Leopard hunting

It is a truth universally acknowledged that it is more embarrassing to be caught staring at someone peeing in the park than to be stared at while peeing in the park.  Okay, perhaps it's not universally acknowledged, but it's the core tenet of my moral philosophy - one which finally came in handy yesterday when I caught someone peeing in the park.

We were taking a stroll in the crisp afternoon air down by the parks near the racetrack, when I glanced to my side and noticed someone behaving furtively.  She was middle aged, well-dressed, and would not have looked out of place sharing a bruschetta in a trendy cafe with her friends.  Except she was standing beside a clump of trees, looking back and forth anxiously.

Curious, I stared.  Suddenly she whipped her daks down and squatted at the base of the tree.  It was apparent to me that she was peeing in the park.  Normally I would have laughed and looked away, but now she'd committed to the act she was carrying it off with great zeal and elan.  In fact I wasn't even sure that she was peeing at all.  She wasn't hunched awkwardly forward - she was restfully squatting with a split-stance and gazing calmly into the middle distance in the manner of someone who is hunting a leopard and has just finished contemplating its spoor.  Perhaps I had misjudged the situation.  Perhaps she was in fact hunting a leopard in the Adelaide parklands.  With her pants down.

At this point I realized that if she were to look around and see me staring in astonishment I would be mortified.  The tables would be turned and I would feel like a creepy pervert.  The thing is, if you need to pee in the park, so be it - you just have to.  Whereas I was a voluntary participant in this sordid drama and I felt it reflected very poorly on me indeed.  So I alerted my companions to the situation so that we would be in the majority.  Excellent!

The woman then stood up, whipped her daks up again, and briskly strode off casually adjusting her fly as she went, in that way that people do when they are trying to look as if they aren't really fiddling with their groin when they actually are.  About 40 yards away a family picnic continued in blissful ignorance, which she then rejoined.

I wonder what she told them she was doing?

Aristotle said

"All men who have attained excellence in philosophy, in poetry, in art and in politics, even Socrates and Plato, had a melancholic habitus; indeed some suffered even from melancholic disease."

Maybe we still are in Kansas, Toto!

As usual, we went out tonight to celebrate Willie Nelson's birthday.  We had a great time, going back to our favourite Japanese restaurant.  We ate extravagantly, and lapped up the admiration of our fellow diners for the Hatchling.

Afterwards, we headed south and checked out a new dessert-only cafe.  Its doors don't open until 8pm and we fortunately arrived on the dot and secured a table to beat the rush.  Sticky black coconut rice, rose panna cotta and a stein of teh tarik.  Mmmm.

We got up to pay at the counter and I overheard one of the girls behind me admiring the Hatchling:

Girl

(to friend)

Look, look, how gorgeous!

PTR

(turning to show off the Hatchling a bit more)

Thank you.

Girl

(to friend)

Look at the little half-caste baby!

Gotta love Adelaide...

Comrades, fill no glass for me

Oh! comrades, fill no glass for me

To drown my soul in liquid flame

For if I drank, the toast should be

To blighted fortune health and fame.

Yet, though I long to quell the strife

That passion holds against my life,

Still, boon companions may ye be,

But comrades, fill no glass for me.

I know a breath that once was light

Whose patient sufferings need my care

I know a hearth that once was bright,

But drooping hopes have nestled there.

Then while the tear drops nightly steal

From wounded hearts that I should heal

Though boon companions may ye be,

But comrades, fill no glass for me.

When I was young I felt the tide

Of aspirations undefiled,

But manhood's years have wronged the pride

My parents centered in their child.

Then, by a mother's sacred tear,

By all that memory should revere,

Though boon companions may ye be,

Oh! comrades, fill no glass for me.

- Stephen Foster

Turnaround

Aged Mother

You're a dreadful photographer!

PTR

Why?

Aged Mother

In those photos you sent me of the Hatchling she looked like a real fatface.  But she's gorgeous!

Going with the flow

Each night, as I lift the Hatchling from her bath and place her gently in her mother's arms where she is wrapped in a thick white fluffy towel to soak up the water and keep her from the cold, I am accustomed to shouting out, "No prisoners!  No prisoners!"  It's just the way I roll.

A few days ago I was surprised when my Smaller Half asked me why I did it.  Naturally enough I told her that I was channelling Peter O'Toole in Lawrence of Arabia.  I'd been assuming for several months now that she knew what I was referring to.  It turns out she had no idea and thought it was just best to go along with it unquestioningly in order to stop me from becoming even more deranged.

How to win at med school

Medical school.  You can work your little heart out if you wish.  You could graft your buttocks to a library chair.  You could shamelessly brown-nose a senior doctor and hope to "noticed" and taken on as a new protege.  You could get all military and launch "Operation: Study".

But frankly, why bother?  The sole determinant of your clinical confidence as a med student is your ability to place intravenous lines into people's veins.  You may have eaten your textbooks for breakfast but if you can't slam in that cannula your mojo will be shot, down in flames, MIA.  Conversely, you may have skipped your last few years of classes but as long the first cannula of the day slides in sweetly, you'll feel like you can cure cancer.  Or at least dehydration.

When I was doing my anaesthetics rotation recently I noticed that anaesthetists like to hover over you and give you gratuitous advice.  If this happens to you, do not listen.  They are trying to steal your mojo using this old anaesthetic voodoo curse.  Shrug off the advice and dwell instead on this advice, given to me last year by a nice GP-anaesthetist:

Find the vein.  Put the needle in it.

Seriously.  You need to approach this task with a Zen-like serenity.  The less you are thinking, the better.

The reason anaesthetists try to steal your mojo is that cannula mojo is a zero sum game.  The better you get, the worse someone else gets, and vice versa.  Thus, it is important to mentally destabilise other students if you see them trying to place cannulas (or cannulae, as we used to call them in the Vetus Hospitium Romae).  This is easily done by offering advice, or more subtly, implying that they are so good that they don't need advice and thus the pressure to perform is on.

