tag:blogger.com,1999:blog-176121412024-03-07T09:10:16.414+00:00Musings Of A Disheartened Doctorthe struggle to find happiness in a system where there isn't a great deal to be happy aboutDazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.comBlogger86125tag:blogger.com,1999:blog-17612141.post-56933422837617383612018-04-16T16:06:00.000+01:002018-04-16T16:06:25.765+01:00I keep ticking onAnd now it's been four years since I last published anything on here. I was drawn to writing again because I was telling a much younger colleague (who is having some career dilemmas) about this blog and how writing it helped me articulate my frustrations and feelings. I also mentioned how much I benefited from the collective wisdom of those who have visited this site and commented or reached out in another way over the years.<br />
<br />
Well a lot has changed since this blog started. I'm still a doctor - of sorts. I haven't practiced clinically for coming up to two years now.<br />
<br />
I have found paths and directions that fit me better. I did manage to finish up all of my postgraduate training (in a hospital based area of medicine) whilst also pursuing my other healthcare interests.<br />
<br />
How did I do it? Well the world is short of doctors and I managed to 'sell' to my employers that they could employ me less-than-full time. That way I was able to do some 'other bits and pieces.' There is no rule-book for this stuff and the mentoring is non-existent. I would have loved some advice along the way. It's good I had this blog đ (emojis didn't exist in 2005! isn't that crazy?)<br />
<br />
I have also managed to spend a considerable amount of time abroad working in a totally different healthcare system. The grass is never greener; but having some time to walk on different lawns is definitely good for the soul.<br />
<br />
And wow I'm approaching middle age now! I have kids! I still don't know quite what I want to 'do' with my life or career. But every step has been an adventure and I'm glad I had the courage to take those steps. When I talk to people about my career and experiences I do laugh inside - I'm able to tell the story like every step was planned and it comes across that way. How little they know!<br />
<br />
As always I would say don't give up on yourself. I still have those dark times, those times when I feel I have nothing going for me, the times where the imposter syndrome is absolutely crippling. I suspect many of you do too. You will get through it.<br />
<br />
I still read every comment that is posted on this blog (including the spam!) and although I don't reply any more I'm walking there right beside you. Stay strong and look after yourselves.<br />
<br />
<br />
<br />
<br />Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com7tag:blogger.com,1999:blog-17612141.post-89616168368213818102014-10-05T19:50:00.001+01:002014-10-14T21:07:00.341+01:00Definitely still hereIt is almost a decade since I started writing this blog.<br />
<br />
Wowsers. Time disappears bloody quickly.<br />
<br />
"Writing" is a bit of a subjective term because I neither write particularly well (stream of consciousness borne out of frustration/emotion) nor have I written on this blog regularly.<br />
<br />
It still touches me deeply when I read the comments section of the "<a href="http://thelostdoctor.blogspot.co.uk/2005/10/i-hate-medicine-and-want-to-leave.html">I hate medicine</a>" entry (well maybe not the spam posts) as so much of what people are going through is exactly what I've been through/still go through.<br />
<br />
I don't think I have much advice for you all and, more importantly, I'm not qualified to give you any decent advice. I've pretty much felt my way through my professional life to date, muddling through (not so) elegantly and so would NEVER want to suggest what the best/worst decisions might be for you. Those are decisions we must ultimately make ourselves. <a href="http://www.bethortonofficial.com/">Beth Orton</a> is pretty spot on when she sings:<br />
<br />
"this beautiful life that we build by hand<br />
From scraps and shards and broken strands."<br />
<br />
Medicine is such a weird career - capable of filling you with unimaginable joy and happiness whilst simultaneously bringing you to your knees at the foot of an unsurmountable mountain of misery. Is there a way to ride this stupid emotional roller-coaster without feeling like you want to hurl? I still don't know.<br />
<br />
What I do know is that we are never alone. Regardless of how miserable the world might appear, there are millions of wonderful people out there. Reach out to them and suddenly everything seems a little bit brighter. "No man is an island" wrote Donne. Clever man.Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com19tag:blogger.com,1999:blog-17612141.post-46806464301949430982012-10-10T19:40:00.000+01:002012-10-10T19:40:17.830+01:00And you still have those sorts of days...Today has been ok. If anything a little mundane and slow.<br />
<br />
I've got lots of stuff to do that is work-related but not directly related to my hospital work. It's all pretty exciting stuff that I am interested in and keen to make a success of...<br />
<br />
But...<br />
<br />
I do feel a little lost. Nothing in particular has triggered this. It was a gorgeous day outside and my current colleagues are OK.<br />
<br />
I guess that although life isn't anything like it was 7 years ago, these periods of feeling adrift do seem to come and go and I suppose today I'm adrift again.<br />
<br />
What to do?<br />
<br />
Hang on. Go with the flow.<br />
<br />
[I am listening to <a href="http://shinstagram.theshins.com/">The Shins</a>]Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com13tag:blogger.com,1999:blog-17612141.post-86565553956103579462012-10-01T19:24:00.002+01:002012-10-01T19:24:39.150+01:00I'm still here...It's been years since I posted on this blog. I wanted to write a quick message to say that I still follow every comment that's posted on here. (Also updated the template a little! Bit mid noughties style wise...)<br />
<br />
It's tragically comic that if "I hate medicine" is put into google, the number one hit is this blog and the post which that link takes you to (<a href="http://thelostdoctor.blogspot.co.uk/2005/10/i-hate-medicine-and-want-to-leave.html">http://thelostdoctor.blogspot.co.uk/2005/10/i-hate-medicine-and-want-to-leave.html</a>) still gets hits and comments pretty regularly. It's taken a bit of a life of it's own beyond the blog itself which is perhaps one reason that I never deleted this blog. Some of the comments are pretty depressing, some are rallying and supportive and the rest are spam (!)<br />
<br />
I haven't decided if I'm going to keep writing - a lot has changed for me in the intervening years and old favourites like the venial sinner and vegas have changed too. If there's any demand to find out what I did or have been up to (how arrogant am I!) I could be tempted...<br />
<br />
Anyway the main point of this is to simply say I empathise with almost every comment on the <a href="http://thelostdoctor.blogspot.co.uk/2005/10/i-hate-medicine-and-want-to-leave.html">"I Hate Medicine" post</a> and I hope that everyone who writes on their at a dark time or a time of confusion finds some solace in the fact that a lot of doctors/medical students go through similar dark times. You are not alone and please remember that life generally deals out bursts of shittiness but in the end it all works out for the best.<br />
<br />
Much Love, D&C<br />
<br />
<span style="color: #cc0000;">[I am listening to <a href="http://thisisfirstaidkit.com/">First Aid Kit</a>]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com14tag:blogger.com,1999:blog-17612141.post-27758624255974057232008-01-11T22:12:00.000+00:002008-01-11T22:34:45.058+00:00see you all very soon*sigh*<br /><br />*another sigh*<br /><br />but not sighs of desperation, misery and discontent<br /><br />no, these are sighs of relaxation, happiness and inner peace (albeit through the obstructed sinuses, productive cough and general shitty feeling that man-flu lends itself to.)<br /><br />it has been just over a month since i left work. for the first time in four years i had the whole of christmas and new year (and also weeks either side) to relax and rest myself. money hasn't been an issue because i've been doing a few locum shifts (extra last minute shifts to cover illness, etc) at my old job. perversely, locum shifts are paid much much better than if one does the same shift as a regular salaried doctor. as anti-consumerist and anti-materialistic as i am, it is amazing how double (sometimes triple?) pay will make even the most mundane tasks bearable.<br /><br />and, in a week, myself and Ms D&C (who has also quit her job) will take ourselves off travelling for a few months. i can't wait.<br /><br />some have told me what i'm doing is mad, career suicide, etc. fuck them i say. i've never been one to do what i've been told. at the end of the day it comes down to what makes you happy (surely?) having said that, i do have a bit of a back up plan for when i come back. looking back at the stuff i've written in this blog, if i was to be honest, i don't think i ever really could leave medicine full stop. for all the shittiness and shitty shitty times, at the end of the day i think it's what i'm good at. given the short time we each have on this planet, i've come to the decision that by being a doctor i can still make a bit of a difference. i'm not saying i'm going to cure cancer or save millions. it's not about that. as time has gone on, i've realised that (for me) it's about the little things, the small changes, the conversation here, the bit of advice there that makes the difference. ripples in a pond.<br /><br />what i think the problem over the past couple of years was that i've been dying for a bit of time out, respite if you will. now that i've got it, i'm VERY VERY content.<br /><br />so this is not really goodbye (as i've been melodramatically threatening in the posts preceding)... more of a "see you later." i'm going off to have some adventures, experience a different way of life away from medicine, see the pretty colours of the world.<br /><br />i do think i'll be back. i'm pretty sure i'll be back. hopefully i won't be a miserable bastard when i return. at worst i'll return pissed off to be home but at least ready to start afresh.<br /><br />and at best i'll be a rejuvenated person with a few exciting stories to tell.<br /><br />i'd also like to thank everyone who comments/supports/encourages me to continue this blog. even if i don't reply, i do read every single response.<br /><br />so long everyone. i'm not sure when i'll next post but i'll see you all very soon.