do you mind if i do a J?

now i'm never one to preach but i feel that i should for once (halleujia, y'all can be saved ma brothas and sistas.)

pete libertines doherty is in the news again this time for allegedly injecting into one of his fans/entourage/groupies. until now i haven't really given a shit about the whole junkie/kate moss bruhaha that the tabloids are so interested in because let's face it most of the country takes a drug of some kind (hash/tobacco/alcohol/ribena/religion) and most importantly because babyshambles are rubbish (NME hat on again) and, as the new dirty pretty things album demonstrates, the libertines were the sum of their parts and when separated are purely mediocre.

but it is starting to piss me off that doherty is getting off every time (and it must be about a million now) when i've worked with/treated enough addicts who've gone to jail for far longer for far less. the even more tragic thing is the misguided doherty obsessionados - you know, the ones who throng outside the courthouse - who rant on about how he is being unfairly persecuted by the police. here me now, oh deluded public school teenagers. persecuted or not, he has actually been in possession each time he's been nicked and it seems that this time he's been so off his face that he's fallen for the "someone wants to take a picture of me" trick AGAIN.

getting off drugs is difficult. i think maybe only one of the many users i've been involved with ever got close to sorting himself out. doherty has the luxury to fly off to arizona to detox at any point if he so wishes. not everyone has that. he can't be arsed and would rather be "playing" gigs wasted. i was really annoyed that the love music hate racism charity were stupid enough to put him on the bill at the trafalgar square gig this weekend. he shouldn't be championing such a cause.

anyway, he'll never get off drugs and he'll never go to jail - not to do a significant period of time like my patients - and this will be to the applause of the white, upper class kentish town teenage girls who love him so much. perhaps it was one of them that he's been photographed injecting. daddy has probably picked her up the following morning anyway. in which case should i really be getting so worked up? after all stupidity (and misery) loves company.

[i am listening to up the bracket and wondering about what might have been]

i don't want your sympathy; i just want my johnson

the surgeons managed to shit on us today. however it was not us who suffered in the end. it was the patient. who died.

i was hovering on one of the surgical wards where one of my other patients was going a bit nuts when i got a nudge from one of my house officers. he informed me that the surgeons were referring back a patient to our care (even though our boss had not been informed) and oh yes by the way his blood pressure is crashing.

i put on my stroke my beard glove and stifled my need to tell him that we should only see patients that have been officially referred to us and that he should not be accepting patients without running it by a senior. but i held my tongue and wandered over to check out what was going on.

this old man was not a very good advertisement for health (or a very good advertisement for disease depending on whether you're a half empty/full cup person) he was six days out of an operation to remove his right lower leg because of very shit blood vessels not being able to provide his limbs with enough oxygen and nutrients to stay healthy. furthermore amongst his huge list of problems, his heart beats in a rhythm called atrial fibrillation. Dr Crippen has written at length on this topic. whilst it is very common the problem with this rhythm is that blood pools in the heart, forms clots and then there is a risk that these clots fire out of the heart to other parts of the body.

well he was in shit. he had a crap blood pressure, his breathing was awful and his tummy had swollen up and was very tender to touch. he had stopped peeing and was vomiting bile. it didn't take a lot to work out that what had most likely happened was that a clot had fired off into the blood vessels supplying his bowels thereby interrupting the blood flow to his gut. his bowels were now complaining as they slowly died of no oxygen.

myself and the house officer proceeded to resuscitate the patient but the only way to treat this condition is to operate. i called down the on call surgeons, the vascular surgeons who had operated on him in the first place and the high dependency unit. i was bounced from one to the next to the next and then back again. finally after four hours the surgeons decided that they would operate but only after a CT scan.

but by then it was too late and he died.

and no-one was really bothered. no-one would take any responsibility for the patient. except for us and only because we happened to be across the corridor at the right time.

would it have been different if he had gone to HDU? maybe. but there were no beds. so he stayed in the sideroom on the ward vomiting up more and more bile.

another nice happy ending.

[i am listening to black and white by the upper room]

i like the way you do business jackie

i have finally lived a little in the last few weeks, perhaps at the most inopportune of times.

yesterday was the resit of my stupid exams, an exercise in masochism which i am convinced will need to be repeated in a few months time but hey i'm getting used to the idea that i am fundamentally stupid.

anyway much more interesting was firstly turning 27 which was not depressing at all and also my continuing canadian outreach project.

as you may have seen in a previous posting, Roger Dean Young and the Tin Cup finished their UK tour last week and i had the pleasure of three of the lads hanging out and stinking out my flat for a little while.

i met most of the guys through other Vancouverians (Vancouverites, Vancouverers?) over the past few years and have always been struck by how down to earth and well... nice they were. i guess i've spent so much time interacting with wankers that you forget that there are actually "good people" in the world. and they're in the music industry which in my experience in hobnobbing with C-list bands and sometime music journos is a vacuous self-absorbed scene indeed.

i also realised that there are so many talented people in the world that it's quite sobering when compared to your own pathetic achievements. i did find myself tinged with feelings of jealousy at one moment at the last gig. but perhaps it was the staropramen.

it's been a bit of a comedown to see the guys leave. it's difficult when you don't see people that often and your only contact is email. still i shall try to not get too depressed about that. after all that's what postgrad exams are for.

so a year older and a year stupider. i shall now enjoy the holiday weekend (not working) and hell maybe i'll dust down my guitar too.

happy easter

PS. roger was quite troubled by the ALF dream. unfortunately he didn't have any deep meaningful thoughts on the underlying symbology much like everyone else. i'm still waiting.

PPS. i would also like to announce the maiden voyage of my second blog: The Chelsea Rebel. no medicine and a slightly different background to MOADD. please also note the radically different layout.

[i am listening to the Foo Fighters]