Last week on the wards, an Esteemed Colleague had been asked to change the cannula in one of the patients, a lovely old lady.  I wandered past in the nick of time and was able to wage psychological warfare on him from the outset.  Sadly, he got me back immediately.

PTR

Oh, going for that vein there, eh?  Huh.

Esteemed Colleague

Well it seemed like the best one.

PTR

Oh sure, you've got to go take your best shot.  

Esteemed Colleague

Darn it, I've burst the vein.  Big haematoma there.  Sorry, I'll have to try your other arm.

PTR

Oh yeah, that looks like a great one.  A sure thing.

Esteemed Colleague

Darn it, not again.  Maybe that first arm was best.

Lovely Old Lady

Maybe PTR should have a try?

PTR

Sure, I'd be happy to.  Hmm, this vein here looks good.

Esteemed Colleague

PTR's just done six weeks of anaesthetics where he did this all day, he's great at this.

PTR

Darn it.

On frailty

As previously noted, I own many books.  Many books.  This has been made abundantly clear to me by removalists, friends, visitors, and even - in what must surely be an exemplar of the pot calling the kettle black - my own Aged Mother.  Nevertheless, when I hear about a discount book sale I go rushing headlong to buy more.

I do this even though it would actually be cheaper to buy books online from places like abebooks in the UK, especially with the Australian dollar as strong as it is.  But I don't buy books online because I am inept at the key step of figuring out what I want to actually acquire.  Hence bookshops.  It's great to walk in and be immersed in walls of books, a paperback prison that frees rather than constrains.  It's not until I look at ten shelves of books on ancient history that I suddenly realize that my life hitherto has been incomplete because I lack a comprehensive knowledge of the campaigns of Scipio Africanus.  That's the kind of insight that you just can't get online.

Little did I know that this is merely the tip of the iceberg.

Yesterday my Smaller Half, the Hatchling and I went to the big sale at Borders in the city, which is going into administration due to bogus management.  20-40% off everything in store.  We split up and agreed to meet back in half an hour.  I was super restrained and only got two books: some stories by Jorge Luis Borges (whose name I mention here primarily because I don't know how to pronounce it and hence will never be able to use verbally) and a book by Jon Krakauer called Into Thin Air, both of which I have been coveting for some time and merely needed a tiny knock such as a 20% discount to crystalize the purchasing impulse in my mind.

My Smaller Half failed to arrive at the designated rendezvous point so I went searching for her.  With a dark sense of foreboding I made my way to the only possible place she could be - the children's books section.  Forty five minutes later I was only able to crowbar her away from there by surreptitiously provoking the Hatchling into a tantrum and announcing that it really was time to leave.  We had to leave the store with me carrying the Hatchling and the pram piled high with new kids books.  In a stroke our book-buying tendencies have multiplied.

Mind you, we got some absolute crackers.  Several Richard Scarry books, an incredible pop-up book that I probably would have bought for myself anyway, a set of Beatrix Potter books, some cute little fairytale books, and more.  And more.  And more.

Buying kids books makes me feel simultaneously old and young.  I tend to buy the books that I remember from my own childhood.  Partly it's selfish nostalgia (literally "the pain of homecoming") but also partly the sincere belief that if I know I'll enjoy the books that I'll read to the Hatchling then I'm more likely to read to her.  Reading books such as "The Very Hungry Caterpillar" again takes me right back to my childhood, when I would flip the pages back and forth looking at how the holes in the fruit line up - amazing!  What makes me feel old is when I try to poke my fingers through those holes and they are now too large to fit.

Hopefully I don't have acromegaly.

My child is a genius

PTR

Oooh!

Hatchling

Igg-yeah!

PTR

Igg-yeah!

Hatchling

He he he!

PTR

Igg-yeah!

Hatchling

He he he!

Smaller Half

Igg-yeah!

Hatchling

He he he!

PTR

Igg-yeah!

Parent hood

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

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

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

The expo was targetted at three groups of people:

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

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

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

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

Olfactional heavies

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

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

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

A New Hope

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

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

Dishevelled Man

Don't you know how to use a comb?

PTR

Ha, ha, I do need a haircut.

Dishevelled Man

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

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

Play misty for me

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

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

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

Bugger.

What kind of doctor?

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

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

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

The procedure is as follows:

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

List A:

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

List B:

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

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

What kind of doctor do you want to be?

Proof that slugs can't read good

LD50

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

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

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

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

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

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

Pan solo

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

Waiter

Just by yourself today sir?

PTR

Yes.

Waiter

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

PTR

That's right.

Waiter

Well don't you worry about it sir.

PTR

Thank you.

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

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


What really pisses me off is that he was right.

Physiological

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

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

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

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

Ee ecky thump

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

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

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

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

Damn it.

Parents say the darndest things

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

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

Watch out

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

Animal with different plants

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

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

Trivia of the day

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

Perky

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

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

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

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

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

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

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

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

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

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

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

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

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

The Doc Is A Cock

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dreams can come true

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

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

PTR
Oh, yeah, sure.

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

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

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

B-sides and rarities

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

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

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

What's in a name?

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

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

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

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

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

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

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

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

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

No verbs please, we're British

The anaesthetist I was with one day this week was a strange chap.  Only once did he initiate conversation.  He was happy to answer questions and did so most informatively.  But it was as if he was simply at a loss for anything to talk about unless I raised a topic myself.  Either that or he was perhaps a sunflower in disguise and was unaware of the basic human need for interconnectedness.

The only time he spoke to me unprompted was towards the end of the list, after we had wrestled the patient off the theatre table and onto the bed, and we were starting to roll her out to the recovery ward.  He looked at me and said, "Theatre dress standards.  Mask on.  Mask off."