<br /><br />much love<br /><br /><span style="font-family: arial; color: rgb(255, 0, 0);">[i am listening to <span style="font-weight: bold;">She's A Rainbow</span> by the <span style="font-weight: bold;">Rolling Stones</span>.]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com23tag:blogger.com,1999:blog-17612141.post-8205420269914588582007-09-27T19:23:00.000+01:002007-09-27T19:25:23.196+01:00Musings Of A Disheartened Ex-Doctorwell that's not quite true.<br /><br />however i did resign today.<br /><br />i'm not quite sure how i feel. come january there will be no more of this nonsense.<br /><br />the future awaits.<br /><br /><span style="font-family: arial; color: rgb(255, 0, 0);">[i am listening to Wilco]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com32tag:blogger.com,1999:blog-17612141.post-17539963608466361342007-08-05T18:37:00.001+01:002007-08-05T18:51:43.975+01:00the MOADD twilightit's been a while since i've put fingers to keyboard on here.<br /><br />i blame (in particular order):<br /><br />1. general tedium with the medical blogosphere - my ranting about Modernising Medical Careers, the general shittiness of the medical profession in the UK and ennui with the lack of control of my career and life is starting to bore even me.<br /><br />2. Facebook - i thought this would be a fad that would die in a few months but sadly no it is taking up a large part of my internet time.<br /><br />since the last time i wrote, things have changed and i've done quite a few things.<br /><br />i went to the amazing Latitude festival in Suffolk. i had a spiritual experience watching the Arcade Fire.<br /><br />i went to Cornwall and ate well, surfed and lazed around.<br /><br />i've been getting into the british street art scene and went to a couple of private shows in uber-passe Shoreditch. not tempted to buy anything yet.<br /><br />i spent about three months not doing any on calls, sitting in outpatient clinics looking after the elderly. a very rewarding and chilled out time. i miss it.<br /><br />i am also now a Member of the stupid Royal College of Physicians which means nothing to most people and in reality means nothing at all. except that i finally passed some exams and 3 grand simultaneously passed out of pocket. i have a few more letters after my name.<br /><br />i have left my hospital (where i was for three years) and moved to an even bigger hospital to work in intensive care. it's ok. the doctors however are all posh toffs who don't listen to anything you say. i may as well be invisible.<br /><br />i am planning to resign in January and go travelling for the rest of the year. this is career suicide as i obtained a training position for 2007-8 unlike thousands of my peers. but frankly i don't really care anymore.<br /><br />i think that i shall probably delete this blog soon. it hasn't really served the purpose that i felt it would but it was fun while it lasted.<br /><br />i'm dreaming of far away places. the sun is setting here.Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com23tag:blogger.com,1999:blog-17612141.post-18999977627614771182007-06-07T12:13:00.001+01:002007-06-07T12:13:44.840+01:00Dr D&C is disheartened with bloggingDazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com13tag:blogger.com,1999:blog-17612141.post-4589979975776155362007-04-30T19:11:00.000+01:002007-04-30T19:21:21.529+01:00this man is a genius<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.theage.com.au/ffximage/2005/09/30/nic_cave.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px;" src="http://www.theage.com.au/ffximage/2005/09/30/nic_cave.jpg" alt="" border="0" /></a>i have been far too busy to post recently. i am burning the fun candle at both ends as they say. this weekend i have been at <a href="http://www.atpfestival.com/events/vs-the-fans/">All Tomorrow Parties</a> and a jolly good time i had too. anyways i am now a nick cave fanatic and i urge you all to be fanatics too.<br /><br /><span style="font-family: arial; color: rgb(255, 0, 0);">[have a guess at what i'm listening to sherlock]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com5tag:blogger.com,1999:blog-17612141.post-62224879224384964312007-04-02T19:05:00.000+01:002007-04-02T19:36:09.453+01:00i am honoured to have this man as a friendi wrote about him a while back. long time readers of MOADD will remember that a year ago current medical students petitioned the government/DOH/MMC people regarding the stupid system they had to use to apply to their first medical jobs after graduation (have a read <a href="http://thelostdoctor.blogspot.com/2006/03/modernising-medical-careers-update.html">here</a> - sound familiar?) i at the same time condemned the medical student leadership in this country as being a bunch of <a href="http://thelostdoctor.blogspot.com/2006/03/sycophant-corner.html">sycophantic wankers</a>. hmm... medical student reps... wankers... doctors' leaders... ineffectual pricks... everybody... sold down river... hmm. i feel there may be a connection here.<br /><br />anyway my buddy orchestrated <a href="http://www.ipetitions.com/petition/Thedoctorlottery/">this petition</a> against the moronic system. it got some press. it got noticed. for his troubles he got asked to join the MMC team to represent students and help make it better. he slowly realised that he was appointed to be used as PR, to silence the protesting masses. as a result he resigned his position in MMC. here are his eloquently polite yet damning letters to the mendacious serpents:<br /><br />____________________________<br /><br /><span id="PostList">This is my letter of resignation, as sent to Professor Crockard 18/03/07.<br /><br /><br /><br />Dear Alan,<br /><br />I am sorry to inform you at what must be an impossibly busy time that I wish to resign from my position as medical student advisor.<br /><br />When I took the position I had many reservations with the MMC systems but believed that I would be able to help students get the best deal from these changes. Seven months on, I retain these reservations and regret that I have not been able to have the impact I had imagined.<br /><br />Now as then (when I presented you with a petition signed by 1300 students), I believe:<br />⢠The nature of the new application system effectively randomises medical students to jobs across the country<br />⢠The importance of academic achievement has been downgraded<br />⢠The importance of other achievements at medical school has been nullified by the nebulous nature of questions and the lack of a CV<br />⢠Two years is not long enough to decide on oneâs specialty, to gain a broad enough range of experience, to become a good enough doctor: pressure is on to decide early, but the random nature of the application leaves no scope for strategising or planning ahead<br />⢠Morale at medical schools is low; they are not the aspirational, centres of excellence they should be, rather âcentres of competenceâ<br />⢠This anxiety has filtered down to those students considering applying for a place at medical school<br /><br />Through contact with a wide range of students over the last seven months, I know that these views are widely held. Just two nights ago, I talked to a Bristol student representing a group of 40 who echoed my above sentiments. I have, however, come to realise that continuing to transmit such views to the MMC team can have no effect as it is focused on the successful implementation of a system rather than the guiding principles and details of that system.<br /><br />In my limited experience, the role of student advisor is not used, as MMC aspires, to âencourage dialogue with the stakeholdersâ. Instead the role seems to be a token attempt to suggest the involvement of students in MMC strategy; a publicity vehicle to lend validity to a system that has not, in fact, considered student opinion and insight at all.<br /><br />When I was asked recently to find some students / SHOs who were happy with the new system to help build some positive press, I knew this role was not for me. I am not interested in spin or image, in making something seem other than it is. I am interested â perhaps naively - in getting the popular voice heard and acted upon and in standing by my own personal, political and professional principles. I now realise that in order to do this effectively, I need to be working within a different framework.<br /><br />I would like to thank you for giving me the opportunity to fill the role and personally wish you all the very best for the future. I can honestly say that I have enjoyed meeting you and having the chance to work with you and the team as a whole.<br /><br />Yours Sincerely,<br /><br /><br />Alex<br /><br /></span><span id="PostList">This is my letter as sent to the CMO 31/03/07:<br /><br /><br /><br />Dear Professor Sir Liam Donaldson,<br /><br />I recently resigned as medical student advisor to MMC.<br /><br />Despite claims from the health minister that the new Foundation Programme has âwidely been acknowledged as a successâ there are, and always have been, huge misgivings about it at student, junior doctor and all other levels. I hoped that access to the MMC team would give me an opportunity to make these views heard. I was wrong. Although you continually tell us that you are âworking with the professionâ you are not, at any level, listening to it. This is why I resigned: please find enclosed my letter of resignation to Professor Alan Crockard.<br /><br />From a grassroots level upwards, your recruitment of those from the profession has been tokenistic at best. My role was little more than a publicity stunt. You want to be seen to be involving us but care little for the reality of what we actually have to say.<br />Even at the highest levels you have been seen to charge professionals with responsibility but withhold authority.<br /><br />It is not my job to outline the infinite professional, personal and philosophical problems that blight your new systems â the 12,000 junior doctors who recently marched through London could do this more eloquently than I could ever hope to â but it is my job to expose the growing chasm between yourself and the profession.<br /><br />Your agenda does not meet with the approval of the profession. You must acknowledge this. It is not acceptable for you to enlist members of the profession from all levels and to then ignore them. It is not acceptable to use your implementation team â MMC â as a vehicle for spin, as a way to convince the profession that things are other than they are. It is not acceptable for you to hide behind the responsibility you have dispensed to MMC and at the same time maintain your authority so you can push through your own agenda.