimbin cheese is green.  I was so enraptured that I threw it into my basket without a moment's further thought.  I thought about it all the way home though.  This cheese, from the home of the hippie, is a triumph of marketing.  Distinctive name, distinctive colour, colour has multiple connotations directly linked to the distinctive name (green = eco & green = dope).  The only comparable idea I can come up with right now would be to sell a Tony Abbott blue.  But the idea of somehow extracting milk from Tony Abbott to make it is an even worse concept than Elbo cheese.

Which is why I was so bitterly disappointed when I got home and unpacked the shopping and found a plain old boring block of pale yellow cheese in my bag.  Had I grabbed the wrong cheese off the shelf in my excitement?  Was the green colour just a product of my fevered imagination when I read that it was Nimbin cheese?  Was I stoned out my mind?

No, no, and no.  It turns out that Nimbin cheese is not green at all.  It's just ordinary looking cheese inside a wrapper which is green on the front and clear on the back.  Man...  I've obviously read Green Eggs and Ham one time too many.

Rusty steel sculpture, Madrid

Blogging

Like you, I've been pondering this strange thing called "blogging" a bit recently.  I very nearly called it quits with this blog recently but decided to just leave it and stew for a while instead.  Ultimately I seem to have decided to keep things going, so I suppose that's good for those of you who come here to read this stuff because you enjoy it rather than because you hate me and you're slowly assembler a dossier to clonk me over the head with one day when I'm running for Prime Minister.

Anyway, one I'd stopped writing here frequently I suddenly became unable to figure out how to start again.  I kept thinking of ideas but was unable to develop them in my head into fully-fledged posts ready to leave the nest and soar the information superdooperhighway without me.  It took me about three weeks to realize that that has always been the case.  I don't develop these posts in my head at all. 

What actually happens is that I have an idea or two, or maybe not even that - sometimes just a feeling that I need to discover or explore - and I sit down and let things go.  That's why it's fun.  Planning things is not fun.  Doing things is fun. 

When I succumb to the urge to plan I usually find myself trying to perfectionize things, which results in a clean crisp dull icy ache in my brain and a clean crisp dull icy ache on the page.  Sure, structure is good, and structure is something that is probably a good idea to plan, especially if you're trying to make some kind of point.  Fortunately for me I seldom am in such an unfortunate position.  I have the liberty of just blabbing all this stuff down onto the page.

And why?  Why do I do it?  Mostly just so I don't think so much about it any more.  Once I notice that there's a post welling up inside me I tend to start to overthink it, which, as mentioned above, kills it.  So the more frequently I blab this stuff, the sooner I can launch my unconscious out through my fingertips and onto the screen.

Stand by stomach, here come banana!

Profundity

Why are they called recorders when they can only play?

Exterior wall of Mezquita-Catedral, Cordoba

Horse artillery

Like you, I've always been unsure how to use horse artillery effectively.  I've been doing some research on the matter, and it seems that the way to handle them is to gallop right up to the enemy infantry and use your cannon to shoot large iron balls at high velocity into their ranks, rending limb from limb, soaking the ground with blood, and tearing the veil from Death's face so he stares them right in the the eye.

Art meets science meets Aspergers

Like you, I'd never really paid much attention to textures until I tried to get my computer to recognise and classify them using a Wold-like decomposition.  This was for my honours project in engineering - as previously noted in these pages, I managed to get an electrical engineering degree even though I only did two classes on electricity, one of which I failed the first time around because it was too easy.

As a result of my hate-hate relationship with electricity, I fell into signal processing, basically because the mathematics of it all kind of clicked for me.  What I was trying to do was nothing particularly original - I was just trying to duplicate some results I found in a paper with a view to extending the method later on.  Of course the extending bit never eventuated because I sat on my backside for 7 months then crammed all the work into the last couple, but anyway.

The general idea was that I would feed these texture swatches into my computer which would do some two-dimensional signal analysis on it, treating it as a sum of a deterministic signal found by Fourier analysis and a random signal being a random number generator being fed into a filter.  This is a Wold-like decomposition.  The computer would assemble a library of texture signatures and then if you gave it a new swatch it would spit out a list of which textures resembled it the most closely. 

The hope was that the textures that the computer thought were most similar would also be the ones that a person would think are most similar, thus ushering in a new era of happiness and plenty throughout the globe.  This too did not eventuate.

The textures I was working with were a semi-standard set of photographic plates known as the Brodatz Textures.  Here's a link to them: <linky>

So that's all a prelude to the main point, which is this: textures are interesting.  Once you start really looking at textures and trying to think about what makes them unique, you notice that lots of things - in fact, pretty much everything - are covered with interesting textures.  Grab some random object and examine it right now.  Really peer at it closely, turn it to and fro in the light.  Take the time to notice what you've always taken for granted.  The object may be ugly but it's not because of its texture.  What is an ugly texture?  Do this regularly, day after day, and pretty soon the world is a richer and more beautiful place to be in, which will compensate for all those friends you've lost by behaving like such a freak.

