i choose hell

Dr P was a miserable man. i first met him in 2000 when i, as a fresh faced medical student, was spending time on a cardiology ward at one of the london teaching hospitals on placement. he was a registrar (not quite consultant), quiet, not up for any bullshit, happy to have a go at you (quietly) if you didn't know your stuff and seemed ever so world weary for someone who must have been about 34 years old. he was of course fiercely intelligent, hardworking and career minded and even then i knew that he would go far. his long fought after consultant post was surely looming.

last night, 6 years on, i receive a transferred patient from the same cardiology department at the same hospital. as i trudged through the dreary reams of photocopied notes imagine my surprise when i see entries from Dr P. the same concise instructions, the same copperplate handwriting, the same aura of tiredness... and yes still in the same position. STILL a registrar after all these years.

i couldn't believe it. i knew he'd been a reg for at least 4 years when i was a student so to date he must have been in the same position for at least 9 years.

he has been slogging his guts out for so long and has moved very far sideways. he was passionate about his subject and keen to please his bosses (they seemed to love him) and where has it got him? nowhere. what kind of job ensures that you do not progress after 9 years service.

i realised that night (in a fred savage wonder years voiceover moment) that tieing myself to hospital medicine (as i am 95% sure i have) is no guarantee of any progression to becoming a specialist in my field, no guarantee of any ascension to the right of some autonomy to research and practice as an expert. i too may flounder despite having years of experience when i am close to 40, hanging on the crazy whims of my superiors whilst around me the rest of life dessicates into a shrivelled world-prune, PURELY because the NHS has no scope to provide a clear career structure and trajectory. how passionate do you have to be to tolerate that? i have chosen a pathway to specialist medicine. i also appear to have chosen a pathway to (my idea of) hell.

"this year Dr D&C you will be doing a year of nights."

[i am listening to will you still love me tomorrow by the shirelles - i am DJing at a wedding in April and though it might be a good slow dance despite the lyrics]

shambles

my fear of total carnage on starting nights in doctor changeover week was confirmed. fortunately the doctor covering before i began my shift is a bit of an old hand and was almost on top of everything but there was still a load of crap to do.

renal medicine is all about pissing. if you piss that makes us happy. in fact a lot of medicine is about pissing. it is guaranteed that very soon into their first job a newly qualified doctor will be called up at an unsocial hour with the (in)famous "you remember Mr Eriksson, the football manager who's had his stomach taken out today? well he hasn't passed any urine for four hours." this is very important because the amount of urine someone passes is a good indicator of how well hydrated they are and whether their kidneys are receiving adequate blood flow. so the appropriate response to that call is to make a full assessment of the patient and their fluid balance. i must add that it is the appropriate response. the reflex response might actually be tempted to say "well doctor here hasn't had time to pass any urine all day but no one gives a shit about him."

so imagine my frustration to be told that the ill looking young guy in the side room, yes the one who's kidneys not only failed years back, but his first transplanted kidney failed and has been admitted cos his second bloody kidney transplant is also failing because of roaring infection, has not passed any urine all day. "i told the doctors during the day" said the nurse "but i'm not sure if they did anything." un-fucking-believable. this is the bloody RENAL unit! the whole bloody point of him being here is so that we can SAVE his transplant. anyway i wasn't happy. though i think i was happier than his melting kidney.

i was also pleased to receive a torrent of abuse at 6am from the guy who was supposed to go to theatre today for his surgery. i was told by the day team "oh yeah, can you check his bloods early in the morning as we want everything to be OK for his op today." yeah sure guys no problem. oh yeah, you might want to actually TELL the patient, nurses, surgeons, anaethetists and theatre staff that he's supposed to be having surgery. does help in my experience. so i got a lot of:

"you fucking cunt, you can't just fucking swan in here to take my bloods and tell me i've got to got for an op when no-one's told me fucking nothing. you're all cunts. i'm sure i've got MRSA from you dirty cunts. i'm gonna fuck you all up"

and so forth. but, by this point, the sun was rising, i could hear the birds singing and i'd spent 40 quid on Amazon buying CDs so i wasn't offended.