<br /><br />And yet, this is what you are doing. No matter what the profession says, no matter how vociferously it protests, no matter what damage is done to families up and down the country, this is what you will continue to do. How kind of Lord Hunt â at a time when faith in your systems is at its nadir - to illustrate the DoHâs utter contempt for the profession, by saying âI would like to reconfirm our commitment to MMC which aims to recruit and train the best doctors to provide the best possible patient care.â<br /><br />This is your project. Everyone else â from MMC to MTAS, from the royal colleges to PMETB, from the advisors to the spin doctors â are merely your implementation tools. Ultimate authority rests with you. It is now time for you to take responsibility. If you continue to force through these reforms, I want you to know that it is obvious - even from a medical student level - that you are a million miles away from being the âbridge between the profession and the governmentâ that you claim: you could not be acting more undemocratically if you tried.<br /><br />If you find this image unappealing, your options are clear: take heed of the groundswell against you and your agenda and cede your authority back to the profession. If this is also unpalatable to you, then you must resign.<br /><br />Yours Sincerely,<br /><br /><br />Alex Liakos<br /><br />_______________________________________________<br /></span><br />what i love about the letters (apart from beautifully expressing the bigger picture of MMC) is the way they say FUCK YOU CUNT so politely. thinking about my buddy, he is actually the consumate gentlemen, even if he is from southampton.<br /><br />anyways, he's far too busy with things that are bigger (or littler...) and more important than MMC at present, to which i wish him the best. i'm sure i'll see him soon and there'll be much to celebrate. it's a shame however that i am STILL keeping my pessimistic hat on: i don't think it'll make a difference to this imbecilic process. it is going to continue. at least with the march, the press coverage and letters like these, we can say that the medical profession in the UK, even if it was a bit too much too late, went down guns blazing.<br /><br />see you soon dude. i've got a pint of guinness and some tea trolley treats waiting for you.<br /><br /><span style="color: rgb(255, 0, 0);font-family:arial;" >[i am listening to the new </span><a style="color: rgb(255, 0, 0); font-family: arial;" href="http://kingsofleon.com/">Kings of Leon</a><span style="color: rgb(255, 0, 0);font-family:arial;" > song. they've shaved off their tashes. i'm distraught.]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com4tag:blogger.com,1999:blog-17612141.post-81551347710244934392007-03-15T19:50:00.000+00:002007-03-15T22:01:58.933+00:00without a paddle<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.bookscape.co.uk/images/chimp.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px;" src="http://www.bookscape.co.uk/images/chimp.jpg" alt="" border="0" /></a><br /><div style="text-align: center;"><a style="color: rgb(51, 204, 255); font-family: arial; font-style: italic;" href="http://www.mmc.nhs.uk/">MMC</a><span style="color: rgb(51, 204, 255); font-style: italic;font-family:arial;" > steering committee holds urgent meeting to modify the online application process (Prof Alan Crockard, far right)</span><br /><br /><div style="text-align: left;">and so the crisis goes on<br /><br />this week the department of health announced that the process by which 30000 junior doctors are applying for 22000 jobs is to be urgently reviewed.<br /><br />the reason for this was that several groups of consultants on interview panels refused to participate in the process on the basis that the entire selection system was moronic.<br /><br />i have mixed feelings about the actions of these consultants. on the one hand i am glad they spoke out and got a review to take place. on the other hand i pose the question:<br /><br /><span style="color: rgb(255, 0, 0);font-size:130%;" >where the fuck were you guys nine months ago?</span><br /><br />this disheartened doctor has been wingeing about MMC since last year. everybody in the medical profession knew this was going to happen and knew that the implementation was going to be a joke. we knew this from the way the newly graduated doctors had been treated by a similar system. yet the warnings were not heeded. our union, our royal colleges and our bosses sold us down the river with a group shrug of the shoulders and an indifferent "well who knows what's going to happen" whilst all along we were screaming "it's a shit idea, it's going to be shit and it'll fuck up our lives, your lives and those of our patients."<br /><br />so this review: i'm not convinced. not convinced at all and sadly don't hold the views of my fellow learned bloggers (<a href="http://angrymedic.blogspot.com/2007/03/empire-is-struck-back-against.html">here</a> and <a href="http://laylasramblings.blogspot.com/2007/03/sun-is-shining-weather-is-sweetand-we.html">here</a> for example) though i wish i did.<br /><br />the first round of selections is nearly over. there is talk of the second round being modified to be "fairer."<br /><br />what this actually means, and we can debate for days about what modifications should be made, is that MMC <span style="font-weight: bold;">will continue</span>, we WILL do exactly what we are told to do and we WILL BLOODY WELL LIKE IT. it is marxism at its most literal. you will be allocated and perform the task that we deem you appropriate for.<br /><br />patricia hewitt and the department of health: why can you not see that our NHS is held together by the altruism of its nurses and doctors. you've already slain the nurses (below inflation pay rise this year most recently) and through MMC you've killed the morale of already demoralised doctors. the boat carrying our altruism is sinking because you've punctured so many holes in the fucking hull. time is running out patricia. how can you not see this?<br /><br /><span style="color: rgb(51, 204, 255);font-size:180%;" >HOW CAN YOU NOT SEE THIS?</span><br /><br />there is a <a href="http://www.remedyuk.org/">protest march on saturday</a>. i shall certainly be attending. so shall many of the british medical bloggers. will it make a difference? i doubt it. optimistically it may burgeon public support. realistically the public will probably wonder what all these rich doctors are bitching about, the power-obsessed bastards. pessimistically i think 10% of the doctors who say they are going to attend will actually show up.<br /><br />for we are the most ineffectual group of lobbyists ever. oh for being a bit more militant and bit less self-serving (like the new zealand junior docs who took strike action last year).<br /><br />i've been eyeing up the canadian medical board exams. even if i get a job for august, what precedent does the behaviour of the DoH set for working in the NHS in years to come. i personally can't wait for the next set of "reforms" circa 2008. surely better to go somewhere or do something where you are valued as a person with skills to offer society.<br /><br />i'll report back after the march. i really hope that there will be a sea of angry doctors there, like Sauron's army of orcs and that the british public will be thrusting their fists into the air and willing us to go and give the DoH hell.<br /><br />but i worry that it will make no difference. i worry it's too late. i worry that come august this will all be done and the protests of the future physicians, surgeons and professors of this country on saturday will become but a whisper in the tragic history of the NHS.<br /><br /><span style="color: rgb(255, 0, 0);">[i am listening to the new <a href="http://theshins.com/">Shins</a> album]<br /><br />ps. this is fucking psychedelic genius:<br /><br /><object width="425" height="350"><param name="movie" value="http://www.youtube.com/v/cYU6_qeeH7o"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/cYU6_qeeH7o" type="application/x-shockwave-flash" wmode="transparent" width="425" height="350"></embed></object><br /><br /></span></div></div>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com7tag:blogger.com,1999:blog-17612141.post-20814477747262457202007-03-03T13:32:00.000+00:002007-03-06T21:05:27.825+00:00the slimiest of slime - something reptilethe HAL9000-esque automated medical job allocation process robot (<a href="http://www.mtas.nhs.uk/">MTAS</a>) sent me to an interview last week. let me tell you about the moronic sequence of events running up to this interview.<br /><br />regular readers will know that the Lost Doctor filled in his online application whilst snowboarding in Whistler at the end of january. by doing this i achieved 2 objectives:<br /><br />1) i managed to avoid everyone at home stressing out immensely about the idiotic questions that needed to be answered<br />2) being on holiday was a great panacea in reducing my outrage at the idiotic questions<br /><br />the system crashed due to the sheer number of applicants several times. little space was given for detailing achievements in medicine to date. the details of jobs available were sparse and uninformative. after finally submitting my responses, i was inundated with daily emails informing me how there would be more delays as the system was not getting people's references and that the shortlisting process was taking too long. i overheard one of my consultants two weeks ago saying how she had been couriered hundreds of applications and asked to score them all in a day. she also said how she didn't feel the application form was a particularly good discriminator of good from bad doctors at all and that is was all a "fucking painful joke."<br /><br />friday (23/2/7) came and i began a weekend of nights. it was a lot of fun because i had the company of <a href="http://venialsinner.blogspot.com/">the venial sinner</a> (MIA in the blogosphere but very much about in reality) who was also doing nights. at the same time MTAS emailed to say that the shortlist which was supposed to come out that day would only be revealed the following monday. the venial sinner and i decided that after finishing our night shift on monday morning we would go out on a bender to recreate the halcyon student days.<br /><br />10am monday morning (26/2/7) and tvs and i headed into town for the obligatory caner. at about midday i received a call from <a href="http://gettingcaned.blogspot.com/">vegas</a> who informed me that MTAS had crashed and died again. no-one knew about whether they had been shortlisted for possible employment in medicine in this country for august. tvs and i continued to drink and drink. 2 tycoons (triple sec, apricot schnapps, gin, cointreau, lemonade) and 2 long island ice teas later the eyes were drooping, the gait was ataxic and home and bed beckoned, oblivious to the fact that MTAS was secretly sabotaging the airlock doors.