If you're now more enthusiastic about textures, here's some things to ponder:

• Is the texture you're looking at more cellular or is it more amorphous?
• Is the texture you're looking at designed or is it emergent or natural?
• Is the texture you're looking at due to colour variation on a surface or is it due to lighting effects on a surface of varied elevation or both or neither?
• Does this texture have a direction?
• Does this texture have a size or scale?
• If a person had this texture on their forehead would they resemble an alien from Star Trek or a severe dermatological condition?

It's not an exhaustive list by any means but it should be enough to get you started.  Go forth and enjoy textures today!

This week I have been mostly thinking about

Sabbatical

Just so you know, I'm hanging up ye olde keyboarde for a while.  I need a break from this place.  Lots of ideas coming and going all the time but to be honest my interest in bothering to capture them for the Library Of Congress and the CIA is pretty minimal right now.

So I'll be going back to basics for a while.  See you when I see you.

Shadowlands

This is something that I almost didn't write but I need to write it to keep going here, so forgive me my sentimentality.

I won't lie - having the Secret Cat die last week was awful.  She was 19 years old, and although we didn't start to look after her until she was about 10, it still feels like a lifetime.

In the end, we had her put down by the vet.  She had been deaf and blind for about a year.  Surprisingly, she adapted well to moving into a new house, and she learned to find her way around.  Gradually though, she got sicker and sicker, slowly getting thinner and thinner and wasting away.  Part of it was arthritis.  She clearly was uncomfortable moving.  But part of it was the slowly evolving diabetes that we didn't know about.

Lots of people said we should have her put down, but we always thought that she was still enjoying life.  She'd find the sunny spots somehow.  She'd find her way to the kitchen when she could smell us cooking and ask us for some meat.

In the last fortnight though, things went downhill fast.  She got painfully thin.  She seemed to have trouble walking straight and seemed to get lost.  And she sometimes got very weak and couldn't straighten her legs out.  We would find her crouched on the floor in the morning, stranded in the dark for who knows how long, waiting for us to rescue her. 

A cat that can't or won't move is a cat that is suffering.  And we couldn't watch it, and there was nothing we could do to help her.  So we took her to the vet one last time. 

It was such a hard decision to make.  I knew what my decision was though, when I found myself hoping that she had died overnight so that it would be over for her, and for us.  At least this way we could be there with her as she died.  I think she deserved that.

I'm glad that we had her put down when we did.  Any earlier and it wouldn't have been right for us - we would have felt that we did it for convenience.  Any later and it wouldn't have been right for her - she would have suffered too much.

But it doesn't make it easier when the time comes.  It had never occurred to me that you sometimes need to plan these things.  There was no last minute call to the vet, begging for help in an emergency.  There was just an appointment made, a schedule to keep.

We walked out with an empty cage.  And she danced by the light of the moon, the moon, the moon - she danced by the light of the moon.

Heartache

The Owl and the Pussy-cat went to sea

In a beautiful pea green boat,
They took some honey, and plenty of money,

Wrapped up in a five pound note.
The Owl looked up to the stars above,

And sang to a small guitar,
'O lovely Pussy! O Pussy my love,

What a beautiful Pussy you are,

You are,

You are!
What a beautiful Pussy you are!'

Pussy said to the Owl, 'You elegant fowl!

How charmingly sweet you sing!
O let us be married! too long we have tarried:

But what shall we do for a ring?'
They sailed away, for a year and a day,

To the land where the Bong-tree grows
And there in a wood a Piggy-wig stood

With a ring at the end of his nose,

His nose,

His nose,
With a ring at the end of his nose.

'Dear pig, are you willing to sell for one shilling

Your ring?' Said the Piggy, 'I will.'
So they took it away, and were married next day

By the Turkey who lives on the hill.
They dined on mince, and slices of quince,

Which they ate with a runcible spoon;
And hand in hand, on the edge of the sand,

They danced by the light of the moon,

The moon,

The moon,
They danced by the light of the moon.

           - Edward Lear

In memory of Belle, 4 March 1992 - 22 July 2011

Kapow!

After my glorious salmon joke yesterday, I was zinged back by the consultant today.  He was examining a little 5 month old girl and she kept craning her head back to peer at me where I had suddenly appeared above her head.

Consultant

She is trying very hard to look at you.

PTR

It's because I'm so handsome.

Consultant

I am very worried about her eyesight.

Courage

Sometimes an opportunity to make a stupid joke arises and you just have to seize it.  This morning I was standing in the room with a patient, her mother, the consultant, two registrars, an intern, and four other medical students.  We were discussing animal vectors of infectious enteritis.

Consultant

So, PTR, what type of animal is a frequent carrier of salmonella?

PTR

Salmon?

He laughed.  In a strained, God-help-me kind of way.  I was so proud of myself for not wussing out. (For the record, the correct answer is "reptiles".  So not only are Galapagos tortoises immune to ouabain, they are also dangerous to kiss.)