[i am listening to Get Free by The Vines who apparently have a new album out soon]

bleary eyes

http://thismassage.blogspot.com/

check out this blog. it is hilariously mad in a "i am delirious" kinda way. i have images of kevin spacey's character from Seven sitting behind a computer.

[i am listening to Float On by Modest Mouse]

not quite dead

no i haven't emigrated (yet) but i have been a little too distracted by other things to refill the blog of late.

i have however managed to travel around the country (taking in wales, hereford and nottingham) and spent a week snowboarding in Italy (i did take a tumble on the dunes and fear that i may have fractured my coccyx.) i have also failed my Part 2 exams (hurrah) but instead of self-flagellating have turned my attention to enjoying myself. in the pipeline i do have another visit from a group of canadians (their band are playing in london in march), tickets to sigur ros, a stag weekend and a week in stockholm. so all is good.

of course this shall be preceded by the ritual week of nights. happy happy joy joy as a tail-less cartoon cat once rejoiced.

furthermore this wednesday heralded the biannual changeover of doctors.

a quick word to you. NEVER EVER EVER be admitted to a british hospital in the first week of february or august. the NHS in all its incredulous wisdom ensures that every single junior doctor in the UK changes positions/hospitals on these two dates.

i haven't changed over for various reasons but our department is amok with new doctors who do not know how to do anything (because they have never worked at my hallowed hospital before) and hence i have had to carry the burden once again. this is not so bad except that i have left work very late the past few days (change the record) but a little disconcerting because, as i am on nights from today, the ward will be left in the hands of doctors who have never done any renal medicine at all.

hence, i apologise for my absence. i am not quite dead but after this week i cannot guarantee the same of the patients.

ciao ciao

the most depressing things about the age you live in - the list

leading on from the point before, i suggest we compile this list. please leave your suggestions in comments and i shall collate them at some point. then you can print it out and stick it on your wall, or email it to colleagues. and then maybe it shall be used as soundbite for some talking head on BBC2 or perhaps even get it's own spin-off series on Channel 4. "The Best Worst Things About The Modern Age Ever" - can you imagine?

whilst i'm here please go and see NHS Blog Doctor for a dark, funny, eloquently written weblog by a similarly disheartened doctor (albeit with much more experience. i don't think he has much hope for me - or my patients...)

two thousand and six

happy new year my friends. i hope that you are all dusting off your gym memberships and promising to be a little nicer to your fellow humans in the months to come.

i managed to forget the travails of my special christmas nights on call with a quick sojourn to the countryside (ah how the urban squalor is being knocked out of me as time ticks on) for new year weekend and a meeting of minds with my dear vegas oop north on tuesday. a grand round if you like. i think that, having missed out on any human contact outside of work over the holiday period, this period of post-nights recuperation has been extremely therapeutic for my emotional wellbeing. i shall return to work tomorrow beaming. i do have the weekend to do but let's set that to one side.

vegas and i did not make any headway in the search for life/job satisfaction. there were no answers to be found and we have conceded that four months after starting our blogs we are no better off. we did however discover that rio ferdinand is a waste of space and that jose antonio reyes should perhaps be referred to a local falls assessment programme. we also found out that it is possible to dance without a care in a club filled with less than twenty people if the Arcade Fire are playing and enough Red Stripe/whisky has passed over the bar (the venue happened to a be a local indie nightspot and as such was "filled" with A-level students as comes with the music - how old we felt and looked).

the news has been eyeopening and tearshedding in equal measure over the new year period. there appears to be a glut of horrible things happening to young children. i am never sure if this reflects a Catholic degeneration of our society or whether we are just more aware of such sinister goings on as a result of increased reporting.