<br /><br />i woke on tuesday (27/2/7) and went to my outpatient clinic where i checked the website. MTAS said that i had 2 out of 4 interviews. i quickly booked interview times online (gone are the days of someone phoning you) and continued on with a busy clinic.<br /><br />while awaiting MsD&C's return from work that evening i decided to consult MTAS again (who had by now killed the astronauts in hypersleep) to double check when my interviews were, as in the rush of the clinic i had neglected to note this important detail down. upon accessing his mainframe i found out i had a third interview. attending this interview would require a day off work and a not insignificant train ride. oh yes and it was the following day.<br /><br />thanks for the notice.<br /><br />i hurriedly scrabbled together a portfolio with the ridiculous number of things that i had to take there. i also printed out my answers to the questions i had completed one month earlier in canada so i could review them before the interview.<br /><br />i felt sick.<br /><br />i read back some of my answers. they were PAINFUL.<br /><br />when you're writing the twentieth draft of something you become quite dissociated from the content. you're concentrating on grammar and flow.<br /><br />i was ashamed i could come out with such drivel.<br /><br />i attended said interview the following day. it was quite funny actually because, finding dry shirts difficult to iron, i said out loud in my flat "fuck this, i'm going to wear the clothes i had on yesterday" and went to the interview smelling of urine and C.difficile.<br /><br />i hate waiting for anything. being an hour early, i quietly sat in the waiting room drinking water and listening to the five other candidates chat to each other (Dr D&C was ignored probably because he isn't posh enough).<br /><br />sometimes when you walk into a pub or a bar you can sense an atmosphere of foreboding. in these cases the correct action is to finish your drink and leave quickly without drawing too much attention to yourself. sometimes when you meet someone for the first time you can tell that they are complete utter wankers. in these cases the correct action is to bite your lip and pray they move on to bother someone else.<br /><br />well these five people were amongst the biggest fucks i've ever met in my entire life.<br /><br />oh the pain! the continuous, self-serving, droning conversation. the false smiles, the belly laughing, the lack of grounding in any plane of reality. i wished the aliens from war of the worlds would appear and disintegrate them all. i prayed for their unnecessary fountain pens to fly out of their pockets and impale them in their foreheads. everything they talked about was prime, chargrilled bullshit and they were loving it.<br /><br />and then i realised what it was. i realised what it was about these people that made them all so similarly disgusting examples of our species, and why i was so unfortunate to be breathing the same air as them.<br /><br />they had all been summoned to this place on the basis of their answers to the stupid questions on the application form, answers that encapsulate their inflated egos and sense of self-importance. i felt like bruce willis at the end of the sixth sense when it dawned on me that i too was one of them. cheapened.<br /><br />the interview was fine in itself. one of the panels didn't have my application form and so knew nothing about me. the interviewers seemed fair and normal people trying to make the best of a ridiculous situation. at the end of the day it wasn't too dissimilar to any normal job interview. just the getting there, which was marxist to say the least.<br /><br />and all the way home i couldn't stop thinking about the cunts in that waiting room. this new medical system will roll on because people like them will secure their jobs and then they won't care about their colleagues (if such care ever existed.) there is a protest march on the 17th of this month. do you think any of them will go? course not. they have their interviews. fuck the rest of you.<br /><br />be warned the UK public. from august your hospitals will have greatly reduced numbers of doctors working at night in an effort to make the NHS balance its books. when you finally do get to see a doctor it won't be someone experienced able to deal with most of your problems. MTAS has ejected these doctors from the cargo hold.<br /><br />no, what you'll be left with is these five penises, appointed because they are adept in using buzz words such as "motivated" and "empathy" and "nonce." these are the sort of people the NHS of 2007 want to employ. i hope to god i'm not one of them.<br /><br />people of britain - do not got to hospital after august lest you come across such people in a dimly lit examination cubicle. it is time to stockpile the ibuprofen, turn your kitchen into a operating theatre and find a good VET to look after you when you get ill. medicine in this country has been sold down the river by the government, the royal colleges, our "union" the BMA and our bosses because, as jarvis cocker recently said, cunts are still running the world.<br /><br /><span style="color: rgb(255, 102, 102);font-family:arial;" >[i am listening to willie nelson]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com17tag:blogger.com,1999:blog-17612141.post-73931563219352643692007-03-01T21:22:00.000+00:002007-03-06T21:06:08.715+00:00cullingthis week has seen the biggest culling of junior doctors' career aspirations by a computer system and an ill thought out application form (<a href="http://www.mmc.nhs.uk/">MMC</a> and <a href="http://www.mtas.nhs.uk/">MTAS</a> respectively - i've talked about this before). this is probably the biggest change to medical training in the past forty years and within days hundreds of doctors have had their dreams of pursuing a medical specialty shot down. it's like the beginning scenes of saving private ryan. i, unlike many, have survived the initial onslaught of career killing fire and shrapnel. i am currently lying on the normandy beach of possible interviews, unsure of my future. i know a LOT of doctors who've been *BANG* taken out just like that and will have no job to go to in august. some of them (the ones with slightly more experience) will probably never work again as a result. absolutely gutting. absolutely fucking gutting.<br /><br />the most eloquent explanation of what's been happening is quoted below and taken from the <a href="http://www.doctors.net.uk/">doctors.net.uk</a> forum. i'll let it speak for itself:<br /><br /><span style="font-style: italic;font-family:arial;" id="PostList" >"I feel like crying.<br /><br />All my life there has been only one thing that I have wanted to do. I worked hard at school to get to medical school, I then worked hard at medical school to give myself the best shot at the jobs I wanted later on. I passed all my exams, won a few prizes along the way and was generally a good all rounder.<br /><br />I was warned off medicine by my family and friends, they said it was too stressful and the NHS was in trouble; but I found the subject fascinating and it was not a matter of choice for me.<br /><br />I have worked hard since I qualified and have had good references from all my employers. I have not taken a single day off ill in my first few years of work, and there are days when I have not felt well enough to come into work. I have passed several postgraduate examinations and attended all the relevant courses, as well as having several articles published in scientific journals.<br /><br />There are many others just like me. Each of us has made numerous sacrifices because we love what we do. Our study budgets and study leave quotas have been cut, meaning we have had to pay for our own training and attend courses in our annual leave. The trust has also stopped properly reimbursing us for our travel expenses and removal costs. However we carried on because we thought that it would all be worth it, if we could have a job at the end of it doing what we loved.<br /><br />These last few weeks have been the final straw for many of us. We have been subjected to the most unfair and least meritocratic selection process ever seen, MTAS (medical training application service) via MMC (modernizing medical careers). We have had to sum up our years of work and experience in several politically correct short answer questions, on which we are then judged. Examinations, experience and references are all but ignored in the pursuit of vague waffle.<br /><br />The computer system crashes time and time again, confusion reigns supreme and hundreds of consultants are appalled by the process. Yet it is allowed to proceed. The short listing results are released in dribs and drabs and thousands of juniors tap away on their keyboards in a state of sheer panic, realizing that their future is being decided by the MTAS tombola.<br /><br />Some of us have been lucky enough to get short listed for the jobs we want, but we shouldnât have had to be lucky. The process should have been meritocratic, well organized and fair. It was most definitely none of these.<br /><br />Young doctors such as myself are appalled by what we have had to endure this year. No one should have to go through such a process again. We all know people who are going to have their hopes and dreams crushed by this cruel joke of a system.<br /><br />Shame on those who are behind this scheme. Many a tear will be shed this week by many brilliant young doctors who have had their hopes and dreams crushed in a quite barbaric fashion. Many of us will emigrate and many of us will leave the profession; I hope those behind the scheme are proud of these achievements.<br /><br />Of course we do not all expect to be handed our perfect jobs on a plate. However we deserve not be lied to, we deserve not to be treated unfairly and we deserve to be treated with a little more dignity, respect and humanity than we have in 2007."<br /><br />(Dr Ben Dean)<br /></span><br />our union, the grossly ineffectual bunch of sycophants the <a href="http://bma.org/">BMA,</a> have done precisely fuck all about it. i think they may have indulged the architects of MMC in fellatio at some point. they yesterday announced a press release saying that the system was failing.<br /><br />erm STABLE DOOR CLOSING, HORSE, FUCKING BOLTED.<br /><br /><span style="color: rgb(255, 102, 102);font-family:arial;" >[i am listening to Johnny Cash]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com6tag:blogger.com,1999:blog-17612141.post-1675482237401922722007-02-13T18:38:00.000+00:002007-02-13T19:25:37.398+00:00my cup runneth over with honey lager<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBmNdsFJ1dcnzCREAUyUO9O_A3EYEdEZ1-X7GKYvBYV21TXinjbzhrodu29XsnNCo5cSrFeeo09nYpYcpZwYruLAw3icBZRsoNFcTh2EkMq88bGzQdwgy_jmIQiwcBSPVbLvgayw/s1600-h/whistler2.