I was bemused by this.  Had he suddenly morphed into Mr Miyagi from The Karate Kid?  Or perhaps he had had a stroke affecting that part of his brain which controls the use of verbs and articles?  I knew I had to figure it out soon because he was staring at me quite pointedly.  Or, to be precise, staring at my neck.

Aha!  He was staring at my theatre mask, which I had pulled down off my face so it hung around my neck.  I reached up and pulled it off and hung my head in shame at my gross blunder.  As we left the theatre, I glanced back at the other staff, my cheeks burning, wondering who else had been a witness.

And I noticed that every single person in the room was wearing their mask around their neck.

Perfect Symmetry

Special Operations Paramedic
I don't get paid for what I do.  I get paid for what I can do.

PTR
Same here.

Education revolution

Here are the facts:

• Girls get better educational outcomes in single sex schools.
• Boys get better educational outcomes in mixed schools.
• Girls who go to single sex schools seem reasonably normal.
• Boys who go to single sex schools are thuggish ruffians of the first water.

So sadly it seems that we either have single sex schools and the boys lose out or co-ed schools and the girls lose out.  Unless ... unless ... someone, somehow, can come up with an ingenious scheme whereby we can have the best of both worlds.  But who could possibly be so clever?  Who amongst us, what paragon of untrammelled creativity, could draw together these disparate threads and weave a tapestry to hang high above us all and show the way to salvation?  Who?

Ahem!

My simple proposal is that all classrooms should be fitted with one-way mirrors down their length.  Boys and girls would be separated by the glass such that the boys could see the girls but not vice versa. 

Voila!

On sunflowers

Sunflowers are creepy.

Let's face it - they don't look real at all.  They look like a bad drawing of a flower.  Or someone taking the piss out of flowers.  Or - and think about this carefully, your life may depend upon it - they look like something else entirely that is pretending to be a plant.

Something from a far away place.  Something that doesn't understand what humans expect plants to look like.  So they disguised themselves as these spindly things with flappy leaves and strange giant faces, thinking that they could watch us incognito.  But we're onto them.  We know that they waddle around in the black of night, making their reports and issuing recommendations for our eventual disposal or enslavement.  And when we we drive past them in their fields they give themselves away by all doing the same thing and looking in the same direction at the same time.

It's a conspiracy.

Good questions

Does hard steel soften like wax underfoot?
Do your hands lie to your eyes?
Do your teeth snap like a fox trap?
Are you seized by revolting compulsions?
Do you dwell on painful thoughts?
Does the knife-edge make you blink and tremble?
Do your limbs yield to gravity with no warning?
Is your coffee tainted by memories?

In which I manage to start insulting people before lunch on day one

Anusthetics tech
... whereas this machine here is no longer compliant with the required standards because it doesn't have a negative polarity flux inverter on the hyperspace motivator, so we'll be getting rid of it by the end of the year.

PTR
So will it get sent off to a developing nation like New Zealand?  Ha ha ha.

Anusthetics tech
I'm from New Zealand.

PTR
And what a beautiful country it is.  I loved Lord Of The Rings!

Suspicious minds

Some people might find it refreshing to have a mattress that has been delicately scented with the aroma of limes.  Perhaps if you ate a lot of corn chips or thai food in bed it would be great.  But I just can't help lying there wondering what it is that the mattress would otherwise smell of that the manufacturers don't want me to notice.

Spot diagnosis?

So yesterday I gave a talk to the various paramedics, nurses, registrars and consultants at the end of my first rotation.  I was pretty tense about the whole thing since I was basically getting up and talking to them about stuff that they do every day whereas I have only a pretty tenuous grip on.  So I used my most wily of tricky tricks to make them feel like they couldn't be too cruel and rend me limb from stinking limb for my ignorance.  Trick number one was to put my most cuterest picture of the Hatchling as the first slide in my presentation to make them all go "awwwww". 

So I flashed up the picture and before I could say a word, one of the doctors in the front row who I've spent a bit of time with shouted out, "Noonan syndrome!"

Oh how we laughed.

Strange

I just got the strongest feeling of déjà vu.

Whither blob?

So, let's brush past the alarming fact that the majority of you seem to think that the Kurgan could take out Reepicheep in a cage-fight.  I don't care to dwell on that thank-you.

What I want to talk about, once I've made it clear that I in no way condone the sale of unpasteurized milk products, is that there seems to be some confusion about the purpose of this blob.  Recent comments seemed to invite me to wax philosophical but were in fact simply traps to tempt me to engage in the quoting of lyrics from awful 90's dance hits.  Eurgh.  Somehow some readers seem to have gotten the idea that this would be fun.

To address this issue I have put up a poll, to the right.  (No, your right.)  Please vote for the things that you think this blob should focus on.  You can choose multiple options, of course.  Nobody wants to be like a dog racing in a trench.

Strange

I just got the strongest feeling of déjà vu.

Certain words

One of my favourite words at the moment is "certain".  Not in the sense of "sure", but in the sense of "particular".  I like it because using the word "certain" can change the whole flavour of your sentence, creating an illusionary air of informativeness whilst actually contributing nothing specific that can come back to hurt you.
Here's an example - consider this sentence:

"Whilst reversing out of my driveway I sideswiped my neighbours' cars."

And now consider it rewritten slightly to include the word "certain":

"Whilst reversing out of my driveway I sideswiped certain neighbours' cars."

In one fell swoop I have gone from being a klutzy driver to a malevolent vandal.  The word "certain" has transformed the event from accident to incident.

And think about this one:

"During attempts at resuscitation by emergency department staff, the patient expired."

Which then becomes:

"During attempts at resuscitation by certain emergency department staff, the patient expired."