incidentally, i did note that the ex-director of NICE (national institute for cost effectiveness) was struck off for perving over kids on the internet. well, grooming teenagers on chatrooms actually. he has since resigned from his position as director of the Institute's Interventional Procedures Programme. suspiciously, a week before that, all catheter ablations were cancelledby an oxfordshire NHS trust. (an interventional procedure whereby the electrical wiring system in the heart is altered to prevent funny unpleasant heart rhythms.) coincidence? i don't think so... you just don't know how deep the conspiracy goes. straight to the president. they knew about it all along, etc etc

i also watch with trepidation at the progress of Ariel Sharon more for what it will mean for the middle east (those three words are now the stock epithet for the Israel-Palestine conflict) which by the way is surely high on the "most depressing things about the age you live in" list. besides if he's on the neurosurgical ward he's probably been left without any fluids and his urinary catheter clamped, whilst the infected bedsore slowly disseminates MRSA to his bloodstream. much like the poor bastard i was referred at 4am on christmas morning ("perhaps you would like to prescribe him some antibiotics that might actually kill the bacteria responsible for his sepsis rather than just give him the shits and make his life even more miserable" was my final suggestion before leaving).

this new year i shall also be keeping a close eye on the activities our dear health secretary who is fast becoming the government's Emperor Palpatine to our pathetic rebel workforce. soon you shall feel the awesome power of her fully operational private health service.

i do, as always, have a theory.

it is my fear her multiple trips across the galaxy via some kind of interdimensional wormhole excavated from beneath the desert in Egypt may have affected her mental health. worse still, i suspecting that she may be currently influenced by some kind of symbiotic all-powerful alien being who, inhabiting her human body and feeding off her very life energy, is hellbent on crushing any decent medical care for this country's people whilst simultaneously strangling the motivation of its doctors. we shall see.

Patricia Hewitt, Health Secretary, pictured above fielding questions from journalists

James Spader, actor, pictured above in "Stargate"

[i am listening to Liezah by The Coral]
[i have just finished reading We Need To Talk About Kevin by Lionel Shriver. absolutely amazing - i did hate the main character for most of the book and then you read the last three chapters. i was blown away. certainly one for your list.]

the christmas of a disheartened doctor

it has been five extremely busy days. work has been punishing as always with insufferable late finishes.

the big plus was that my good old bro-seph from Vancouver has been in town so we have been schmoozing around london all week. it has also been quite heavy from a beer perspective and i have had to tolerate his insistence on drinking Newcastle Brown Ale which, for those uninitiated, tastes like tepid hard water. i on the other hand much prefer the gaseous slip of monsieur kronenberg.

but i have been trying to condense the best and worst of London into a few evenings and i certainly have a had an absolute ball. we were privvy to a performance by the worst singer-songwriter in the world at the 12 Bar on Denmark Street. there are photos and video footage which i shall endeavour to post.

needless to say i am shattered by 2am bedtimes and 6.30am wake ups, in addition to the sheer amount of crap at work such as the inability of a handover to be completed at 5.30pm, not because of sick patients but because people are too busy getting cups of tea, discussing their plans for the holidays etc.

ah yes holidays.

as mentioned before i am NOT going to be seeing any loved ones this year (excuse me, for the THIRD year in a row) but instead am getting ready to go into the hospital. it would of course be impossible to organise a rota where the holiday period shifts are equally divided amongst staff so that everyone gets at least one day off. no much easier to completely screw one doctor over (well two - the poor bastard who has to do the day shifts over xmas). so today after waving off my friend and then snatching a few hours with my special ladyfriend before also waving her off, i have been twiddling my thumbs at home. she has kindly left me loads of presents to open on christmas day and made a hamper for me to take in on christmas eve (she is the best!) but it's no way the same.

this christmas eve, santa will do his on call (1 in 365) whizz through london whilst i shall be on the ward trying to make the best of it. and then i shall return home on christmas morning (though i am not sure how because there is no public transport and hmmm of course the hospital has organised transport for its workers not) to my cold flat, maybe eat my turkey dinner for one or perhaps forgo it in favour of sleep. then, whilst families in the rest of england sits bloated in front of the telly, i shall begin my trudge again into work.

i love medicine. everyday i work as hard as possible and try to do the best for the patients even when my motivation levels are below zero.

but, i really did not sign up for this continual soul whipping.

anyway (this is sincere) wherever you are and whatever you are doing, have a great christmas everyone.

[i am listening to one of my favourite songs in the world: one of these things first by nick drake]

saturday sun

it is very exciting this weekend. the weather is gorgeous, i am not working, chelsea play arsenal and tomorrow...

... the canadians arrive.