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBmNdsFJ1dcnzCREAUyUO9O_A3EYEdEZ1-X7GKYvBYV21TXinjbzhrodu29XsnNCo5cSrFeeo09nYpYcpZwYruLAw3icBZRsoNFcTh2EkMq88bGzQdwgy_jmIQiwcBSPVbLvgayw/s320/whistler2.jpg" alt="" id="BLOGGER_PHOTO_ID_5031100723403800498" border="0" /></a><br /><br />no the NHS didn't finally kill me.<br /><br />i've been on holiday for 3 weeks.<br /><br />Ms D&C and i returned to my spiritual home, vancouver, with a view to collect rent from all the canadians who've been staying at my flat over the past three years.<br /><br />it was fantastic. with each visit i struggle to answer why i don't move over there. my friend <a href="http://copperspinerecords.com/">Broseph</a> (who with his lovely wife let us stay for 2 of the 3 weeks) said that if i did go and did a masters degree he'd jack in his job in music production to do one with me. i did remind him that we would probably spend most of the time looking up stuff on youtube and flunk badly. he agreed.<br /><br />highlights, apart from the copious amounts of red meat and pale ale consumed, were far too many to list.<br /><br />we visited MsD&C's great aunt and uncle on vancouver island, caught up with <a href="http://tincupmusic.com/">Roger Dean Young</a> and the new Tin Cup who played a gig in town, bid farewell to a friend and Tin Cup member moving to Toronto, stayed with another of the Tin Cup in his log cabin on the sunshine coast and gushed at a new baby arrival for two other friends. much of it involved hanging out with people but we were quite outdoorsy too: hiking, cycling around stanley park and finally snowboarding for a week in <a href="http://whistlerblackcomb.com/">Whistler</a> with <a href="http://thelostdoctor.blogspot.com/2006/12/gnarls-barkley.html">Gnarls Barkley</a> (whose MSF trip appears to have gone tits up) and his latest and greatest girlfriend. he'd come over from Edmonton, Alberta for a "conference" and managed to divert to spend some time imbibing with us.<br /><br />i think i managed to see pretty much every canadian i know. i've also got a real bug again for snowboarding and am trying to get away again this season. any ideas of good destinations? anyone got a 150 burton board for sale?<br /><br />i've come back in holiday mode to a much less stressful job and am floating on with memories of good times and fresh air.<br /><br />i realised when i got back that everyone was incredibly stressed out about <a href="http://www.mtas.nhs.uk">MTAS</a>. for the non-medics this is an online application process which (nearly) every doctor who wants to work in august has to complete. it is analysed, processed and then refined into energon fuel which powers a huge robot who then allocates jobs. there has been a lot of worry because it's been poorly implemented, not carefully thought through and there hasn't been much information regarding how many jobs are available and how people will be selected blah blah blah<br /><br />in short nothing that should surprise you about the NHS.<br /><br />i did my form when on holiday. very much less worrying when you complete it after spending a day boarding. i also submitted it from the sleepy town of Squamish, British Columbia whilst waiting for a bus. very relaxing as it happens. probably fucked it up anyway.<br /><br />anyways life is still uncertain, frightening and depressing. at least i know for the next few weeks, until the holiday feeling wears off, i can close my eyes, let all the stress wash around me and daydream of snow and mountains.<br /><br /><span style="color: rgb(255, 102, 102);font-family:arial;" >[i am listening to <span style="font-weight: bold;">Concerning the UFO Sighting Near Highland, Illinois</span> by <a href="http://sufjanstevens.com/">Sufjan Stevens</a>]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com7tag:blogger.com,1999:blog-17612141.post-1165699904942270082006-12-09T21:20:00.000+00:002006-12-09T21:31:44.963+00:00grab the yoke from the pilot and fly the whole mess into the sea<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://photos1.blogger.com/x/blogger/2723/1701/1600/857208/profilePicture_179560.gif"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" src="http://photos1.blogger.com/x/blogger/2723/1701/320/967638/profilePicture_179560.gif" alt="" border="0" /></a><br />the votes have been cast, the panel has been ruminating behind closed doors. months of hard work, extra hours after school, meticulous notemaking and detailed tome reading are over.<br /><br />sadly the royal college of physicians have given me a nice big fuck you with another failed exam.<br /><br />it would have been nice for a lift. it would have been nice for a bit of achievement to end the year with. but no.<br /><br />i'm not entirely sure what to do now. i've always been one of those people that has to study hard for results (there's not a lot natural about me) and when i haven't it always shows. this time was different because i worked my little cotton socks off. it's difficult to know how to improve on that.<br /><br />maybe this is the wall! medical gandalf standing in my way bellowing "you shall not pass."<br /><br />i have had lots of kind words from friends and colleagues - it's quite funny in that the response is almost like that to a bereavement.<br /><br />anyways.<br /><br />as i remind the friends who i am worried feel i might go and top myself, i bought a REALLY big christmas tree (far too big for my flat) and decorated it yesterday with not one, not two but three sets of fairy lights. and i did score three strikes bowling on thursday night. i am good at a few things.<br /><br />i'm sure a weekend of nights will make things look better.<br /><span style="color: rgb(255, 102, 102);font-family:arial;" >[i am listening to <a href="http://www.reginaspektor.com">Regina Spektor</a> again]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com13tag:blogger.com,1999:blog-17612141.post-1165329189912321972006-12-05T13:33:00.000+00:002006-12-05T14:49:15.106+00:00gnarls barkley<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://blog.turntablelab.com/images/gnarls.jpg"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 200px;" src="http://blog.turntablelab.com/images/gnarls.jpg" alt="" border="0" /></a>i have had the pleasure this week of meeting up a few times with another good canadian buddy, Dr Gnarls Barkley (his real name is VERY similar and i think that's hilarious). i first met Gnarls in his capacity as best man and organiser of a stag night for another good <a href="http://copperspinerecords.com/">friend</a> in vancouver last year.<br /><br />happy days, with much meat, beer and rye consumed (not always in that order) and the town was set alight. that whole holiday actually supplied a good few anecdotes for the next few months. happy days (tear wiped from left eye).<br /><br />over the past week he has accompanied me to the <a href="http://brianjonestownmassacre.com">BJM</a> at the Astoria and also a great dinner this weekend with his sister, brother-in-law and their fantastic new baby boy.<br /><br />perhaps somewhat unfairly, Dr Barkley gets tarred with the hellraiser/nutter/crazy mofo brush because of many many historical exploits that he and the <a href="http://copperspinerecords.com/">groom</a> became embroiled in through university and beyond. i empathise with him as i too often get similarly tarred. Dr Barkley merely likes to let his hair down when he manages to have the time.<br /><br />in his "normal life", he is an attending physician (read consultant NHS fans) in emergency medicine in Edmonton in Alberta, Canada. in a ferociously busy department, he works bloody hard, does lots of night shifts whilst not losing his humanity or sanity. he's also blessed with good looks (ten quid in post i'm told), a fabulous apartment and a handsome paycheque to take home at the end of the month.<br /><br />despite being at the top of his game, i wonder if something changed in him over this and/or last year. (having said that i only met him in Sept 05 so it may have been brewing for a while before that). this perceived change culminated in him packing up his alberta life for a while, moving to London and pursuing a Diploma in Tropical Medicine at the <a href="http://www.lshtm.ac.uk/">London School</a> (very prestigious, very difficult to get into.) during this course, seeds that had already been sown began to flourish and just under a year later he is preparing to quit his job again and head off as a volunteer with <a href="http://www.msf.org/">Medecins Sans Frontieres</a> to Africa.<br /><br />i have nothing but admiration: respect for him as a senior colleague and pride that someone i know can be brave enough to undertake such a noble odyssey.<br /><br />and once again it triggers me to ask "<span style="color: rgb(255, 102, 102);">there must be something more</span>" than negotiating the depressing quagmire of exams/job applications/specialty training applications/on calls/going to the pub again/wandering around London. i wonder if gnarls asked himself the same question.<br /><br />to be honest i'd be useless in Africa. there aren't many skills a physician (as compared to a surgeon or an anaethestist) could bring to a warzone or refugee camp in my opinion. "i understand that the injuries from landmines here are horrific but have y'all thought about reducing your risk of stroke with a statin?" beyond that, i don't think i'm brave enough. i'm not even brave enough to admit to myself that life is pretty shit stuck in a pathetic "at least i have enough money to live somewhere nice and go out every so often and take a holiday twice a year" existence. there must be something more. whoa. it always comes back to MY problems.<br /><br />anyway Ms D&C and I bid him farewell on Sunday evening. i'm not sure that i'll see him before he disappears off to foreign plains and new adventures. so, if you happen to chance upon this, here's to you Gnarls Barkley. look after yourself, stay safe, and next time you pass through London there'll be an empty bar stool and a Staropramen waiting for you.<br /><br /><span style="color: rgb(255, 102, 102);font-family:arial;" >[i am listening to Nothing To Say (and i don't actually) by <a href="http://thestrokes.com">The Strokes</a>. still no exam results. although having just read what i've written i'm past the point of caring at the moment.]<br /><br />[if you haven't already heard, the <a href="http://trick-cyclingforbeginners.blogspot.com/">shiny happy person</a> has returned]<br /> </span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com4tag:blogger.com,1999:blog-17612141.post-1164628666714208862006-11-27T11:10:00.000+00:002006-11-27T12:12:30.943+00:00one-way or return?<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://newsimg.bbc.co.uk/media/images/39355000/jpg/_39355240_oyster203.