Lazarus Pit

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

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

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

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

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

Not that I'm bitter about it.

Because because because because beCAUSE

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

Sweet action.

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

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

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

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

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

Sweet action.

Double edged

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

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

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

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

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

Birds and ships

The birds are singing in your eyes today,

Sweet flowers blossom in your smile,

The wind and sun are in the words you say,

Where might your lonesome lover be? 

Birds may be singing in my eyes this day,

Sweet flowers blossom when I smile,

But my soul is stormy and my heart blows wild,

My sweetheart rides a ship on the sea. 

- Woody Guthrie

Work it

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

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

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

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

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

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

Smile!

True love

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

Bip the clown

PTR

Have you had any vomiting?

Mr Nesby

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

PTR

Oh. Um. Throw up?  Bleurgh!  Bleurgh!

[Mimes vomiting]

Mr Nesby

Oh! No, no, none of this.

PTR

Have you had any diarrhoea?

Mr Nesby

I no understand.

PTR

Never mind.

Witzelsucht

Nurse

What's the plan for bed 2?

Doctor

I'm just looking at her x-ray.

...

There's no fracture, she can go home.

Nurse

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

PTR

Does she live in a mobile home?

Ba-doom-TISH!

Best foot forward

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

But wait, there's more.

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

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

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

Boom-TISH!

See no evil

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

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

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

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

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

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

Crazy mixup #6

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

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

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

I think we're done here now.

Crazy mixup #5

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

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

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

Crazy mixup #4

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

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

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

Crazy mixup #3

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

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

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

Crazy mixup #2

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

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

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

Crazy mixup

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

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

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

Hooray for rationalisation

Day off - yay!

Compulsory grand round and tutorial - booo!

Decide to skip them - yaay!

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

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

The frogurt is also cursed - booo!

I did it for you

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

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

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

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

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

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

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

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

Just give three

Nurse

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

PTR

Yes.

Nurse

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

PTR

...

Got bicycle clips?

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

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

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

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

Not really our style.

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

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

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

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