[i am listening to the decemberists]

what are the chances of that happening

today i have mostly been wiping my fucking nose and tolerating that boring into your eyes feeling when you get the 'flu. i also got the short straw again by having to do all the frigging central lines too (big drip lines that go into big veins either deep in your neck or charming groin) and then two people decided to have cardiac arrests simultaneously (they are both ok by the way) so lots of running around. so once more i left late (not that i have a problem staying late for sick people) and what's that? oh hello there hospital management. oh really? you've done the audit and i'm working less hours than ever before? well i guess i can't disagree with your study. of course it's fine to cut my take home pay by £500 a month. no, thank you.

i was gagging for a pint but cannot do anything without having to wipe my nose every two seconds and so all hopes of beer have disappeared out the window.

i really cannot wait for christmas when incidentally i am on nights (23rd Dec to 29th Dec.)

"what did you get for christmas?"

"four new admissions."

"what did santa bring you this year?"

"nothing. santa does not bring anything for naughty boys who stay up all night."

you could not fucking make this up. you really could not.

ps. absolutely categorically NO photos. the whole point of this blog is that i remain arrogant behind a shallow veneer of anonymity (despite now having 3 mates on here)

[i am listening to ben folds, songs for silverman]

and my apartment smells of rich mahogany

the herculean trial that was the membership of the royal college of wankers exam Part 2 is thankfully over until the imminent resit and loss of a further £290 (yes £290 - $600 for the Canadians - i know you're reading this.) i can only hope that the tossers at the college had a bloody good piss-up the night before the exams. i can only imagine the scene in the smoking room (i don't even know if they have one but i bet they do):

"i say sebastian we certainly have excelled ourselves this year!"
"ha ha! you're absolutely right charles! i think it is sheer genius that three times a year we continually set the most esoteric of questions, make sure that anyone who does not sit the exam hits a career brick wall and manage to make them pay us for the privilege!"
"ha ha! we're great we are! more champers?"
"is brucellosis rare? by the way what time do the whores get here?"
" very soon i hope. i'll get the lube! thank you junior doctors! i'm going to put this on my weblog tomorrow. ha ha!"

i did suggest that after the exam we partake in a wicker man style burning of the college but opted for the pub instead. (vegas was of course present, on a quick sojourn from the north - his blog will be darker than ever this week as the poor fella is on nights again.)

i was also pleased to hear that the american department of homeland security managed to kill someone who did not possess a bomb/was not a terrorist. a close shave. will this be another jean charles de menezes? or will it be swept under the carpet with all that illegal war/torture/insane foreign policy nonsense?
[NB. i haven't actually caught the full story on what happened there although given that it's not on any of the american news websites at the moment i imagine my gut feelings are correct. i did however read an interesting piece on paris hilton's lawn display at her home on whore island]

back to school tomorrow and that is not depressing at all.

RIP Richard Pryor

[I am listening to Bittersweet Bundle of Misery by Graham Coxon]

Your exam question for the evening

you are called to review a 26 year old doctor in London. he is currently at a career crossroads of sorts partly due to the fact that the profession he is working in is dying a slow painful death under the weight of beaureaucracy, and, that life satisfaction is at an all time low because of the vast amount of time invested without reward in said profession. tonight he is attempting to review a series of topics for his postgraduate examination tomorrow. however fatigue is clearly setting in and you note his heavy eyelids of exhaustion as he thumbs through yet another book of practice questions. you note no rashes and he has no pets but has travelled to western canada earlier this year.

what will be the MOST appropriate way to manage this patient? (select best response from five)

A. sit down with the patient and explain to him that everyone has doubts about their direction in life at some point. this is most likely a transitory period and if in a few months he still feels this way then perhaps some time out to rejuvenate and reflect may be very beneficial. as for the exam, it is not the be all and end all and also can be sat again if necessary.

B. slap him about and kick him in the nads because he's an annoying fuck and deserves a good kicking.

C. nod sagely while he drones on with his "nah nah nah but what is the point if medical training is being sacrificed for meeting government targets nah nah nah" and see if there's anything worth nicking from his flat. hmm... 20 GB 4th gen ipod in corner... doesn't appear to work though...