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 200px;" src="http://newsimg.bbc.co.uk/media/images/39355000/jpg/_39355240_oyster203.jpg" alt="" border="0" /></a><span style="font-weight: bold;"><br /></span><span style="font-weight: bold;">"from 19 November if you donât touch in and touch out you will pay a maximum cash fare for your Tube/DLR journey"</span><br /><br />...as you may have heard/read on the radio/paper in the last few weeks. the oyster card for those non-londoners reading is a credit card sized ticket onto which one can buy tube/bus tickets. the option also exists to load a preassigned amount of money onto the card so that each time it is touched on the yellow disks above at ticket barriers the travel fee is automatically deducted from the card.<br /><br />anyway it was with the above warning in mind that Ms D&C and I descended into the depths of the underground on Saturday night.<br /><br />a bit of background: she'd just finished a fourteen hour shift and i had of course been bumming around at home. a good friend of hers was having a house party in islington and given that poor Ms D&C was so tired by halfway through the shift our initial plan had been to stay in, put on the Shrek soundtrack, eat some cereal, dance in our pyjamas - you know the usual saturday night stuff that everyone does.<br /><br />however on her way home she had a change of heart, decided that if all we did was go to work and sit at home that would make us very very boring indeed. so at about ten thirty we were all set to head off. the bus was going to take five million years and it was icy so we made the executive decision to head on the tube.<br /><br />crate of beers in my arms and bottles of wine in hers we switched at oxford circus to get onto the victoria line to highbury and islington. i powered through the crowds to cross platforms. i saw an opening in the throng and nearly made it through when a hand pulled me back. i turned around to see Ms D&C gesturing with some import at the ground.<br /><br />a man in his 70s lay there. let's say he wasn't looking too well. blue in the face, not breathing. this is generally a pretty bad thing. people were standing around but not doing a great deal. so we started CPR.<br /><br />after three rounds we weren't getting anywhere. still no pulse, still not breathing. the staff were clearing the station and then one of the ticket people ran back with a defibrillator. first aiders will tell you that the whole point of CPR is a holding measure until the heart can be restarted with electricity. sure enough after the first shock, his pulse came back and he started breathing. we waited for the ambulance.<br /><br />his pulse started to get more thready and weak and then it disappeared. he was shocked again and then did two more rounds of CPR and during the third he came back. by this point the paramedics had just come round the corner and we proceeded to load him onto the stretcher.<br /><br />it was that night i realised that the only way out of underground stations is the escalator. there are no emergency lifts. this man was quite heavy what with the oxygen and everything so eight of us had to carry him on the stretcher up those huge escalators to the ambulance waiting opposite topshop. i kept glancing at the heart rhythm which before the second shock had looked like supraventricular tachycardia (a very fast heart beat) but was now sinus tachycardia (a more stable heart rhythm) so was slightly more relaxed.<br /><br />as we rounded the ticket barriers with this man on the stretched neither myself nor Ms D&C validated our oyster cards.<br /><br />he disappeared with his wife and the ambulance crew into the night and we decided to give up on the tube for the evening and a taxi whisked us across town for beers and mulled wine.<br /><br />the next morning we decided to call transport for london to explain why we hadn't touched out at the ticket barrier in the hope of not being charged 30 quid or whatever. i went through where we had got on the tube in excruciating detail and then described exactly what had happened on the platform to the guy on the helpline. the last part of the conversation went something like this.<br /><br />"so this man had fallen down?"<br /><div style="text-align: right;"><br />"well kind of. he fell down because his heart had stopped."<br /></div>"so he had a heart attack?"<br /><div style="text-align: right;"><br />"he had a big bypass surgery scar on his chest so that's a possibility."<br /></div><br />"and you helped him upstairs?"<br /><div style="text-align: right;"><br />"well kind of. it was more we were trying to get his heart started."<br /></div><br />"and why were you unable to validate your oyster card?"<br /><div style="text-align: right;"><br />"there was eight of carrying him on stretcher. i had no hands free. i think we were all quite worried and concentrating on getting him safely out of the station into the ambulance. going back through the barriers to touch out wasn't really a priority"<br /></div><br />"ok sir. i'll refund you this time but may i remind you that from 19 November if you donât touch in and touch out you will pay a maximum cash fare for your Tube/DLR journey and i won't be so lenient."<br /><br />__________________________________<br /><br /><span style="color: rgb(255, 0, 0);font-family:arial;" >[the</span><a style="color: rgb(255, 0, 0); font-family: arial; font-weight: bold;" href="http://www.brianjonestownmassacre.com"> brian jonestown massacre</a><span style="color: rgb(255, 0, 0);font-family:arial;" ><span style="font-weight: bold;"> </span>were superb. a really really tight band. </span><a style="color: rgb(255, 0, 0); font-family: arial; font-weight: bold;" href="http://en.wikipedia.org/wiki/Anton_Newcombe">anton newcombe</a><span style="color: rgb(255, 0, 0);font-family:arial;" > remains as narcissistic, self absorbed, talented, and messed up as ten years ago. i never know what to make of him. i flit between thinking he's a total wanker and then filled with awe and admiration. he spent five minutes having a go at a heckler. hilarious. </span><a style="color: rgb(255, 0, 0); font-family: arial; font-weight: bold;" href="http://en.wikipedia.org/wiki/Joel_Gion">joel gion</a><span style="color: rgb(255, 0, 0);font-family:arial;" ><span style="font-weight: bold;"> </span>seemed oddly mute though.]</span><br /><br />__________________________________<br /><br />i found out today that the man from saturday night survived and is doing well in hospital. i'm relieved and pleased for him. i might look at work slightly differently today. maybe it's not all so bad.Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com13tag:blogger.com,1999:blog-17612141.post-1164456258456057912006-11-25T11:28:00.000+00:002006-11-25T12:04:19.790+00:00fight on stage*ssshwooop* there it goes<br /><br />another friday night disappears. and guess what i was doing. not out. not with people i love (well not till the dying hours.) not relaxing. not even on call. but yes i was at the hospital.<br /><br />we have a ninety year old. he's a bit fragile. he hasn't been able to eat anything for a month because a peculiarity in the anatomy of his oesophagus (food tube from mouth to stomach) means that food isn't going down.<br /><br />as a result the protein levels in his blood are very very low. as a result of that any fluid that goes into him as drips doesn't stay in his blood vessels but pours out into his arms legs abdomen lungs etc. similarly not a lot of blood is going to his kidneys and they are failing.<br /><br />i had to put a large drip into one of the big vessels going into his heart on tuesday night (after work) because he was too swollen to get a normal drip line in anywhere else. however despite this the only way to get him any better is to get the protein levels up in his body and the only way to do this is to feed him. however every effort to get a feeding tube of some kind into him is failing.<br /><br />he has one last chance. one of the clever radiology doctors (a top bloke as it happens) reckons that he can get a feeding tube into this man. this is scheduled for monday morning. in the meantime my patient continues to deteriorate.<br /><br />there are lots of ethical questions. "did you say 90 dr D&C? have you gone out of your handsome little head?" how much should you do for someone so elderly and so fragile? there have been many occasions (see lady in last post) where we've pulled out. my man, despite his body being so weak, is completely with it. i've had about four or five chats with him along the lines of "how much do you want us to do?" and each time he says he says he's "quite up for a go with the tube through the nose."<br /><br />we don't think that he's confused or lacks "capacity" and so our options are to give any therapeutic options a go (provided they don't harm him any more) or... well... to let him starve. the team sat down and had a bit of a discussion about this. despite my harsh impenetrable exterior, i found myself advocating for the "we've got to give him a chance" approach.<br /><br />the problem then arose (on friday at 3pm as always) that we have to keep him going through the weekend. it could be argued that if he hasn't fed for so long is another two days going to make a difference. i always feel that if you make a plan to pursue a certain management plan, you do it completely, without fudging, and properly. so in order to get some protein into him we organised intravenous nutrition for him.<br /><br />to provide this, my man needed ANOTHER big drip going into his heart. i elected to stay back after work with one of the other doctors to put this in, partly because i have more experience.<br /><br />it was bloody hard. i haven't failed getting one in for a long long time but for whatever reason, it didn't work. my colleague had a go but also couldn't get it. i tried again. no joy. at times like this the anaesthetists are the people to call on and sure enough we did. by this time it was 830pm. i sent the other doctor home because 1) it's courteous to wait around for your help to thank them and explain the situation and 2) there was no point two of us being there.<br /><br />the anaesthetist failed three times. finally at about 930pm it went in. my man started his feed.<br /><br />by the time i got home it was late, i was exhausted and not even a cheese and tomato toastie could save me. not even johnny depp's peculiar cockney accent in From Hell either.