Apocrypha

I usually have a small notepad secreted somewhere about my person where I jot down phone numbers, book references, interesting quotes, and other things that I am otherwise liable to quickly forget.  Scattered throughout the book will be little seeds of ideas for things to post about here.  About half the time I follow up on it.  About half the rest of the time I'll decide the idea is a dud.  Very occasionally I'll decide that an idea is good but would be more effort to complete than I'm prepared to give.  And the rest of the time I find the note at some later date and think to myself, "What the hell is that supposed to mean?  I must have been smoking crack."

Sometimes I can look at a note and clearly remember the circumstances under which I wrote it - just not what the note actually signifies.  Sometimes a note makes me think of something quite definite - but I'm pretty sure it's not what I meant myself to think of when I wrote it.  Sometimes a note is truly mysterious - it's in my hand but I have no memory of it at all.

Here's a collection of extinct blog prompts from the last couple of years.  It resembles the ravings of a madman, so I've chosen to arrange it visually to resemble poetry - the poetry of driftwood and lost balloons and old photos. 

Muntries
Sealink!

favourite bowl

Thar she blows!

character "in" a book - from? of?

Greatest American Hero

Wolf Creek Cafe
Calendars and other people's dogs
egogram

Kit fox

itch! actual ants!

glasses with bizarre sideboards

Shadow puppet - doctor?

Sad second-hand stores

HOTKEYS = NERDS

CREATION - FRANKENSTEIN

David Bowie over 20 years

Body dysmorphic effect vs re-reading own writing

aqueous humour - watery joke?

visualizing blood vessels!

eating vs studying - good-bad or bad-good

gold injections!

stress reduction kit

only girls and Italians cook

presentation - ongoing fear

who wants a ride up?

SHOP ANGRY

tuning fork

BKA v DKA

chopping veggies - not dice!/cubed! chinese style

on screws

book cover/binder

concentrate on not reading things

awards for med school

a blob for you

psychic expo

smelling like chicken

towel - bee - cold - A-delta - alfalfa

lostradio - insulting people, standing in dog shit

Colonel Light's laser powers!
evil genius of Pat Rafter accumulating sinisterness
What's next?

New poll

It's been quite a while since my last poll.  If I remember rightly, the Mob called for my child to be female and lo, I complied.  Since then I've been a bit distractabubble and haven't been able to think up something to poll you about.  So that's what I'll poll you about.  It's up now to the right ->

Vote now or else you won't!

Maslow's hierarchy of blogging

1. Naming.  When finally committing to starting a new blog, a blogger needs to find a unique name for his blog which at once indicates his depth of thought as well as his insouciant whimsicality toward the whole thing.  He also needs an online handle which will fulfill the same needs for him.
2. Posts.  Now that she has a blog name and a handle, the blogger actually needs to post something.  She feels fulfilled by coming up with an idea and writing something observant or clever which is long enough to be worth reading but not so long as to not be worth reading.
3. Comments.  Once fulfilled by his ability to generate posts on a semi-regular basis the blogger is driven by his insatiable need for comments.  He will seek them out by asking questions in his posts, leaving comments on other blogs to lure readers to his blog, and casually mentioning the fact that he has a blog that people leave comments on to acquaintances.  He will check his blog dozens of times each day to see if there are any new comments.
4. Subscribers.  Comments are eventually taken for granted as merely the blogger's due return for her efforts.  What she really wants now are subscribers, a.k.a. followers.  She wants a little band of imaginary friends who owe her fealty and might perhaps, in the event of some kind of internet war, be drafted into her private army to fight for her.  She imagines that they check her blog dozens of times each day to see if there are any new posts.
5. Notoriety.  The blogger has now gathered his disciples but what he wants is fame.  He'd like, for example, for his blog to be mentioned in another blog, or in a newspaper, or for him to overhear people at the next table in a trendy cafe discussing some uproarious post that he recently wrote.  Ideally, he'd like for one of his friends who doesn't realize that it is in fact he who writes the blog to recommend it to him.
6. A book deal.  If only someone would just email her and offer to print out all these years of crap and sell them in time for the Christmas gift rush, she'd never have to work again!

Gender mender

So why is it that men seem to behave so strangely around boy babies?  Show a guy a little girl baby and he'll go all cutesy-pie and goo-goo trying to get her attention and he'll praise her gorgeous smile and beautiful eyes and all but start to file adoption papers. 

But show a guy a little baby boy and he'll go all blokey-matey and call him "chief" or "muscles" and not be nearly as snuggly and friendly and generally nice.

Is it some kind of bizarre fear of being thought to be homosexual?  Or are they genuinely unable to relate to other males except via the medium of sport?  Or is it actually a reflection of men only valuing females for their appearance and thus not being threatened by them whereas boys will in future grow up to slit their throats in the night and steal off with their daughters?

Man, I can't wait for my psychiatry block!

Charms to soothe a savage breast

Music which puts the Hatchling to sleep:

• Mozart's string quartets
• Johnny Cash
• I Monster
• 30's swing
• Paul Kelly
• The National

Music which does not:

• Rage Against The Machine
• Queen
• George Michael
• Gillian Welch
• Ladyhawke

Draw your own conclusions.

