Monday, November 28, 2005
i am looking at dermatology/haematology slides before going to bed, reading notes on the way to/from work, doing questions when i get home, etc. i am even more drained than before.
tried to be positive at work today (monday and all) and was frustrated once again. as NO-ONE (nurses/porters/radiographers) seemed to give a shit that one of my patients (not very sick at all, routine investigation booked from friday) needed a chest x-ray i wheeled him round to the department myself, sat for fifteen minutes while he had it done and wheeled him back to the ward. because i knew that if i didn't no-one else would, no-one else would care except me and him, and at the end of the day i'd take the heat when it wasn't done. i hope all the taxpayers in this country are glad that they paid for my six years training and my current salary to be a porter.
so frustrating. i am so annoyed (not really at that - i had a good old chin-wag with the patient on the way to radiology - he's written ten novels!). grrrr. and so very tired.
thinking positively now. tomorrow i have the 8am X-ray meeting to look forward to... and then the on call till nine...
D&C may be away for a little while until after the exam (next weds/thurs)
[i am listening to Only You by the Flying Pickets]
Monday, November 21, 2005
tonight i struggled to get much studying done so instead opted at about 10pm to go meet a guy i grew up with. he was meeting some other friends for a beer and asked me to come along as it was local. he's moving abroad in three weeks and i probably won't see him for some time so i thought now was as good as any night.
it was weird. our lives have diverged so much. we used to spend all our time together from about 5 to 15 years old. but i don't think we could be any different. it was still a good laugh. but... strange. i'm not exactly sure how to describe the feeling. it just didn't seem natural, like when i'm around my friends now, which is all the more peculiar as we have more history than people i know now and regard as my closest.
he was saying at one point (a little intoxicated - he'd been in the pub some time) that he was jealous of me which came as a real surprise and i did feel a little uncomfortable. i suppose it comes down to frames of reference. he has no concept of how difficult i'm finding things at the moment (though let's make it clear my life is no homeless in quake ridden pakistan or bombed baghdad) but to be fair i have no idea of what his life is like. not really anyway. i was struck by how unsure of himself he was despite his essex swagger and gift of the gab (i have inadvertantly given away my background...) and thought underlying all the gags and banter we had that there was this tinge of melancholy. i don't know really. as i said our lives have really gone in different ways.
i wonder what will happen to him when he leaves the country. he's going to canada to live with his fiancee. i hope he'll be happy and i wish him all the best.
will i see him again? honestly? probably not. we are so different now. and although i know that, it makes me very sad. when you're tiny you think that now is forever. it's only later that you realise how transient moments actually are.
will stop now as things are getting too dark! i did see a dog to day wearing a little red jumper which made me laugh. as if he said "hmmm what shall i put on this morning? i know! something bright as it's so miserable outside!"
[i am falling asleep to staralfur by sigur ros]
Tuesday, November 15, 2005
this stupid picture of a sad face has just come up on the screen and i have spent the past two hours doing all the bollocks that apple suggest on their website.
i am actually going to have to kill myself.
time for bed before i have a stroke.
[i am listening to The Promise by When In Rome but obviously on the computer and NOT on my ipod]
Monday, November 14, 2005
no, this is not my equivalent of "Despair" on Nip/Fuct (he's ok by the way) but actually a reference to it officially being autumn!
i LOVE this time of year! it's really cold but it's bright and sunny, the leaves are crunchy on the ground and everyone seems so cosy in their hats, gloves and scarves. well, as cosy as you can get on the tube at rush hour.
and as you can tell i survived my week of nights. the last night was horrifically busy and i had a very ill man indeed. he had suddenly deteriorated about an hour into my shift to what we call peri-arrest (about to arrest ie. stop breathing/heart stops/both.) there were a lot of hairy moments overnight but we managed to keep him this side of alive and in the morning he was much better, sitting up, off his oxygen mask and asking for breakfast. i was pretty happy and left work feeling content. that's the first time that i've felt like that in ages.
i've spent the weekend enjoying myself. no studying, no medicine, just some fun times (and sleeping). got to see some old friends, some of whom had lots of news (i tink you know who you are) and there was of course the England game. what an awesome match! though i have overdone the beer. lucky...
i am now off work till friday (when i work the weekend again) but at a course. it's funny sitting in a lecture theatre again and it's a little irritating being surrounded by annoying doctors who ask inappropriate questions of the lecturers.