<br /><br />i'm not sure what i'm moaning about really. i'm not too fussed about failing the procedure as it clearly was a tricky one. i don't know if it's about staying late either. i suppose it's more that some of the doctors in this system actually do give a shit. i just don't think that managers/royal colleges/the daily mail/the department of health really care. management would have had a go at us for staying so long after our end of shift. they would have said we should have handed this all over to the night team. you can't just dump complicated situations like this on other people. maybe i'm trying to convince myself that i'm still a "nice person" and have some humanity left in me.<br /><br />the flip side of this i'm starting to wonder why i bother. if/when i fail this exam in a few weeks time i'll think what is the fucking point? there are hardly any jobs available for february. if i'm unemployed then i'll also think what is the fucking point? if the change in training screws me over i shall also wonder what is the fucking point?<br /><br />i guess if it give this guy a chance to get better then there's my answer. but, in the scheme of all the other crap in the NHS, i don't know how long "finding happiness in helping people" will keep me going.<br /><br />_____________________<br /><br />on a lighter/darker note, i did laugh to myself when i checked the sitemeter the other day and realised that most visitors to MOADD arrive by a Google search for "i hate medicine."<br /><br /><span style="color: rgb(255, 0, 0); font-family: arial;">[i am off to see <span style="font-weight: bold;">the brian jonestown massacre</span> on sunday night. here's hoping for a fight.]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com6tag:blogger.com,1999:blog-17612141.post-1163454524705200312006-11-13T21:40:00.000+00:002006-11-13T21:50:02.896+00:00this is what happens when you fuck a stranger in the assnot pleased.<br /><br />friday night. the registrar informs me and the house officers that a hand in clinic is required on monday morning as the boss is away on leave. no problem i say, i'll give you a hand. the house officers are both here on the ward. they can kick things off in the morning, see the patients themselves, make some management plans etc etc. then i'll pop back after clinic, get the lowdown, see a few choice cuts, go to lunch and then grab the registrar for the afternoon to go through any issues. i can then nip off to do the third year medical student teaching i've been roped into and pop back for four thirty to tie up any problems. "it'll be great for the house officers" i say. "good practice and character building for the future... especially given that we'll be nearby, only a pager away."<br /><br />fine? the best laid plans?<br /><br />like fuck no.<br /><br />neither house officer showed up for work. convenient annual leave day and A&E shift respectively, conveniently NOT mentioned last friday.<br /><br />result. just got home, patients not properly seen, hurried teaching session, shitty care, and apologies all round.<br /><br />i am FUCKING LIVID.<br /><br /><span style="color: rgb(255, 0, 0);font-family:arial;" >[i am listening to sufjan stevens in an effort to calm me down]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com2tag:blogger.com,1999:blog-17612141.post-1163012357855631782006-11-08T18:34:00.000+00:002006-11-08T18:59:21.740+00:00dreaming of you<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.billions.com/artists/calexico/images/photo2.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 320px;" src="http://www.billions.com/artists/calexico/images/photo2.jpg" alt="" border="0" /></a><br />i heard on the news that captain nob cheese himself pete doherty, the talentless gomer of the libertines inexplicably fawned over by indie kids all over, is releasing a clothing label. i presume this is because he has realised that he is a waste of space whose time in music is near over and soon his name will be less than a whisper in the abyss of lost z-list celebrities.<br /><br />it was also good timing that i caught Calexico at the Camden Roundhouse this weekend. here are a band that have stayed pretty much off the mainstream (not sure why) but still have a strong following. needless to say they were brilliant. they are also such a bunch of chilled out guys (or so they seem) on stage and bloody talented musicians, each playing a couple of instruments. one of the guys (in the back, second left in the picture) is a superb guitarist/slide guitarist. he wandered onto stage with his funny glasses and his exceptionally non trendy shirt, waved once or twice to the audience and then blew us away with his music. at the end he waved again and toddled offstage with the rest of the band.<br /><br />what a great life. he doesn't feel the need to have to impress by getting himself into the tabloids wasted on coke. he wakes up in the morning, puts on his geeky shirt and then goes off and plays his guitar. straight down the line. and people love him for it. a simple existence.<br /><br />(he may be a total cock who beats his wife but go with me on this)<br /><br />oh for the simplicity of it all! it's so simple it's elegant.<br /><br />oh for a simple life.<br /><br />the lady mentioned before passed away on sunday.<br /><span style="color: rgb(255, 102, 102);font-family:arial;" >[i am listening to nina simone]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com7tag:blogger.com,1999:blog-17612141.post-1162593440429481952006-11-03T21:25:00.000+00:002006-11-03T22:37:21.816+00:00burning brighti have increasingly found myself adopting something of a clockwatcher attitude to work and also conveying my ethos to the new junior doctors. part of this is because our bosses badger us to make sure we leave on time for fear of reprimand by the government. more, it is because the NHS is such a miserable place to work these days.<br /><br />to be honest, apart from staying to help the person that becomes acutely unwell at 4.50pm, why <span style="font-weight: bold; font-style: italic;">would</span> anyone want to stay a minute longer than they have to in the dirty wards, in the company of disinterested staff, performing eight contrived tasks to attain one simple goal?<br /><br /> "thankless" is the wrong word to describe my job for it suggests that i want some kind of kudos, some kind of appreciation, above and beyond my paycheque, for what i do. wrong. i don't want hordes of patients throwing themselves at my feet in gratitude, pawing at my converse hightops, shedding tears of euphoria. "halleluia we have been SAVED."<br /><br />all i want is not to feel that i am constantly fighting against the system in order to make it work. everyday involves pushing and pushing and pushing to get things done. i feel like a shaven Samson (after a bit of how's your father with Delilah) trying to topple the pillars in the temple. only there is no divine intervention from God. because God has been replaced in the NHS by a protocol driven 4 hour maximum entry pathway into the kingdom of heaven and because divine intervention is not a part of Hospital At Night as it is provided as cross cover by the ENT registrar on call from home. is it a massive demand to want everything to flow a bit more easily, so that we can sit in a coracle and paddle calmly down the hospital river and out into the sea of good patient care without hitting big fuck off rocks.<br /><br />but back to clockwatching. despite all my efforts, tonight i find myself returning home five hours after i should have. "why Dr D&C?" you lament. "surely you must have been on the beers?" no. i shake my head.<br /><br />there is a lady who is dying on one of the wards. she was brought to hospital on death's door, nay, looking through death's letterbox asking if anyone was home. she has had a big stroke and her body is also riddled with infection. the bacteria have formed colonies on the valves of her heart and with each contraction of the heart little pieces of these colonies fly off into the blood stream and seed her lungs, her skin and her brain. she has been treated aggressively, perhaps out of scale with her pre admission quality of life (largely chairbound, her family doing EVERYTHING for her) but over the past few days it's been clear that we aren't winning and she is slipping away.<br /><br />it has fallen to me to speak to the family to tell them what's going on. i've called them several times each day but no response on their home phone. hardly surprising: the patient's daughter has four kids to school and work at the same time. anyway it gets to today - friday. again no response from the daughter's house but the nursing staff inform me that she did pop in at four and would be coming back later in the evening.<br /><br />the daughter is an intelligent worldly woman and she doesn't need to be a doctor to know that her mother is dying. she knows this and i know that she knows this from talking to her before. i could have just left it, packed my bags at five and taken off. the nurses could tell her that things weren't looking good and that her mum might die this weekend. and when her mum does die the nurses could also tell her that it was to be expected and she would probably have known that too.<br /><br />but i couldn't just leave it like that. nor could i do it all over a five minute phone call. i wanted to see her again in person and talk to her.<br /><br />i waited till she came back from picking her daughter up at 8pm, made her a tea and sat down with her. as i expected, she already knew what was going on, that her mother had not responded to treatment and was deteriorating. i told her that she would probably die in the next few days. she cried and cried and i felt like a proper cunt. i spent another half an hour talking to her about her mother, her life and her kids. she is exhausted from rushing to the hospital daily to looking after her kids and trying to work at the same time. she is in the real sense of the word remarkable. we then went to her mother's room and made sure the pillows were in the right position and that the blankets were covering her properly and that she was comfortable. i stopped all the unnecesssary medications and made sure all the drugs that she might need for pain relief, sickness, etc over the weekend were written up. i went and told the nurses three times what was going just so they wouldn't forget or fuck things up even more. i went back to the daughter, said my goodbyes and took myself off home as she cuddled her mum.<br /><br />so the clockwatching didn't go to plan. and five hours later i am finally home though drained and lacking a third of the weekend. but how could i leave work tonight with a situation like that? i couldn't leave that. you would surely have to have a heart of stone and acid for blood to leave her. and besides no-one else was going to do sit down and talk to her. i wonder whether the nurses would actually do it when faced with thirty other people to look after.<br /><br />i wonder if someone will do it for me or for my kids when i'm leaving this life. and when this lady dies this weekend i hope her daughter in her utter shitty grief can take maybe an atom of comfort in the knowledge that someone had the decency to tell her what was going on during her last days.