A cunning plan

My problem is that I am a bad liar.

When I go home in the afternoon, my Smaller Half will conversationally enquire about what I had for lunch.  And if I had a moment of weakness and had hot chips for lunch I am unable to adequately account for my time and money.  I know perfectly well that not only are chips bad for me but I also feel queasy afterward and regret them.

"Err", I say, "My lunch.  Indeed, my lunch was delicious!  I had something good, I can't recall now the details but it was very satisfying."

"You had chips didn't you?" asks my Smaller Half.

"Yes", I say, "I am so ashamed."

The stupid thing is that even though I know I need an alibi, I am unable to come up with one because I don't want to actually lie.  It would be easy to just tell her that I had a chicken sandwich or some such innocuous thing.  But I think that if a man is going to fib about his lunch he isn't much of a man.

So this is my plan from now on: "I had some potato salad".

Brilliant, eh?  If pressed for details I can concede that it was a deep-fried potato salad, of the French variety.  But otherwise, the truth remains safe with me, you, and the internet.

Top 10 Australian Albums

A little while ago my Wise Brother asked me what my top 10 Australian albums were, prompted by Triple J's recent poll.  I had to dwell on it for a while and then set myself some ground rules.  Here are the rules:

1. No pseudo-Oz Kiwi bands.
2. Only one album per artist.
3. No "Greatest Hits" or "B-sides" type collations.  Which is a shame because some of my favourite CDs are in this mob but it's not really an album is it?  Feel free to assail this decision in the comments section.
4. I must actually own the album to nominate it.  If I don't like it enough to own it, well...

So here's my list, in alphamobetical order, with as brief a review as I could summon:

Cat Empire - Two Shoes.  Joyous chaos.
The Cruel Sea - The Honeymoon is Over.  Dark swaggering.
Mia Dyson - Parking Lots.  On the shady side of the street.
The Herd - Summerland.  Opinion columns to a beat.
Lazy Susan - Long Lost.  Anecdotal.
Professor Ratbaggy - Professor Ratbaggy.  Unscientific experiment.
Powderfinger - Internationalist.  First half: rock epics.  Second half: zap gun duel
Josh Pyke - Memories and Dust.  Extroverted introversion.
The Simpletons-  Matter.  Sign of things not to come.
Something For Kate - Echolalia.  Black humoured life.

Some things jump out at me about this list.  It's surprisingly narrow, dominated by music that got played on Triple J in the late 90's, early 00's, mostly because this was when I had a job (hence could buy music) and also listened to the J's in my car to and from work.  Since then I've been either incomeless or radioless or both, so I've strayed far from the rock of mainland Oz.

Nevertheless this list would be one I would happily take on a long driving holiday.  They're all musically rich and lyrically interesting, at least to me. They're all albums that very quickly got put onto high rotation on ye olde NAD 510, and hence are intrinsically entwined in my memories of those times.

I'd be interested if a few of my Gentle Readers would post their own top ten lists as comments for perusal.

Socrates drank hemlock - we can only wait and hope

One of my pet peeves, if not monstrous hates, is the type of doctor who chooses to "educate" students using the lazy man's version of the Socratic method.  The Socratic method, if you're not familiar with it, consists of not directly answering questions but instead challenging the student with questions that engage them in thoughtful discussion.  This works well if you are Socrates - not so well if you're a pompous git who can't be bothered interrupting your own scribbling in the notes to even look at the student, let alone allow your cerebrum to process more than a few key words in the original question.

My boss last year was a big fan of this.  When I asked him why we weren't getting the tutorials we were supposed to, he got all Zen and said, "My job is to open the door but only you can walk through."  Deep.  Anyway, this is all prompted because I had the following exchange with one of the doctors this week:

PTR

Why is the girl in bed 12 on roxithromycin?

Doctor

Well, why do we put patients on roxithromycin?

PTR

Mmmm.  A telling point.

I wonder if they do this sort of thing every time anybody asks them a question...

Policeman

Do you know how fast you were going ?

Doctor

Do you know how fast I was going?

Bookshelf

Whilst idly perusing my google analytics stats I noticed that I'd gotten a few hits on my "Bookshelf" page.  Which is sad because I've been too lazy to update it for at least six months. 

From time to time I get briefly excited about a new concept, such as writing book reviews in haiku form or as limericks.  But then apathy takes over again and nothing happens.  I did briefly consider starting up another blog just for such reviews, but reasoned that the likelihood of actually keeping it going once the novelty wears off is very slim.  As you may have noticed, new concepts are very exciting to me for about a fortnight.

For those who wonder, here's a short list to update you on some the books I've read since about Christmas.  You may notice that there are quite a few 5/5 ratings here - I was lucky and hit a real purple patch around March...

Currently reading:
Titus Groan - Mervyn Peake.  The Tolstoy of baroque fantasy.