Or even this:

"During certain attempts at resuscitation by emergency department staff, the patient expired."

The first is a statement of fact, the second is an insinuation of incompetence, the third makes you wonder if they were using smoked kippers and AAA batteries to try to revive the poor guy.

So here's my tip of the day.  Try slipping the word "certain" into otherwise innocuous sentences and see what happens.  Even if it all blows up in your face you can just claim that certain people took your remarks out of context.

Wasting rice

One of my hobbies that I just invented for the purposes of this post is collecting sayings relating to the wasting of rice.  I'd never heard of such a thing until my Smaller Half told me about some of the dreadful things her parents used to say to her to get her to eat all her rice.  Apparently this is something of a tradition in families from cultures where rice is king.  They used to say to her:

Every grain of rice you don't eat will be a pockmark on your face when you grow up.

But what really piqued my interest was that they didn't say that to her brother.  To him they said,

Every grain of rice you don't eat will be a pockmark on your wife's face when you grow up.

Ah, the gender politics of grain consumption.

I came across two more when reading Maeve O'Meara's Food Safari yesterday.  From Vietnam we have:

Every grain of rice you waste becomes a maggot that you have to eat in Hell.

Ingenious, not only because of the rice=maggot image that lingers in your mind for far too long, especially if you eat rice regularly, but because of the inbuilt assumption that you're going to Hell anyway.

And from Japan we have:

Be careful when washing rice - if even one grain goes down the drain, you'll go blind.

At first glance this really ups the ante - blindness for just one grain!  But in my opinion it's misguided.  Once that first grain is lost by accident - and accidents happen - further losses are insufficiently disincentivized.

If any of you were threatened in brutal or baroque ways by your parents for wasting rice, I'd like to hear about it.  Please, for the sake of future generations, speak up!

Words of wisdom

This is, apparently, everything you need to know about emergency medicine:

• Assume nothing
• Trust no-one
• Give oxygen

I think I just need to work on the second one.

You're lucky I'm not a Jedi

People sometimes ask me, "PTR - how would my life be changed if some kind of super-villain stole all the liquid helium in the whole world?", to which I reply that I won't be drawn into speculating on hypothetical scenarios and that I would much prefer to talk about why people should keep their goddamn hands off my baby.

We were sitting having caffeinated beverages this morning in a nearby cafe when an adjacent table of oldies got up to leave.  Of course they have all been eyeing off the Hatchling the whole time so this is their opportunity to file past and ask us questions and give us unsolicited advice.  Which is, in general, fine.

Except this morning, one of the oldies thought she'd be funny and came and said, "What's in here, a baby?"  Sigh, yes, a baby.  Then she reached down and slapped the sleeping Hatching on the cheek with her big puffy ham-hock-esque mitt, looking frighteningly like Boris Yeltsin, and asked, "Is it a boy or a girl?"

Which is a question that I normally have no problem with.  In fact, I like it when people ask because it is, in a sense, acknowledgment of our refusal to sail with the prevailing winds and only dress the Hatchling in pink.  But this time I just wanted to fix the intruder with my best cold glare and say, "It's asleep."  Or perhaps just fire up my lightsabre and lop her whole arm off.

Did I?  No.  I'm too nice for my own good.  Plus I don't have a lightsabre.

I'm unsure of whether to be flattered, insulted or amused

Short-sighted Anaesthetist

How old are you, about 25?

PTR

Only in hexadecimal.

Catching earworms

In response to THIS COMMENT I simply wanted to say that the best treatment for an earworm is to use a juicy piece of bait to lure the earworm out.  This usually happens at night when you are sleeping, so the trick is to enlist the help of a close friend, jailmate, casual sexual acquaintance, or ideally someone who is all three at once, to catch the earworm when it pokes out its head and twist it around a short stick which can then be used to gently wind out the earworm over several days.  The best bait to use is a stinking piece of rotten meat such as Tubthumping by Chumbawumba.

So far

I'm three weeks into my first clinical elective for fourth year.  Here's what I've learned so far:

1. The reason you should duck when you're getting in or out of a helicopter with moving rotor blades, even though they are five feet above your head, is that at low speed a gust of wind can bend them considerably and they might just bisect your head.
2. Wearing overalls in 35 degree heat is not fun, no matter how schmick they are.
3. Some people get their kicks out of always telling you that you're wrong.  These people are extremely annoying but fortunately they are a tiny minority.
4. People are, in general, surprisingly good at getting out of the way of speeding ambulances in a timely way.
5. If someone tells you, "This will be your last chance to go to the toilet for a while", you should go to the toilet.  No matter what.
6. If someone tell you, "This will be your last chance to eat anything for a while", you should eat something.  No matter what.
7. A handy rule of thumb for ventilation is that you fiddle with minute volume to manage end-tidal CO2 and you fiddle with PEEP to manage oxygen saturation.

Personally, I think that fact number 5 is the most crucial.

Clinical stimulation

Yesterday I volunteered to be the subject of a brutal and inhumane experiment.  They made me pretend to be a doctor for half an hour and filmed me to see what I'd do.  And then when I tried to leave the ward to lounge around in the cafe they stopped me and said something crazy about having to look after the patients.  Huh!

Actually, it was really interesting and indeed fun (in retrospect).  I volunteered for it because every time I do a clinical simulation with these guys I learn something really useful that I didn't know before.  Plus the guy who runs them is, in my opinion, THE best teacher on campus.  If all our teachers were like him I wouldn't be as bitter and twisted as I am.

However, it was uncomfortable having to watch myself afterwards.  They'd filmed the whole thing with a veritable bevy of cameras and I had to watch the footage and assess my own performance before doing a review with them.  You know how when you hear a recording of your own voice it's always shockingly unlike what you expect?  Seeing yourself on camera is far, far worse.