"oh yes. i have a question. no over here. look at me. it's got nothing to do with your talk and isn't going to benefit anyone else in here - in fact it's going to have dubious benefit for me but i'm still going to ask it because frankly isn't the sound of my voice great? look at me. me baby."
it's in the middle of town, in an area where several university colleges are clustered. i was looking around at all these 18/19 year old freshers (not in a pervy way - well maybe for a few minutes) coming in and out of all these grand old historic buildings and was wondering what it would have been like to go to college round there, instead of having spent my uni years around hospitals.
i'm quite upset by all the trouble in France. (not putting a link as it's on the front page of everything) so much of the media seems to concentrate on putting the blame on someone/something (eg. ineffectual measures by successive governments to address their most impoverished, ghetto-ised communities) without coming up with any solutions. and as much as we'd like to think we're cultures apart from the French, from a social structure frame of reference a lot of British cities are VERY similar. you only have to take a walk around my hospital's catchment area to see that. there is undeniably tension.
all of which means i am SO disinterested in the Tory leadership campaigns of the two davids. they should both be put on lithium (perhaps they could get Patricia Hewitt some too. just a thought.) i am pleased that (Dr) Liam Fox is out because he's quite quite toxic (as one of my lecturers once said) and feel the same of Kenneth Clarke. that tosser has already screwed up the NHS once as health secretary AND he's deputy chairman of British American Tobacco. Blatant hypocrisy? Fucking nuts more like.
finally i am excited because firstly someone i have missed immensely over the past two months comes back to london next week. hooray.
and also another buddy of mine from across the pond is visiting just before Xmas. he has recently got married (though sadly i don't think his charming wife is coming along) and i was well chuffed to have been invited to the wedding in Sept in Vancouver. you should have a look at his record label Copperspine Records.
good times :)
[i am listening to Lovely Day by Bill Withers. awwww!]
Thursday, November 10, 2005
night 6 of 7
i can't sleep at the moment because although it's really quiet a) i'm not allowed to sleep and b) there isn't anywhere to sleep. well there is an on-call room but it's about seven minutes from the ward (too far in case something goes horribly wrong) and it's a bit like the place Buffalo Bill from Silence of the Lambs lives in only not as homely or fragrant.
tonight is actually the quietest it's been yet. i've still managed to make a complete five course meal out of the simple tasks i had to do this evening. sigh.
i've decided that i'm the worst judge of character ever. i've just had a long chat with one of the doctors from A&E who i always see poncing about and acting like a complete dick. he's very posh and i must admit i'm very prejudiced (hopefully my only prejudice) towards posh accents, completely irrationally. anyway, turns out he's really lovely and we had quite a good laugh. i really must stop writing people off after five seconds of exposure.
i don't know if you've been reading the papers this week but it's been completely bizarre. i am convinced that the world has gone completely utterly nuts.
obviously there's the great news that Kaiser Tony's attempt to detain people for 90 days for being brown skinned/bearded has been quashed. i'm sure he's not been the same since he had his supraventricular tachycardia ablated. bloody cardiologists.
also apparently there's a certain percentage of british children that believe that chips/fries are made from apples. un-fucking-believable.
and patricia hewitt. enough said. it appears kim-jong-tony appointed her health secretary for the sole purpose of whipping the NHS' rotting carcass a bit more. "make sure it's completely dead Pat." she of such einstein-ian proposals as giving hospital buildings constructed for NHS use to the private sector. and today she appears to have at some point gained enough credentials to become an oncology specialist [Hewitt "has left NHS toothless"]
well now the news round is over i'm going to go and copy the blood results from the computer to the blood results folder. somebody call the crazy police because i need to be arrested.
[i am listening to Pink Floyd]
Monday, November 07, 2005
i don't think he will disagree too much if i say it's (also?) about a search for something missing.
please please go and see it here.
it's night 3 of 7 and it's going OK so far. well i've managed to get time to put this post up so it can't be too bad.
there have been lots of emergency admissions from casualty so although i've been kept busy it's been a good busy. busy looking after people as opposed to paperwork busy. again there have been some quite difficult cases, one in particular involving a 20-something guy who has really been through the wars with lots of hospital admissions. too many things to go into but suffice to say some people really do get dealt a harsh hand in this crappy life.
i'm pretty tired surprisingly as i don't usually start flaking out till night 6 or 7. i think i tried to go into this set of nights a bit more positive than normal so maybe it's that (emotional energy expenditure or something). i'm also trying to keep myself going with a technique that one of my friends suggested (Vegas who runs the Nip/Fuct blog.) he suggests psychologically splitting the week into 4 nights and 3 nights. so i've only REALLY got one more night left. hooray.
to end with i just wanted to say that i apologise if this blog is a bit too negative and "dark" (which is scarily the adjective several people have used to describe it) - it's not really meant to be. i just put down a stream of consciousness when i start typing. yes there's a lot of frustration but honestly i am still quite cheery in real life! a lot of people who haven't seen me since i started MOADD (have you caught on to my insistence of using that acronym?) are quite surprised when they actually speak to me and find me the same as i've always been. not the jaded, scowling, anaemic cynic they expect.
i would also hate anyone to think that i go to my patients and say:
"how are you today sir? not so good? well you should see the shit i've been doing and how crap this day has been. so yeah why don't you take these antibiotics and get yourself and your pneumonia out of my fucking face."