D. pick up his immaculately compiled revision notes, rip them up then taking a dump on the shreds whilst saying "how do you like that bitch? how do you like that?"

E. intravenous antibiotics and urgent per rectum examination

5 minutes allocated. answers tomorrow.

[I am listening to Hope by R.E.M - formerly Leonard Cohen]

Little things

i'm about to make my way in to tackle the beast. delightful.

at least the bus stops outside my house.

and at least the imperial war museum looks radiant in the winter sun.

[I am listening to young pilgrims by the shins whilst doing some cramming]

Some people are wankers

i've had some troubling news. i was informed by a good friend that one of our old registrars (senior doctor) committed suicide. we'd both worked with him when we were doing surgery in our first year fresh out of med school. he was a great doctor with the driest sense of humour ever and a glowing career. we always knew he was pretty eccentric and did suffer from depression but obviously something changed over the past year or so. i don't know what and probably never will.

I won't go into the background too much. there's a slightly disparaging article from the local press here about the coroner's report. what's worse, however, is this (scroll down to nov 29th): a frivoulous piece of shit that actually makes light of the fact that he committed suicide.

i'm never one to be PC. but, to belittle and poke fun someone who obviously had severe mental health problems and then TOOK THEIR OWN LIFE is a pretty cheap shot.

needless to say my mate and i have written pretty terse emails to the author of the article. i might post my email on here later.

let me know if you think i'm overreacting. i don't think i am.

on a somewhat brighter note, another good friend has also joined blogdom. you can see his site here, also continuing the white on black colour theme that is slowly becoming the watermark of disillusioned medical blogs. go see the confessions of a venial sinner.

[i am listening to arethra franklin, say a little prayer for you]

Flunking

i am rapidly failing this exam. 10 days to go and i still have loads to do, no study leave, three on calls and increasing amounts of crap at work to deal with.

i am looking at dermatology/haematology slides before going to bed, reading notes on the way to/from work, doing questions when i get home, etc. i am even more drained than before.

tried to be positive at work today (monday and all) and was frustrated once again. as NO-ONE (nurses/porters/radiographers) seemed to give a shit that one of my patients (not very sick at all, routine investigation booked from friday) needed a chest x-ray i wheeled him round to the department myself, sat for fifteen minutes while he had it done and wheeled him back to the ward. because i knew that if i didn't no-one else would, no-one else would care except me and him, and at the end of the day i'd take the heat when it wasn't done. i hope all the taxpayers in this country are glad that they paid for my six years training and my current salary to be a porter.

so frustrating. i am so annoyed (not really at that - i had a good old chin-wag with the patient on the way to radiology - he's written ten novels!). grrrr. and so very tired.

thinking positively now. tomorrow i have the 8am X-ray meeting to look forward to... and then the on call till nine...

D&C may be away for a little while until after the exam (next weds/thurs)

[i am listening to Only You by the Flying Pickets]

The road less travelled

apologies firstly for the lack of communication. i was recuperating following the trials of the course and yet another weekend on call. i was so busy doing the course that i didn't really have time to let the horrible belly aching anticipation of a weekend set in. and when it came round to it, it was quick and relatively painless (though not for my patient who needed a chest drain - think of a hosepipe plunged into the chest wall and you're not far off. ouch.)

tonight i struggled to get much studying done so instead opted at about 10pm to go meet a guy i grew up with. he was meeting some other friends for a beer and asked me to come along as it was local. he's moving abroad in three weeks and i probably won't see him for some time so i thought now was as good as any night.

it was weird. our lives have diverged so much. we used to spend all our time together from about 5 to 15 years old. but i don't think we could be any different. it was still a good laugh. but... strange. i'm not exactly sure how to describe the feeling. it just didn't seem natural, like when i'm around my friends now, which is all the more peculiar as we have more history than people i know now and regard as my closest.

he was saying at one point (a little intoxicated - he'd been in the pub some time) that he was jealous of me which came as a real surprise and i did feel a little uncomfortable. i suppose it comes down to frames of reference. he has no concept of how difficult i'm finding things at the moment (though let's make it clear my life is no homeless in quake ridden pakistan or bombed baghdad) but to be fair i have no idea of what his life is like. not really anyway. i was struck by how unsure of himself he was despite his essex swagger and gift of the gab (i have inadvertantly given away my background...) and thought underlying all the gags and banter we had that there was this tinge of melancholy. i don't know really. as i said our lives have really gone in different ways.