It's not that I was expecting to see some manly, Clooney-esque figure striding purposefully from bed to bed, making quick decisions and saving lives with the ease of one born to it.  Oh perhaps I was, just a little.  But what I saw was just my balding, big-nosed, stooped, nerdy self, shuffling around indecisively with my left arm hanging limply by my side as if I'd had a stroke, while my right arm flailed in the air or clutched at my own buttocks or rubbed my face, saying things like, "oh!  err... um... I think the correct dosage is 50... 25... no... do you... I think just give the whole thing".

So I felt like a bit of a goose.  But the nurse in the simulation, who was a real nurse, was really lovely.  Afterwards she said that I'd done well and that she'd be happy to work with me in real life.  And that I should try not to clutch my own buttocks so much.

Summer of 2009

I got my first real stethoscope
Bought it at the five-and-dime
Listened til my ears bled
It was the summer of 2009

Me and some guys from school
Got into medicine, we tried real hard
Jimmy failed, Joey got deported
Shoulda known they'd never get far

Oh when I look back now
That summer seemed to last forever
And if I had the choice
Yeah - I'd never wanna be there
Those were the worst days of my life

Ain't no use in complainin'
When you got exams to do
Spent my evenin's watchin' shit on youtube
And my days stealin' notes from you yeah

Standin' at the ward clerk's desk
I told her that I'd wait forever
To get respect from her
She looked at me and said "whatever"
Those were the worst days of my life
Back in the summer of 2009

Man we were wastin' time
We were young and clueless
Can't be bothered thinking of a rhyme
Thank God nothin' lasts forever - oh, yay!

And now the times are changin'
Look at all the patient's who've come and gone
Sometimes when I use that ol' stethoscope
I think about them, wonder what went wrong

Standin' at the ward clerk's desk
I told her that I'd wait forever
To get respect from her
She looked at me and said "whatever"
Those were the worst days of my life, oh yeah
Back in the summer of 2009, uh-huh
It was the summer of 2009, oh yeah, I got a reaming in 2009
It was the summer, the summer, summer of 2009

More lyrics: http://www.lyricsfreak.com/p/prone+to+reverie/#share

The simple things in life are often the worst

Tense Doctor

Here PTR, take the phone while I do this.

PTR

Ok.

Tense Doctor

Call the Operations Centre and tell them that the patient's O2 sats have dropped to 60% and we've initiated forceful ventilation and suction.  Tell them there's no indication of pneumothorax.  And tell them to inform the duty consultant what's going on.  And tell them...

PTR

Er, how do you unlock this phone?

Slow learner or slow teacher?

Deranged Old Lady
Ooh, what a gorgeous baby!  How old is she?

PTR
Almost 7 weeks.

Deranged Old Lady
She's beautiful!  I was a midwife for 27 years at the old hospital over there so I've seen plenty of little ones like this.  I'll give you some advice.

PTR
I love advice.

Deranged Old Lady
If you stuff some stockings and pop them under her legs, it'll stop her wriggling down under the blankets in her cot.

PTR
That's a good idea.

Deranged Old Lady
Yes, it stops them wriggling down under the blankets.

PTR
I see.

Deranged Old Lady
Yes, if you stuff some old stockings and pop it under their legs, it stops them wriggling down under the blankets.  I did it with my children and they've done it with theirs.  It stops them wriggling down under the blankets.  You just stuff some old stockings and pop it under their legs.

PTR
Yes, I think I understand.

Deranged Old Lady
If you stuff some old stockings and put it under their legs, it stops them wriggling down under the blankets.

PTR
Excuse me, I have to call the police.

Papa Uniform India (ink)

Wow, it's been a whole week since I blobbed last.  Attempting to be a responsible adult is playing hell with my fun-time.

I can't remember if I mentioned that I got to go for a ride in a helicopter last week.  So excitement!  But I shouldn't call it a helicopter - that's not the lingo.  Nor are planes called planes.  It's "rotary wing" and "fixed wing".  I can't imagine why these terms are more useful or precise than "helicopter" or "plane", but there you go.  I suppose pilots are just like doctors in a way - why say "sweating" when you could talk about "diaphoresis"?

Unfortunately during the flight the cap came off a big thick black permanent marker which was in my pocket and it leaked all over me.  Fortunately I wasn't wearing my own clothes.  Unfortunately it was on day 2 of a six-week placement and I was wearing the uniform that I had been issued.  Fortunately it was a super-duper uniform that is resistant to water, fire, etc etc.  Unfortunately it was not resistant to ink.  Fortunately there are more of these uniforms around.  Unfortunately the uniform costs $500.  Fortunately I won't have to pay for it.  Unfortunately the taxpayers of Australia will.  Fortunately I don't currently pay any tax.

Ha ha!

Two anti-pimping gambits

Pimping, in the medical context, is the act of asking a junior person deliberately challenging or obscure questions in public and then denigrating them for not knowing the answer, ostensibly in the service of education.  An excellent guide to pimping has already been published over there and I recommend it heartily. In response, I have recently developed a couple of useful gambits for diverting pimpage.

The Strawman Gambit: Make a purposefully inaccurate statement in response to the question, attributing the factoid to a previous instructor, and subtly indicate that you yourself don't quite think this is right.  Correctly executed, this gambit will divert the pimp into attacking your previous instructor rather than yourself.  True example:

Doctor

What do you know about thiopentone?

PTR

I've gotten the impression that it's a bit outdated, kind of a World War 2 relic, which made me wonder why it's still being used.

Doctor

Whoever told you that is a fucking dickhead.

The Polarizer Gambit: Most useful in response to a pimp that you know absolutely nothing about so you can't even bluff successfully, this gambit involves making a joke which candidly exposes your ignorance but seeks to distract the pimper with a humorous reference to a different topic which tends to produce strong feelings one way or the other and thus changes the direction of the conversation.  I find that this works best with Intelligent Design vs Evolution, as in this true example:

Doctor

What's your take on the Strong Ion theory of acid-base homeostasis?