Recently read:
Never Let Me Go - Kazuo Ishiguro.  Haunting and sinister chick-lit. 5/5
Dictionary of the Napoleonic Wars - David Chandler.  Can you really "read" a dictionary? 4/5
Rifles - Six Years With Wellington's Legendary Sharpshooters - Mark Urban.  Like a Napoleonic Peter FitzSimons. 3/5
Welcome To The Monkey House - Kurt Vonnegut.  Assertively off-kilter.  3/5
Blind - Matthew Farrer.  Confusingly creative non-genre genre sci-fi.  3/5
Open - Andre Agassi.  Inside the tennis racket.  5/5
How To Make Gravy - Paul Kelly.  This is what blogs should be.  5/5
Into Thin Air - John Krakauer.  Tragic personality clashes at altitude.  5/5
Invisible Cities - Italo Calvino.  Hallucinatory travelogue.  5/5
Brighton Rock - Graham Greene.  Queen's song is better.  2/5
The Book Of Sand + Shakespeare's Memory - Jorge Luis Borges.  Betrayed by elevated expectations.  3/5
The Gospel According To Jesus Christ - José Saramago.  A cynical epiphany.  3/5
The Happiest Refugee - Anh Do.  A dull comedian from a fascinating family.  2/5
Eisenhorn Trilogy - Dan Abnett. Batman in the 40K-verse.  4/5
Titanicus - Dan Abnett.  Kill! Crush! Destroy!  3/5

Paeds case review

A 37 year old male presented to the Paediatric Ward this morning at 0830 hrs complaining of tiredness and abdominal pains.

The tiredness has been present since early December 2010 when his first child was born.  The tiredness has been relatively constant but generally is better on weekends and is relieved by additional sleep. He complains of a lack of motivation and concentration, precipitated especially by his enrollment in a medical degree.

The abdominal pains began shortly before his arrival on the ward.  Further questioning elicited that he had not had any food or drink yet today due to rising late and rushing out of the house.  He states that in similar circumstances in the past he has suffered from identical abdominal pains which persisted until he ate.

On examination he was thin although healthy, mildly dehydrated, showed no neurological abnormalities, and had a clear chest.  He was prescribed a caffeine solution and referred to the volunteers BBQ breakfast in the courtyard, where he was treated with oral toast, bacon, sausage, egg, hash brown, onion and sauce.  Shortly after treatment he was observed to be sleeping soundly in the doctors' office.

Please review in the afternoon - should be suitable for early discharge to home care.

They hate me because I am pretty

They hate me because I am pretty.  That's the only possible conclusion.

After the ward round this morning the consultant drew me aside for a private conversation where he pinged me for not using my initiative.  This soon after I volunteered to write a letter to the school of one of the patients addressing a problem and the hospital's stance on it, discussed it with the mother, wrote the letter, got the registrar to sign it, gave it to the mother and also put a copy in the notes.  All in ten minutes tops.  I thought I was a bit of a hero actually, so I was mildly taken aback to be rapped on the knuckles for not trying.

And what was the actual problem?  It seems that earlier in the round I had had the temerity to walk with the consultant to the next patient's room, rather than run off and grab the notes.  Parenthetically, the reason that I didn't scurry off and get the notes was because someone else was already doing so, so it seemed superfluous for me to make a token effort.  Little did I know that my presence alongside the consultant for those ten or fifteen seconds that it took for the notes to arrive would be so distasteful to him.

I got thrown into a bit of a funk by it, but after lunching with some of my Esteemed Colleagues, I'm back on track.  Let's face it, it's not my fault I was born so pretty.  I can't be held responsible for the fact that merely glancing upon my godlike visage unprepared can stun the viewer into a drooling stupor.

Heavy

I was doing my special curtain dance this evening for the Hatchling.  It's the one where I pull the strings that draw the curtains surreptitiously and meanwhile make like David Copperfield, as if I'm magically enchanting the curtains to close without touching them.  The Hatchling loves it.  She also loves the curtains when they are totally stationary, so maybe it's them rather than me, but I'm keeping it fresh until she's old enough to tell me just in case.

Anyway, after putting on this great performance, my Smaller Half made some remark to the Hatchling, that she should be scared because half of her genetic material is mine.  I pointed out to my Smaller Half that since I weigh almost twice as much as her it's probably more like me:her in a 2:1 ratio.

It's kind of strange the way people usually talk about being half Scottish or a quarter Aboriginal or one-eighth Indian, but you seldom hear people say that they are one-third this or two-fifths that.  Yet a set of scales and some simple arithmetic is all that it would require to calculate much more accurate genetic histories for the purposes of determining risk.  Tip for all you first-year med students out there: in your upcoming genetics exams you'll get top marks if you include these types of weight-based calculations in your answers.

Knife edge

Fresh start today.  I'll be doing six weeks with the little people, by which I mean paediatrics.  I've been really looking forward to it, from both a personal and an professional point of view.  I got to see very few kids last year so this will be a good learning experience.  Plus, I like kids.