i wonder what will happen to him when he leaves the country. he's going to canada to live with his fiancee. i hope he'll be happy and i wish him all the best.

will i see him again? honestly? probably not. we are so different now. and although i know that, it makes me very sad. when you're tiny you think that now is forever. it's only later that you realise how transient moments actually are.

will stop now as things are getting too dark! i did see a dog to day wearing a little red jumper which made me laugh. as if he said "hmmm what shall i put on this morning? i know! something bright as it's so miserable outside!"

[i am falling asleep to staralfur by sigur ros]

who's got a gun?

my ipod has just died.

this stupid picture of a sad face has just come up on the screen and i have spent the past two hours doing all the bollocks that apple suggest on their website.

i am actually going to have to kill myself.

time for bed before i have a stroke.

[i am listening to The Promise by When In Rome but obviously on the computer and NOT on my ipod]

The Fall

no, this is not my equivalent of "Despair" on Nip/Fuct (he's ok by the way) but actually a reference to it officially being autumn!

i LOVE this time of year! it's really cold but it's bright and sunny, the leaves are crunchy on the ground and everyone seems so cosy in their hats, gloves and scarves. well, as cosy as you can get on the tube at rush hour.

and as you can tell i survived my week of nights. the last night was horrifically busy and i had a very ill man indeed. he had suddenly deteriorated about an hour into my shift to what we call peri-arrest (about to arrest ie. stop breathing/heart stops/both.) there were a lot of hairy moments overnight but we managed to keep him this side of alive and in the morning he was much better, sitting up, off his oxygen mask and asking for breakfast. i was pretty happy and left work feeling content. that's the first time that i've felt like that in ages.

i've spent the weekend enjoying myself. no studying, no medicine, just some fun times (and sleeping). got to see some old friends, some of whom had lots of news (i tink you know who you are) and there was of course the England game. what an awesome match! though i have overdone the beer. lucky...

i am now off work till friday (when i work the weekend again) but at a course. it's funny sitting in a lecture theatre again and it's a little irritating being surrounded by annoying doctors who ask inappropriate questions of the lecturers.

"oh yes. i have a question. no over here. look at me. it's got nothing to do with your talk and isn't going to benefit anyone else in here - in fact it's going to have dubious benefit for me but i'm still going to ask it because frankly isn't the sound of my voice great? look at me. me baby."

it's in the middle of town, in an area where several university colleges are clustered. i was looking around at all these 18/19 year old freshers (not in a pervy way - well maybe for a few minutes) coming in and out of all these grand old historic buildings and was wondering what it would have been like to go to college round there, instead of having spent my uni years around hospitals.

i'm quite upset by all the trouble in France. (not putting a link as it's on the front page of everything) so much of the media seems to concentrate on putting the blame on someone/something (eg. ineffectual measures by successive governments to address their most impoverished, ghetto-ised communities) without coming up with any solutions. and as much as we'd like to think we're cultures apart from the French, from a social structure frame of reference a lot of British cities are VERY similar. you only have to take a walk around my hospital's catchment area to see that. there is undeniably tension.

all of which means i am SO disinterested in the Tory leadership campaigns of the two davids. they should both be put on lithium (perhaps they could get Patricia Hewitt some too. just a thought.) i am pleased that (Dr) Liam Fox is out because he's quite quite toxic (as one of my lecturers once said) and feel the same of Kenneth Clarke. that tosser has already screwed up the NHS once as health secretary AND he's deputy chairman of British American Tobacco. Blatant hypocrisy? Fucking nuts more like.

finally i am excited because firstly someone i have missed immensely over the past two months comes back to london next week. hooray.

and also another buddy of mine from across the pond is visiting just before Xmas. he has recently got married (though sadly i don't think his charming wife is coming along) and i was well chuffed to have been invited to the wedding in Sept in Vancouver. you should have a look at his record label Copperspine Records.

good times :)

[i am listening to Lovely Day by Bill Withers. awwww!]