<br /><br />and that's the final and probably most important thing i want. i can do without making the fancy diagnoses and performing the clever surgery. i can do without the stupid exams and the teaching hospital jobs. i just want this system to have a bit of fucking decency.Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com8tag:blogger.com,1999:blog-17612141.post-1161971006847739222006-10-27T18:18:00.000+01:002006-10-27T18:53:28.780+01:00MRCP PACES is one of my favourite things<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.jacobsschool.ucsd.edu/%7Elsmarr/photos/pensive%20daddy.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 200px;" src="http://www.jacobsschool.ucsd.edu/%7Elsmarr/photos/pensive%20daddy.jpg" alt="" border="0" /></a><br /><br /><br /><br />the car crash that was the MRCP PACES examination is over and the charred body of Dr D&C has been pulled from the burning wreckage. "he's so young" say trenchcoated detectives surveying the scene.<br /><br />it was needless to say a painful and humiliating experience. the work i'd put in for the past few months seem to head directly at high velocity down the toilet. having spent a sleepless night in a coastal guesthouse and arriving at the exam centre particularly nauseous (probably due to the earlier presentation of cereal and a full english breakfast in the hotel dining room), they proceeded to keep us waiting for an hour. nervous frivolous conversation with the other candidates was forced ("where do you work?" "is surrey nice this time of year?") interspersed with long periods of silence when all along i just wanted to scream and scream and scream whilst prising my eyeballs out with my stethoscope.<br /><br />the actual exam itself was even worse. for those potential candidates out there: people who say "enjoy it" and "it goes really quickly" and "they just want to see that you'd be someone they'd want to work with as a a registrar" are talking UTTER UTTER HORSESHIT. none of the above are true. i was criticised, grilled, wrongfooted and grilled and grilled and grilled again. i could not leave the hospital quickly enough and sped back to london thoroughly depressed.<br /><br />and i am still feeling pretty shit about it. like i said before i worked really hard, it didn't show and i can't bear to do it again. and i am forced to relive it regularly at work with everyone who keeps asking me what cases i got.<br /><br />on the plus side i am free now for at least for a month and a bit. i have been drinking every night (recreation and not always to drown sorrows) catching up with people i haven't seen for ages, reading normal nonmedical books, going to the theatre, i caught the david hockney exhibition at the national portrait gallery at the weekend, been cooking, and have LOTS of gigs lined up.<br /><br />i am also seriously thinking about quitting when it gets to august. i've seen a few postgrad courses in nonmedical things that i'd like to do. i think if i don't do this now i never will. the problems of financing and living in the extravagant way i have become used to rear their heads.<br /><br />i've realised that friends/colleagues who say they feel the same way about medicine as i do, don't actually do so. i don't think anyone i know will actually leave medicine despite what they say; in fact i think they are all planning the furthering of their careers despite their apparent misery.<br /><br />this makes me feel very lonely.<br /><br />and scared.<br /><br /><span style="color: rgb(255, 0, 0);font-family:arial;" >[i am listening to Saint Simon by <a href="http://theshins.com">the Shins</a>]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com18tag:blogger.com,1999:blog-17612141.post-1160933223636968692006-10-15T18:06:00.000+01:002006-10-19T22:46:16.633+01:00beer anyone?<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.carling.com/media/splash-logoonwhite.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px;" src="http://www.carling.com/media/splash-logoonwhite.jpg" alt="" border="0" /></a><br />no, this does not refer to the blanket text message i normally send out to most of my mobile phone's address book on a miserable sunday night.<br /><br />actually i thought i'd mention about the gazumping of music venues by Carling in this sometimes fair city.<br /><br />whilst Dr D&C has been getting the academic shit kicked out of him at various practice sessions/courses for the stupid exam this friday, Miss D&C has been having a jolly old time.<br /><br />last night she and three of her friends went to the <a href="http://www.xfm.co.uk/">XFm "big night out"</a>. Xfm for the non-Londoners among you is one of the indie/alternative radio stations here and despite being owned by the heinous Capital FM is relatively sound in its playlist. notably it doesn't play exclusively to the student population as Radio One (BBC) seems to do, and it has the brilliant Adam & Joe on Saturdays.<br /><br />anyways the line-up was supposedly quite good with the Fratellis playing and being held at Brixton Academy (one of the more cavernous venues in the city) the potential was there for some good music and a decent opportunity for some good ol' like mama used t'make indie clubbing action.<br /><br />Miss D&C was however sorely disappointed.<br /><br />for starters the three promised dancefloors turned out to be the main auditorium and then two corridors. not quite three dancefloors.<br /><br />secondly it was HEAVING and she and her friends were faced with hour long waits at the bar. like Dr D&C, she likes a tipple so i sympathise.<br /><br />but worst of all was the pricing. many of the music venues in london and increasing throughout the country are being bought out by big conglomerates. Carling, them of the beer fame, now own the Brixton Academy, or to give it's proper name the Carling Academy - Brixton, and as a result the five beers you can buy at any of their venues are Carling, Carling, Carling, Carling and Carling Extra Cold.<br /><br />Miss D&C and entourage had partially been enticed to pay the fifteen quid cover by the lure of 1.90 pints. oh the upset when they realised that this was only the case at one of the bars, and that the other bars in the venue ie. the emptier ones charged the same beer at just shy of four quid.<br /><br />"outrageous!" i cried. an indictment of the franchising at the expense of music. what next? see Foo Fighters at the KFC Empire Shepherds Bush? don't miss Primal Scream, headlining the Primark Koko, Camden? shame on you XFm for cashing in. but then as i said, they are owned by Capital Radio.<br /><br />anyways, tonight this lost doctor is sitting in a "luxury" room in a seaside town hotel as he awaits his membership of the royal college of ingrates exam tomorrow. a listless sleep i think. i have spent the past month and a bit buried in tomes and examining as many patients as possible. my brain feels like it's going to burst. i don't know if i'll be successful this time. all i know i'll give it my best shot and to be fair i've spent a lot more time preparing for this exam than any other.<br /><br />as of course dear readers i shall let you know how it goes. in the meantime it is time for some slumber, listening to the dirty sea lapping against the rubbish-strewn essex coastline.Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com5tag:blogger.com,1999:blog-17612141.post-1160391956433679762006-10-09T11:54:00.000+01:002006-10-09T12:05:56.453+01:00MOADD is one today!yes it is the first birthday of this blog and boy it is a happy day. the sun is shining and the intermittently good people of london are going about their business. i am not at work this morning either for i am currently in the second of two weeks of study leave.<br /><br />on the 20th of this month i shall be sitting the practical assessment of clinical examination skills or PACES which is the last examination for membership of the royal college of physicians, the arcane body that we must all seek to penetrate if we are to progress in our miserable careers. as always it is a ridiculously expensive, soul destroying affair and i for one cannot wait for it to be over.<br /><br />i spent a ridiculous amount of money on a course this weekend. it was very good but although i learnt a lot, the consistent grilling that i received from the examiners has torn a new arsehole in me. pictures some other time.<br /><br />otherwise what has changed in this year of MOADD. well the bookshelves are still up. i have had a few great holidays. i have had a lot of boozy nights. i am still very disheartened in my job.<br /><br />i have come to the (massive) revelation that it is not necessarily medicine but the NHS and healthcare in the UK that is upsetting me so. perhaps a move is on the cards?<br /><br />whatever happens i have decided that if i pass this exam i shall resign my job and chill out for a few months. and yah boo sucks too the consequences.<br /><br />of course the "if i pass" is a mountain of a proviso.<br /><br /><span style="color: rgb(255, 0, 0); font-family: arial;">[i am listening to The Coral, Dreaming Of You]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com3tag:blogger.com,1999:blog-17612141.post-1159954398373647382006-10-04T10:29:00.000+01:002006-10-04T10:48:13.380+01:00yee-ahhh, yah, yahhhhh: the best fight scene everi promise that this posting of videos is just a fad but i thought that maybe you should have a look at this excellent piece of hand-to-hand fighting choreography. it is classic for a number of reasons. there are several things about it which are absolutely bizarre:<br /><br />why is he in a white coat at the beginning?<br />where are they?<br />why do they take their tops off?<br />where did she come from? is her stunt double a man (is she a man)?<br />how did she break her arm?<br />what purpose did that bedsheet in the bucket serve ordinarily?<br /><br />i'm unsure as to what film this is so if anyone knows please tell (i think it may be one of almodovar's)<br /><br />vegas this one is largely for you.<br /><br /><object height="350" width="425"><param name="movie" value="http://www.youtube.com/v/T_tiBGOEoVM"><param name="wmode" value="transparent"><embed src="http://www.youtube.com/v/T_tiBGOEoVM" type="application/x-shockwave-flash" wmode="transparent" height="350" width="425"></object><br /><br />PS. given that i am currently studying for the royal college of wankers examination part 3 i also feel as though i should be removing my eyeballs. "yeah! see ya!"<br /><br /><span style="color: rgb(255, 0, 0);font-family:arial;" >[i am listening to cut the f*** up]</span>Dazed And Confusedhttp://www.blogger.com/profile/11718774509783516577noreply@blogger.com6