A few times I've heard people say to me, "I couldn't do paediatrics, I hate seeing kids in pain".  Which kind of confused me.  I always felt like replying, "But you like seeing adults in pain do you?"  I didn't actually say that since obviously that would be a pretty jerkish response.  But I guess I couldn't really connect to what they were saying.

But last week I was reading a book on death and dying and I opened it up to a chapter on the death of children.  The sentence that fell under my eye was: "Parents who have a child that dies will often experience grief, guilt and anger so severe that they feel that they are losing their minds". 

As I read that sentence I involuntarily contemplated how I would feel in that situation.  And it was like a panic attack.  For about twenty seconds, my chest was tight, I couldn't breath, my whole body seemed to tense up and freeze.  And that was just from reading one sentence in a book.  I can't imagine the horror of having to cope with it in reality, day after day, forever.

So now I'm feeling quite apprehensive about the next six weeks of paediatrics.  Hopefully I'm not going to be a walking mess of raw nerves.  On the round this morning I didn't see any kids who were really life-threateningly sick.  Which was nice.  But it meant that I spent the morning wanting to grab them all and play with them and then feeling increasingly homesick and missing my little Hatchling.

This is going to be tiring...

And on and on

One of my Esteemed Colleagues was lamenting to me that the Moronic Nursing Student has now appeared in this blog more often than him.  I say to him, "Good sir, thank your lucky stars.  For the Moronic Nursing Student is my arch-nemesis, and were your deeds to match his in infamy your brain would be in a most parlous state, unfit for the practice of medicine."

Meanwhile...

Moronic Nursing Student

People are so stupid.  The number of people who say to me that they don't like to take medication because they don't like chemicals is incredible.  Don't they realize that everything is made out of chemicals?

PTR

I suppose not.

Moronic Nursing Student

And people who want to take herbal remedies because they're natural and organic but won't take medical drugs.  Don't they realize that the definition of organic is that it contains carbon?  So all drugs are actually organic?

PTR

What about lithium or gold?

Moronic Nursing Student

(puzzled) They're natural.

PTR

But they don't contain carbon.

Moronic Nursing Student

No, but they're natural.  God people can be so stupid.

Gold

O rapture, O sweet sweet manna from heaven, O light of my senses, O dream of summer days!  I just witnessed a thing of marvel and wonder.  The nurse who has been very rude to me for the last six weeks just slammed the Moronic Nursing Student.  I experience the whole thing in slow-mo, it seemed to last for hours.

Nursing Student

I just wanted to say thanks very much to you guys, I really learned heaps from being here compared to when I started.

Nurse

Ha!  Compared to when you started I'm not surprised!

Trained monkey

So today is the last day of having to put up with my friend the Moronic Nursing Student.  I turned up this morning and had to grit my teeth so hard that they crumbled like chalk.  Here's a rough transcription of the first 30 seconds, prompted by me throwing a piece of paper at a bin and having it land right on the rim:

Moron

You've obviously never played basketball.  I used to play basketball with my mates, half of them were in the state team, they were just psycho.  How'd your plumbing problems go yesterday?  I reckon a trained monkey could be a plumber.  It's not hard.  I don't know why they get paid so much.  It's like electricians.  I reckon a trained monkey could be an electrician.  I don't know why they get paid so much.  So tell me, why do you reckon that person was there in the hall?

PTR

The special sitting on the chair? Presumably the patient is bonkers or violent or a wanderer.

Moron

See, the thing is, with age-related cognitive decline, people forget they can't walk, so they're a falls risk.  Some people fall over really easily, they get up and boom, they fall down.  We had one guy who fell down more than six thousand times in one month, he was full on.  So you've got to have someone sitting there watching them to make sure they don't try to walk.

PTR

My goodness, I never suspected.

Moron

It's pretty boring having to watch them, I reckon a trained monkey could do it.

He has also lectured me extensively on painkillers, napalm, styrofoam, back pain, how to put in cannulas, his last bout of diarhoea, his mobile phone plan, the legality of restraining patients, what the effective dose of anti-epileptic medication is, and so on and so on and so on. And so on.

I got some small measure of retribution just now when he slipped up and admitted to never having heard of conversion disorder.  So I expressed great astonishment that such information was not in the nursing curriculum and wondered why he had never come across this in his background reading, then brutally patronized him him for a few minutes whilst desperately trying to remember the few scanty shreds of knowledge that I could dredge up from second year.

Revenge is a dish best served hot!

Lower back pain explained

In the last five weeks I've seen a lot of patients with chronic lower back pain.  Depending on the cause, they can also present with other symptoms which can be quite mystifying unless you have a detailed knowledge of the lumbosacral plexus - the network of nerves which leave the spine in the lower back and control the motor and sensory function of the lower body.

The problem is, the lumbosacral plexus is rather complicated.  That is, it has always been considered complicated until just this week when I realized that it can be easily understood in terms of the battle of Waterloo.  A little bit of work and voila!  This aide memoire inventee a moi pour la purpose de la education medique, as they say in France.

To use it, simply note that the French commanders are in blue, the Allied commanders are in red (British), grey (Prussian), and black (Brunswick), and the local villages and farm buildings are in brown.  (The Dutch are not included in this diagram since they correspond better to the visceral innervation.)