PTR

I think they should teach both sides of the controversy.

Doctor

Ha ha, those fucking Americans have no idea do they?

Good luck using these gambits in your daily life.  If you have a notable success or if you come with other ideas, please let me know!

Achievement

Doctor
PTR used to be an engineer.

Nurse
You're an overachiever, aren't you?

PTR
If you think that being an electrical engineer who knows nothing about electricity is an achievement, I suppose so.

Snappy comebacks aside, it really threw me that the nurse said that.  For a start, I wasn't entirely sure whether it was a compliment or a snarky insult..

The whole under/over-achiever label is a very strange one.  The under-achiever is the person with clear potential, obvious talents, who chooses deliberately to waste them, typically because he lacks the drive to pursue his gifts or because he is lazy and takes it all for granted and simply coasts through life.  Hmm, sound familiar?  So you'd think that perhaps an over-achiever would be a lumpen prole who somehow conquers all through his singular obsession and force of will.  And occasionally the label is used like that.  But more often, it's a not-too-subtle put-down aimed at a person perceived to have too many feathers in his cap and needing to be cut down to size, by implying that they are just doing this stuff in order to garner grudging admiration if not outright jealousy from the drab crowds left in their wake.  And every now and then the over-achiever tag is used as a short-hand simply for someone who is outstandingly successful.

I don't feel like any of those sorts of over-achievers.  Not because I can't see shadows of myself in at least one of those descriptors, but because I don't feel like I have actually achieved anything.  I have one of those tissue-paper C.V.'s that looks nice and full but if you hold it up to the light you can see straight through it.

When I was young - that is, at school - I used to feel like a high achiever.  I would take home shiny new report cards every few months which had nice things written on them and I felt like I was succeeding.  Hmm, actually that's not true.  I felt like I was a high achiever because I got good marks in tests.  I always flunked my assignments because I left them to the last minute.  So my report cards tended to have varying grades on them depending on how much assignment work was part of that subject, and the comments from my teachers looked superficially like praise but were packed full of dogwhistled alarms that indicated that I was goofing off and annoying the hell out of them.  So on a day-to-day basis I felt like an over-achiever of the third kind, but when my report card arrived I'd feel like an under-achiever.

That continues to this day.  My colleagues tend to view me as some kind of Smart Guy while my supervisors tend to view me as some kind of Smart Arse.  As a result, people seem to never quite know whether I'm under-achieving or over-achieving.  And it seems to drive them nuts.

In my most recent exams I was paranoid about running out of time, so I had a schedule for how many questions to do every fifteen minutes.  I'd glance up at the clock and think, "Okay, good, got those done in 12 minutes, it'll be okay", and I just seemed to get faster and faster.  During the reading time I knocked off a bunch of questions too, with the end result being that two hours into the three hour exam, I was finished.  And since I have a policy of never changing my answers, I picked up Yoda and walked out.

The reason I tell you this story is because a couple of weeks later, I was talking to one of my Esteemed Colleagues who said to me, "Someone told me you left the exam really early so you must have either smashed it or just crashed and burned".  It made me think of the under/over-achiever tightrope that I seem to spend my life walking.  I explained my exam strategy to my Esteemed Colleague and admitted to her that I had neither excelled nor failed, I simply did okay really fast. 

Which is pretty much me in a nutshell: top-speed adequacy.  No wonder it gives people the shits.

Boundlessly optimistic

I found out today about a "Fatigue Score" that the ambulance service uses to try to make sure that they don't wrap themselves around stobie poles when they are supposed to be unwrapping you from them.  It's a simple three-step process:

1. You get a certain number of points for how many hours of sleep you got in the last 24 hours.
2. You get more points again for how many hours of sleep you got in the 24 hours before that.
3. You get a final chunk of points for the difference between the points you got in the first two steps and how many hours you will have been awake by the time your current shift finishes.
4. You get more points again if you have to keep going back to the start because you're so tired you can't remember how many points you have.
5. You lose points if you notice that this is no longer a three-step process.
6. If you understand the process you automatically score zero.

If you score higher than a certain cutoff you must ring the shift coordinator who will tell you to go home.  Preferably in a taxi.

I was excited about this concept, so I approached one of wise old doctors:

PTR
Can I have a copy of the fatigue score algorithm?

Wise Old Doctor
Sure, here you go.  Why do you want it?

PTR
I reckon I can use this to get out of the 4 a.m. nappy change at home.  I'll just show my score to my wife and go straight back to sleep.

Wise Old Doctor
That's a great idea!  Except no matter how high your fatigue score is, I can guarantee you your wife's will be higher.
 

The beginning of the end

Yesterday was my first day of fourth (and final!) year medicine.  The most surprising thing I learned yesterday was how to extract myself from an upside-down underwater helicopter.  Hopefully this will be something that remains in the arena of theoretical knowledge for me rather than something gained through practical experience.

Apart from a few strange things like that, the day was pretty quiet.  I had a chat with one of the paramedics after lunch:

Paramedic

What have you been up to so far today?

PTR

Not much, I've spent the past couple of hours taking it easy watching the cricket in the tea room.

Paramedic

It's not "taking it easy" - it's "fatigue management".  Very important skill to perfect if you want to be operationally effective.

Ich bin Kevin Bacon

A couple of years back I found out that, in one of those strange coincidences that probably happen all the time but you rarely actually find out about, the mother of the fiance of one my Esteemed Colleagues is also the daughter of my Aged Mother's bridge partner.  Although there is a word in Cantonese to describe such a relationship, there is not in English, so I have taken the liberty of illustrating it with this simple diagram so that we can all be "on the same page", if you will forgive me a brief pun.