Strange Days

night 6 of 7

i can't sleep at the moment because although it's really quiet a) i'm not allowed to sleep and b) there isn't anywhere to sleep. well there is an on-call room but it's about seven minutes from the ward (too far in case something goes horribly wrong) and it's a bit like the place Buffalo Bill from Silence of the Lambs lives in only not as homely or fragrant.

tonight is actually the quietest it's been yet. i've still managed to make a complete five course meal out of the simple tasks i had to do this evening. sigh.

i've decided that i'm the worst judge of character ever. i've just had a long chat with one of the doctors from A&E who i always see poncing about and acting like a complete dick. he's very posh and i must admit i'm very prejudiced (hopefully my only prejudice) towards posh accents, completely irrationally. anyway, turns out he's really lovely and we had quite a good laugh. i really must stop writing people off after five seconds of exposure.

i don't know if you've been reading the papers this week but it's been completely bizarre. i am convinced that the world has gone completely utterly nuts.

obviously there's the great news that Kaiser Tony's attempt to detain people for 90 days for being brown skinned/bearded has been quashed. i'm sure he's not been the same since he had his supraventricular tachycardia ablated. bloody cardiologists.

also apparently there's a certain percentage of british children that believe that chips/fries are made from apples. un-fucking-believable.

and patricia hewitt. enough said. it appears kim-jong-tony appointed her health secretary for the sole purpose of whipping the NHS' rotting carcass a bit more. "make sure it's completely dead Pat." she of such einstein-ian proposals as giving hospital buildings constructed for NHS use to the private sector. and today she appears to have at some point gained enough credentials to become an oncology specialist [Hewitt "has left NHS toothless"]

well now the news round is over i'm going to go and copy the blood results from the computer to the blood results folder. somebody call the crazy police because i need to be arrested.

[i am listening to Pink Floyd]

I Am My Job

one of my good buddies has just informed me that he has started his own blog. i am a little embarrassed because firstly he says that it was inspired by this one and secondly his writing is much more accomplished.

i don't think he will disagree too much if i say it's (also?) about a search for something missing.

please please go and see it here.

Resident Evil

it's night 3 of 7 and it's going OK so far. well i've managed to get time to put this post up so it can't be too bad.

there have been lots of emergency admissions from casualty so although i've been kept busy it's been a good busy. busy looking after people as opposed to paperwork busy. again there have been some quite difficult cases, one in particular involving a 20-something guy who has really been through the wars with lots of hospital admissions. too many things to go into but suffice to say some people really do get dealt a harsh hand in this crappy life.

i'm pretty tired surprisingly as i don't usually start flaking out till night 6 or 7. i think i tried to go into this set of nights a bit more positive than normal so maybe it's that (emotional energy expenditure or something). i'm also trying to keep myself going with a technique that one of my friends suggested (Vegas who runs the Nip/Fuct blog.) he suggests psychologically splitting the week into 4 nights and 3 nights. so i've only REALLY got one more night left. hooray.

to end with i just wanted to say that i apologise if this blog is a bit too negative and "dark" (which is scarily the adjective several people have used to describe it) - it's not really meant to be. i just put down a stream of consciousness when i start typing. yes there's a lot of frustration but honestly i am still quite cheery in real life! a lot of people who haven't seen me since i started MOADD (have you caught on to my insistence of using that acronym?) are quite surprised when they actually speak to me and find me the same as i've always been. not the jaded, scowling, anaemic cynic they expect.

i would also hate anyone to think that i go to my patients and say:

"how are you today sir? not so good? well you should see the shit i've been doing and how crap this day has been. so yeah why don't you take these antibiotics and get yourself and your pneumonia out of my fucking face."

not all of them anyway. only the ones that have hurt people.

so, for the record, i am not severely depressed. (that can change, however, as i have just seen the football scores.)

and just to prove i am not entering a dark dark place, here is a story from the onion about a big doggy to warm you to the cockles of your hearts and maybe to below your cockles, to the sub-cockular area. (points if you post the song title and singer in comments)

http://www.theonion.com/content/node/29848

[i am listening to Robbie Williams because i can't get another station on the radio in the office]