not all of them anyway. only the ones that have hurt people.
so, for the record, i am not severely depressed. (that can change, however, as i have just seen the football scores.)
and just to prove i am not entering a dark dark place, here is a story from the onion about a big doggy to warm you to the cockles of your hearts and maybe to below your cockles, to the sub-cockular area. (points if you post the song title and singer in comments)
[i am listening to Robbie Williams because i can't get another station on the radio in the office]
Friday, November 04, 2005
it's november 4th 2005? really?
well that can mean only one thing...
it's time for a week of nights.
yes that 6 weekly funfest of rocking into work when everyone else has gone home to sort out all the crap that should have been done during the day, and pacing the spooky corridors at 3am trying to find a coke machine that works, has returned.
i'm sure i shall be informing you of how it goes (why are you holding your head in your hands like that?)
in other news:
had a good day yesterday! got into work to start the usual "copy the blood results from the computer which isn't working into the bleeding blood results folder because the printer doesn't work," when i was asked by one of the registrars (the one that i did my last weekend with) if i could go and help her with a sick patient on another ward. well i wasn't going to say "no sorry i'd rather sit here with all this paper" so off we toddled.
turned out he was bloody unwell and needed lots of stuff doing to sort him out. so one hairy transfer to our HDU (high dependency unit) and one central line (like a big drip line but one that goes into one of the more massive veins in your groin or neck) later he was "stable". poor guy though. i don't think he will do very well. he's about 80 and not in very good nick in general, exceptionally friendly (we'd often talk about our common support of a certain premiership football team which shall remain undisclosed in case i lose readers) and with a very supportive wife. because he's got so many other medical problems the amount of medical intervention that can be done is limited (ie. his physiology would not be able to tolerate for example general anaesthetic for an emergency operation). i always find this difficult - knowing how far to go when treating someone who is this sick. the decision is normally taken out of my hands (ie down to the consultant) and in this guy's case our management will be what is known as conservative - ie we're not going very far at all. difficult.
also went to clinic which was good. nice to have a change of scene - and get off that bloody ward. still got to do my letters from clinic... grr...
and finally: the high point of the day was that i went for a late drink with one of my old bosses from when i worked in intensive care to see if he could sort out my life. he's a decent bloke and it was good of him to take time out to listen to my woes. obviously i didn't get the elusive answers i was looking for but it was really worth getting another person's perspective, especially as that person is someone i respect and not one of the TOTAL WANKER consultants that you come across in day to day life. and then the whisky came out and conversation degenerated into decent bands, good films and toilet humour (the recipie for an awesome evening.) but i'll talk about the general "career" gist of the evening tomorrow (i see your head in your hands again.)
off to put my flares on. it's time for some (week of) night fever.
[i am listening to Island In The Sun by Weezer]
Tuesday, November 01, 2005
had a good week off. got some studying done (though not as much as i'd hoped), caught up with lots of friends (you forget how many people are around you when you never get to see them) and managed to chill out.
then back at work yesterday and it was the same old crap. running around asking people to do tests, schedule them correctly, admin, etc
oh yeah. the most ridiculous thing yesterday was trying to send a patient home (for god's sake)
- one of our dialysis patients is admitted in the early hours to a liver ward (Ward 1) as it's the only place with beds
- night doctor for our team goes over to see her, thinks she's fine, and makes the plan that she's got a very mild chest infection, she can have her dialysis in the morning and go home with some antibiotics if all is ok.
- i go over to see her first thing. she is fine, no temperature, clinically well, bloodwork is all fine. i agree with my colleague's plan that she should go to the dialysis unit, have her dialysis and then go home.
- dialysis goes fine. i see her again afterwards. she is very well and keen to go home
- at 5pm i do her paperwork and say to the dialysis team that she can go home with her meds. they tell me that she has to go back to Ward 1 to be discharged.
- i trudge round to Ward 1. staff there tell me that she has been moved to another ward (Ward 2) because they needed the bed and she was off the ward the whole day. i say i've done all her paperwork can you not just discharge her anyway. they say no, they've already moved her to Ward 2.
- i go down to ward 2. they say they don't know who the patient is as she hasn't arrived yet. she is still on dialysis. i explain that i think she will be coming soon as she's finished dialysis but she can go home.
- ward 2 staff phone up dialysis team and say why can't she be discharged from there. they reply because she is officially admitted onto Ward 1 they can't discharge her from the dialysis unit.
- ward 2 then tell me that patient will have to be admitted formally before they can be discharged (ie. be assessed by a nurse, blood pressure taken etc)
- i say this is a bit mad because she can BLOODY WELL GO HOME.
- ward 2 say she can't go unless she's been admitted and then discharged.
- i leave paperwork with ward 2 staff and decide if the only person who can go home without being admitted/discharged is me, then i am going home
i hope she got home at a reasonable hour.
[i am listening to Somebody that i used to know by Elliott Smith]