For example, if a patient came in complaining of lower back pain and sudden onset ineffectual cavalry charges in the genital area, the diagram clearly shows that this is the fault of Marshal Ney, and that the underlying lesion lies somewhere in the vicinity of the sleepy hamlets of Rossomme and Papelotte.  Or if the patient instead complained of lower back pain and surprise arrival on their flanks of a brigade of horse artillery, the diagram indicates that this is related to the activity of General Bulow of Prussia.

Every patient is different, of course, so please use these suggestions with caution and don't leap to conclusions.  But it's definitely worth asking, when your next patient comes in with long-standing back pain unresponsive to conventional treatment, whether or not a whiff of black powder or a snifter of grape-shot might help!

Insidious mind-control

As you know, life is unfulfilling unless I have something to rail against.  At the moment, things are going fantastically because I am on a righteous crusade against non-canonical nursery rhymes.  It may seem harmless when people tweak these little rhymes and songs a bit but stop for a moment and think about what these shadowy powers-that-be hope to achieve with their historical revision?  I put it to you that the culture wars are being fought (and lost!) right under our noses.  Soon our children will be placing calls to the Stasi in the dead of night to report on our activities.  Think I'm exaggerating? Read on.

It all started when we were given some type of poster-thing by a community midwife to encourage us to sing and read to the Hatchling.  All well and good.  But these are the lyrics to Twinkle Twinkle Little Star that were printed on the poster: (the emphasis is mine)

Twinkle twinkle little star

How I wonder what you are

Up above the world so high

Like a diamond in the sky

Twinkle twinkle little star

I'm so glad that you came by

How about that last line eh?  Stupid or what?  Stars don't "come by" to visit like they are your friends.  And it completely stuffs up the rhyming scheme of the song.  I can't say for certain why some faceless bureaucrat in the Department of Nursery Rhymes saw fit to change it.  But I'm pretty sure it's part of some leftist conspiracy to indoctrinate our children into thinking that it's nice to have people just dropping in out of the blue, so as to weaken our resolve in the Great War On Immigrants and erode the sanctity of property ownership.

It's amazing how many leftist conspiracies you can find in children's literature once you become sufficiently deranged and paranoid.  For example, one of the Hatchling's favourite books is one called Where is the Green Sheep?  This simple book shows us all sorts of other sheep in our lengthy search for the Green Sheep.  Entertaining stuff, to be sure, but the author and illustrator don't miss a single opportunity to brainwash us into their pinko views.  Here's a short list of some of the sheep in the book and their barely subliminal messages:

• The red sheep and the blue sheep - clearly intended to make us think that it's okay to look funny or to be born ethnic.
• The train sheep and the car sheep - the train sheep reclines in unnatural comfort amidst a seething menagerie of unhygienic foreign animals while the car sheep struggles to repair his broken vehicle.  How much multiculturalism, environmentalism, communism and other isms can be crammed into just one page?
• The thin sheep and the wide sheep - because sheep can't be called fat anymore because it might hurt their feelings.  Still, they can't stop me from the enjoying the juicy strip of wide down the edge of my lamb chops!
• The wind sheep and the wave sheep - more environmentalism, more lazy layabouts.  I see there's no brown coal sheep, no uranium sheep, not even a natural gas sheep.  Sheep don't need real jobs, being happy to fly kites and go surfing.  Hence no need for a construction worker sheep or a chartered accountant sheep or a soldier sheep or any other form of gainful employment sheep.  I'm surprised the illustrator didn't just draw the surfing sheep with a disability support pension sticking out of his back pocket while it laughs all the way to the bank!

 I'll bet you're not laughing now.  The next time you are reading a book to your child or singing a song to your baby, give some thought to what they might really be hearing.  Remember, if you don't vote Right, don't vote at all.
 

In a nutshell

Doctor

So, what did you think of that patient?

PTR

Well his relationship with his wife seemed very strange.  She's very passive and seems to out-source her aggression to him.  And she's very dependent on him but he just shuts her down when she vocalises her guilt.  He seems like someone with a lot of frustration in his life but the only way he is able to express that frustration is through anger.

Doctor

There's a simpler way of putting it - he's an arsehole.

My five favourite soups

My five favourite soups are:

1. Pho
2. Potato and leek
3. Pea and ham
4. French onion
5. Minestrone

Thank you for your help

Before I start... bugger.  Now that I've started, I want to make it clear that I do not have a seething contempt for nurses.  Oh sure, some nurses.  Like the bizarre passive-aggressive nurse I currently work* with.  He somehow manages to undercut me at me every opportunity.  Like the time I called in sick and he answered the phone.  When I told him I wouldn't be in, he said "Oh.  Well, I don't suppose it really matters anyway."  He's either a comic genius or a brutal misanthrope.  Or both.  Or neither.  Yep, that about covers it.