This is all well and good, and has served to provide my Esteemed Colleague and I with many minutes of interesting conversation.  But now my Aged Mother is putting pressure on me and my Smaller Half to invite my friend's fiance's mother around for afternoon tea.  I mentioned this to the Esteemed Colleague concerned and he speculated that perhaps my Aged Mother wanted to meet his future in-laws to discuss her bridge partner (a.k.a. his mother-in-law's forbears).  I had to clarify to him that my Aged Mother is 1600 km away - she merely wants me and my Smaller Half to invite them around to show off the Hatchling, under the assumption that the Hatchling is a creature of ineffable beauty and is to be much wondered at by all who encounter her.

When I told my Aged Mother that I thought her plan was strange and eccentric, she was most put out and asked me to explain myself.  I said that I had never met my friend's future in-laws, in fact I didn't even know their names, and to suddenly invite them around for afternoon tea purely on the grounds of a doubly tangential association thrice removed seems both precipitous and presumptive.  She said that my behaviour was most unnatural, that she was unaware that she had raised such a prodigious misanthrope for a son, and that forthwith she would not venture to assail me with suggestions purely intended to relieve me of the solitary burdens of child rearing despite her best instincts to the contrary.

So I casually mentioned to her the over-ripe plum that I habitually carry in the pocket of my jerkin, muttered "whatever", and hung up the phone.  She won't mess with me again!

I rock, apparently

The threshold for paternal competence seems criminally low.  In the last month, since the Hatchling arrived, plenty of people have complimented me either straight to my face or via my Smaller Half, saying what a great dad I am.

I do not understand why, because what I am doing at the time is simply holding my own child.  So I'm standing there just holding a sleeping baby and some complete stranger comes up to me and says, "You're a great dad!"

It just doesn't make any sense.  Perhaps if the baby was screaming and I was holding it in one arm while ironing a shirt with the other and making pancakes with my feet I would understand that people would be impressed.  And as for how impressed people are when I change a dirty nappy.  Good Lord.  You'd think I'd transplanted my own liver into the kid, the way it causes people to fall all over the places in rapturous praise.

Elderly women are the worst culprits.  I've had them grab me by the arm as I walk past, demanding to inspect the Hatchling, then praise me for my parenting skills.  Incredible, that I can walk in a straight line and yet, somehow, contrive to not drop the Hatchling or accidentally feed her peanuts.

Meanwhile, my poor Smaller Half, who busted a gut (literally) to produce the Hatchling and is in a permanent daze from the shock of being tethered to her 16 hours a day, looks on in wonder as she is elbowed to one side by hordes of women singing my praises and ignoring her contribution completely.  The upside of it all though is that it's very rapidly rebuilt my self-esteem after it was destroyed last year by my jerk supervisor.  Right now, I'm pretty sure that I'm some kind of superhuman.

And if you'll excuse me, I have to go.  I've been recklessly holding the Hatching in my arms while I type this and her neck seems to have developed more joints in it than mine does.  Gotta straighten her back out again.  All in a day's work for Super-Dad!

Hypothetical

Happy New Year!  And now for a purely hypothetical situation that I'd like your input on.

Just say, hypothetically speaking, that you and your dear wife had had a trying day with your darling newborn baby.  And just say, hypothetically speaking, that after cooking a delicious meal you prepare a plate of cherries, apricots, and seasonal stonefruit varieties to be enjoyed by you and your dear wife.

And imagine, if you will, in this hypothetical situation, that one of the red plums on that plate was the very same red plum that languished alone in the refrigerator for a week while you and your dearest went home to celebrate Christmas in the lunatic asylum that passes for your family home and as such this hypothetical red plum is past its prime.  To put it bluntly, the red plum is too soft.

And, hypothetically speaking, imagine how you would feel if your dear wife was to say, "I don't like the look of that plum", and you, in this hypothetical scenario that bears no relation whatsover to any events that may have occurred right here in my own house this very evening, were to bravely offer to try the super-soft plum and then were to pronounce it fit for consumption only to have your dear wife decide that "fit for consumption" was perhaps setting the bar too low in terms of the suitability of after-dinner treats and thus decide that the entirety of the super-soft red plum was yours to eat.

So hypothetically speaking, which do you think is true:

1. You are entitled to some of your dear wife's cherries to compensate you for having done the manly thing by eating the possibly suspect fruit on her behalf?  Or,
2. Your dear wife is entitled to some of your cherries to compensate her for having missed out on the red plum?

I really want to know how you think on this weighty issue.

Smaggie

My Smaller Half and I became bogans yesterday for the day.  It was a bit like that Bowie song, We can be heroes, except boganish because we ate at Ikea.

We took the Hatchling along for a shopping trip because my Smaller Half wanted to suss out ... something ... I can't remember what it was any more, because we emerged blinking into the sunlight 3 hours later with some picture frames, a hanging photo thing that looks like a roll of film, and some fabric.  I almost bought some fake bamboo plants but it was wrestled out of my hands by my Smaller Half who failed to appreciate my primal urge to cannibalize Ikea products to make wargames terrain.  Tragic.

Anyway, after we'd been careening around for a while looking at Molger, Stokki, Ribbi, Svalbo and the other Swedish dwarves, the Hatchling decided that she really needed to be fed RIGHT NOW so we plonked ourselves down in the cafe and plugged her in.  Then I discovered that Ikea sells bottomless cups of coffee for a buck ninety five.  Even the worst coffee in the world is a bargain at that price.  (Side node: why is it called "bottomless"?  It's a very poor analogy indeed. A bottomless cup would be absolutely useless and you'd get nothing to drink at all.)  So I filled up on cheap coffee which was actually about 3 stars out of 5, so not the worst coffee I've had recently.