Anyway, I was telling you that I don't hate nurses.  I have no stories to tell you about likeable nurses to prove this because stories in which everyone acts in a reasonable and pleasant way aren't very memorable or interesting.  But just keep in mind that most nurses are great because I'm about to unload on one chump who happens to be a nursing student.

The problem is this - he seems to be very competitive with me and is always trying to show me up.  For example, on his first day I had a syringe driver that I was about to hook up to a patient.  The guy stops me and points to a series of tiny bubbles in the tubing and insisted that I flush them out of the line.  When I said I hadn't noticed them, he said "That's what nurses are for!  Lucky I was here."  For the record, to give someone an air embolus you need to get about 200 mL into their veins,  The bubbles in the tube would have been a fraction of a drop.  Still, nice catch there, Inspector.  He spent the next 10 minutes flicking the syringe to try to remove some errant molecules of nitrogen clinging to the side of it.

This week he managed to creep up behind me while I was discussing a patient's medication with her, and chip in with unhelpful comments just at the worst moment:

PTR

So you've gotten good pain relief from fentanyl.  This means we'll be able to think about a range of medications to find one that's right for you.

Annoying Nursing Student

It's a class of drugs called opioids.  Things like morphine.

Worried Patient

Morphine?  I don't want to take morphine! Isn't that for people who are dying?

PTR

A lot of people are worried about that.  But there are lots of people who use morphine or similar medications for pain control.  The reason that these drugs have this reputation for being for dying people is that they are effective.  So they do get used in extreme situations.  But they are also useful for people like you who only need much smaller doses.

Annoying Nursing Student

Watch out though, because if you take too much you'll stop breathing and die.

PTR

Sigh...

*"work" being defined in this case as performing pointless tasks for no remuneration.

The truth shall set you free

Baffled Consultant

I've never known students to be placed in that unit before.  Did you choose it?

PTR

Well, it was my 5th preference so, in a sense, yes.

Monologue

A rabbit.

A rabbit.

A rabbit.

Trust and safety

Today I simply present a longish quote from the book "Evidence-Based Medicine: How to Practice and Teach EBM".  Those long-time readers familiar with my tribulations in 2010 will understand why it resonates with me.

First, an extract from a table:

"Table 7.3 The top 10 mistakes we've made or seen in in teaching EBM.
Teaching EBM fails when:
...
9. When it humiliates learners for not already knowing the "right" fact or answer.
10. When it bullies learners to decide or act based on fear of others' authority or power, rather than on authoritative evidence and rational argument."

Then, the discussion:

"The ninth and tenth entries are included here because they are still commonplace among medical education programs, and at some of these institutions they remain a source of twisted pride.  Such treatment of learners by their teachers is not simply wrong in human terms, it is demonstrably counterproductive.  First, the resulting shame and humiliation learners feel will strongly discourage the very learning that the teacher's ridicule was meant to stimulate.  Second, in adapting to the rapid loss of trust and safety in the learning climate, learners will start employing strategies to hide their true learning needs and protect themselves from their teachers, undermining future learning and teaching efforts.  Understandably, learners with prior experiences of these behaviours may be very reluctant to even start the practice of EBM by asking a question, since it exposes them to the potential threat of repeated abuse.*

"*Contrast this with the actions of colleague David Pencheon, who asks new medical students questions of increasing difficulty until they respond with "I don't know".  Upon hearing these words, he rewards them with a box of Smarties and tell them that these are the three most important words in medicine."

Confidence booster

PTR

Hello, is it okay if I put a drip in your arm?

Patient

Oh my god! Oh Jesus!

PTR

Do you have a needle phobia?

Patient

No, I just saw what you did to that other woman.

Welcome to Port Adelaide

WELCOME to historic Port Adelaide! 

THRILL to the wide open vistas of the deserted streets. MARVEL at the endless blocks of boarded up shopfronts!  RELAX in a neighborhood cafe where moustachioed women ignore your every whim!  PONDER the local economy which seems to be dominated by the police station and magistrates court!  FEAR for your life as belligerent bikies roar past!  TRUDGE down the waterfront and wonder if things will open some other day!

Port Adelaide is happening.  No really, it is!  It's happening to you, right now!  Can you feel it?

Crazy horse

Being a parent sometimes seems to be a kind of benign psychosis.  You get so caught up in it that you lose track of reality.

The Hatchling really laughs and smiles when I bounce her up and down on my knee.  While I do this I sing an amazingly tuneful song that I made up about riding horses.  It goes:

Doo da doo doo doo-da-doo,
Doo da doo,
Doo doo doo-da-da-doo!
Riding on a horsey,
Riding on a horsey,
Doo doo doo-da-da-doo!

I've been doing this several times per day for the last two weeks and it only just occurred to me tonight, for the first time, that she has no idea what a horse is.  She doesn't understand a word I'm saying.  She just likes being bounced around.

It isn't her pretending that she's riding a horse, it's me.

I can speak English

Elderly Man
We've just been admiring your beautiful baby.

PTR
Thank you!

Elderly Man
If you don't mind me asking, where is your partner from?

Smaller Half
Queensland.