Oh, and the reason I've been banging on about Ikea at all is that the checkout chick's name tag said "Smaggie".  I asked her if her name was really Smaggie, and she said that it was a nickname because her real name was very long.  I said that Smaggie sounded just like an Ikea product and I'd thought that maybe the staff all Ikea-ize their names.  Smaggie just gave me a funny look.  I thought it was a fair question though.

My philosophy of life

When I was young I thought that life was like a simile.  Now I think it's a metaphor.  But I'll probably end my days thinking it's a synecdoche.

Tech support

I got an email this afternoon from the Fine University reminding me that I'm supposed to submit a form to get approval for my elective 6 weeks before it starts.  And it starts in less than 2 weeks.  Oops.  I really really really don't want to miss this elective because I'll get to fly in helicopters and jump out of submarines and kill snakes to drink my own urine from their freshly stripped skins and so on.  So I quickly grep up the form and try to print it.  But I'm at my Aged Mother's house for Christmas and nothing here works exactly as advertised so, as unlikely as it may seem, I go to my Aged Mother for tech support...

PTR
Mum, does your printer work?

Aged Mother
Err, why?

PTR
Because I want to print something.

Aged Mother
Oh well, it works off and on.

PTR
So you're saying I should try it and see what happens?

Aged Mother
Yes

PTR
It's not working.  It says the cartridge is broken.

Aged Mother
Yes, it's been doing that for a while now.

PTR
So when you said it worked off and on, you really meant that it used to work and now it doesn't.

Aged Mother
Yes, that's right.

Vital statistics

People have been demanding that I publicly release the all-important birth parameters of the Hatchling.  So here they are.

Age: zero.
Density: 1.01 kg/m3
Temperature: 310.15 K
Head circumference: 0.0001836 nautical miles
Resistance: > 1000 ohms
Str 3
Int 18
Wis 12
Dex 4
Con 16
Cha 25

It's a hard life

It's a tough gig being a dad.

First, there's the whole birth thing.  We went into the hospital after midnight and I kept being woken up by these bloody midwives who were coming into the room to check on my Smaller Half.  And I didn't even have the nice comfy hospital bed that my Smaller Half had - just a scuzzy fold-out arm-chair.  And when I tried to take blankets from the blanket warmer to snuggle up in, they told me that those were for newborn babies only and made me put them back.

Nobody paid me any attention at all.  They just kept asking if my Smaller Half was okay and they offered her painkillers and foot rubs and swiss ball rides and aromatherapy whereas I got not so much as a chupachup.

And as for the rest of the day, it was a nightmare.  Breakfast was okay but there was no honey for my cereal.  And I didn't get any coffee until after lunch, which I didn't get to eat anyway because all the panicky doctors took the table away.  And the only reason I got coffee at all was because during a part of the birthing process that I didn't like the look of I excused myself and went across the road for a break.  And anyway, when I got back, feeling much better and more alert, it was still going on.  Man.

Then there's whole baby thing.  That's tough for dads.  While my Smaller Half is having a great time breast-feeding every few hours, I have to awaken up to twice each night to change the Hatchling's nappy - a task which takes up to 5 minutes each and every time.  It's debilitating.

And is the Hatchling grateful?  No, I do not believe so.  She gave me this look today when I picked her up.  She opened her eyes and sneered at me as if to say, "Oh, it's you.  Sure, you may be good for entertainment but you certainly aren't very nutritious.  Not like the other one."

I tried to explain Maslow's Hierarchy of Needs to her and pointed out that I was providing the upper four levels, with a particular emphasis on self-actualisation through my special program of hot-housing which I'm pretty sure will succeed in getting her into an astronaut suit by 15 or 16, and that food would be provided to her contingent on her continued progress through her educational programme.  But she just kept trying to suck my fingers so I gave up and handed her to my Smaller Half and grabbed some much-needed zzzz's.

Super Friends redux

Oooh, how exciting!  Today the Hatchling made a new friend: Holly.

L to R: Willie Nelson, Racially Sensitive Gollywog, Fiennes the Giralph, Holly, Mankey Monkey, Elzee Waverider (front)

From the family album #7

Dot, sister-in-law.
You can see where the Hatchling
Gets her fine looks from!

Super Friends

For someone who has only been around for 10 days, the Hatchling has already accumulated a healthily diverse range of pals.

L to R: Willie Nelson, Racially Sensitive Golliwog, Mankey Monkey, Fiennes the Giralph, and (front) Elzee Waverider the Ballerina Mouse.

Meet the Hatchling

The arrival of the Hatchling has caused much excitement in our families.  We'll be going home for Christmas to my Aged Mother's place which will be the first time that everyone else will get to meet her in the flesh.  Until then we are stringing them along with a drip-feed of photos every couple of days to illustrate astonishing developmental milestones such as lying on her left, lying on her right, kicking her feet, wearing a cute new outfit, being held by various people, and being generally gorgeous.

I was particularly amused this morning to receive a photo back from the Clan with this picture, a robot version of the Hatchling constructed spontaneously and surprisingly accurately by one of her talented cousins out of Lego:

Welcome to the world

Okay, so the people have spoken!  They demanded, in the most recent poll, that I have a baby girl and I, in my wisdom, did so order my Smaller Half.  And fortunately, that's exactly what happened or else I would have ended up looking pretty silly and my sense of masculine authority over the reproductive outcomes of mine own loins would have been severely compromised.

So yeah, my Smaller Half and I are the proud parents of a leetle baby girl.

Yay!

What should we have?

Okay, so this baby is coming soon and I still haven't decided whether to tell my Smaller Half to have a girl or a boy.  I'm such a terrible procrastinator.  Help me make up my mind by voting in the poll to the right.  Once a clear majority emerges I shall issue instructions post-haste, so vote promptly, because I really should get this finalized.