MRCP PACES is one of my favourite things

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.

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.

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.

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.

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.

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.

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.

this makes me feel very lonely.

and scared.

[i am listening to Saint Simon by the Shins]

beer anyone?

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.

actually i thought i'd mention about the gazumping of music venues by Carling in this sometimes fair city.

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.

last night she and three of her friends went to the XFm "big night out". 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.

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.

Miss D&C was however sorely disappointed.

for starters the three promised dancefloors turned out to be the main auditorium and then two corridors. not quite three dancefloors.

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.

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.

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.

"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.

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.

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.

MOADD 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.

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.

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.

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.

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?

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.

of course the "if i pass" is a mountain of a proviso.

[i am listening to The Coral, Dreaming Of You]

yee-ahhh, yah, yahhhhh: the best fight scene ever

i 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:

why is he in a white coat at the beginning?
where are they?
why do they take their tops off?
where did she come from? is her stunt double a man (is she a man)?
how did she break her arm?
what purpose did that bedsheet in the bucket serve ordinarily?

i'm unsure as to what film this is so if anyone knows please tell (i think it may be one of almodovar's)

vegas this one is largely for you.



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!"

[i am listening to cut the f*** up]

lost doctor in holiday shocker

i shall be leaving these shores for a bit of a break tomorrow. Miss D&C and i shall be drinking the finest croatian champagne and sitting on the beach for the next week

in the meantime i leave you with two links

the first shows what a "grrreat" country i live in. i particularly enjoyed the mass rape catalogue (have a look) - the authors of this site are clearly in the parlance of our times a bunch of utter fucks

i am an englishman

secondly and much more fun and a work of SHEER UTTER GENIUS is the latest video from OK Go! who you might remember from their single Get Over It a few years ago. who would have thought treadmills could be so good.

watch this and enjoy!

see you in a week



[I am listening to Ok Go! of course]

miserable sullen bastards

regular readers of MOADD (all 4 of them) will probably have realised that the lost doctor is not always the happiest of bunnies with stethoscopes (possible playboy shoot).

this is generally due to the fact that the NHS is actively and passively raping him day in day out. it would not be a huge generalisation to suggest that this motif of melancholy courses through most of the UK doctors' blogs listed to the side (except the venial sinner perhaps as he is too often loaded or in lurve.)

the current few weeks have been particularly trying. you may well remember that august and february are seminal in the NHSian calendar because these are the times when the new blood hit the wards. the recent intake of new doctors are fucking me off.

firstly they don't do a great deal. secondly i don't think they CAN do a great deal - this is likely to be due the dumbing down of training. thirdly, 1 and 2 could be overlooked if these guys were a bit of a laugh but FUCK ME they are DULLARDS.

admittedly my two juniors are very good and fun to work with it's just that i find myself wondering around the wards keeping myself to myself in case i am trapped in a ritual seppuku inducing conversation with anyone else.

things haven't been helped by the fact that my job has changed and i have leapfrogged in on call rota back to two months ago when i was doing shitloads of nights. i feel i am being taken for the proverbial ride when it comes to night shifts.

this aggression shall not stand.

in the interim, the FISH continue to multiply. next to the fish false idol posters over the wards have appeared small whiteboards with the "attitude of the day" written on them. these are such vacuous mindsets as "fun" or "thoughtful" or "happy" for example. the management haven't thought about asking me to suggest the attitude for the day yet probably because they understand that "fuck your mother" is not the best way to engender a culture of teamworking.


[i am listening to The Concretes]

lost doctor in internet voyeur shock

as gary oldman once said, "i am very disappointed."

i have shed the shackles of this profession in the past few days and have been out drinking and clubbing for not just one but two weeks (count 'em) in a row.

i have been, to say the least, very pleased with myself.

until i realised that the photographer supposedly taking random shots at the last club i was at had actually decided to snap my normally beautiful face in the most awkward of poses and, to add insult to injury, plaster it all over the internet for all to see and point and laugh at.

you will of course appreciate the reasons for not posting a link to said picture here on MOADD.

i lament the state of the world when ordinary folks like myself should fear going out for being snapped by a wannabe paparazzo.

posh and becks: i know how you feel.

and to top this, the CANADIANS have pulled a similar stunt. they have hidden a pic on their website which is also the least flattering portrait one could imagine, emphasising an extremely tired D&C post nights attempting to non-chalantly point at the camera very casually but ultimately looking like what can only be described as a total cunt. and therefore no link shall exist to this photo either.

i can only imagine that they have done this for pure comedy reasons.

as a result the london canadian embassy 2 is closed indefinitely.

the lost doctor is very disappointed.

[the holloways are barely keeping me happy with their new single two left feet. alternatively i suggest you check out apathy using a sample from the white stripes on "it takes a seven nation army to hold me back."]

[if you haven't already bought a copy of Casa by my good buddy Roger (Dean Young and The Tin Cup|), I implore you to do so - "eez very cheeep for to do romance inside you" as Borat might say - look here]

the miscalculation

i feel a bit like denzel washington at the end of "Man on Fire" - i shall not spoil the ending but i foolishly have swapped my on call shifts with oblivion this week.

having finished my set of nights on friday morning, i now realise that i also agreed to do this weekend too. hence i have that heartsink feeling one gets when england go out on penalties (man on fire is not about on call rotas or football for your information.)

so off i am to work in half an hour. i know for a fact that NO-ONE is awake at this time on sunday morning. i also feel disconcerted because a friend of mine had a spare ticket to the Red Hot Chili Peppers last night. i keep telling my self that i don't actually like them (release the same song over and over, never topped 1991's Blood Sugar Sex Magik, etc) but it would have been good to see my buddy with whom i spent three months touring the world a few years back.

i am going to have my breakfast and think about the milk situation at work.

[i am listening to Oh Inverted World, the first album by the Shins who i keep missing each time they play the UK because of surprise surprise work]

the memory of milk

this is the door to the fridge in the doctors mess.

each of the bottles has about 30mL of milk left in the bottom. there are about 15 full unopened bottles in the fridge itself.

people do not finish the bottles. some unspoken fear of drinking the milk at bottom of the bottles prevents them from doing so. they replace the bottles in the door and open a new one, which, in time, also joins the graveyard of nearly finished bottles. the milk remnants are perfectly drinkable and at the correct temperature (cold).

no one speaks of this. lips remain tightly shut, heads turn away. it is the way it has always been and it is the way it shall always be.

what has happened here? who is controlling this?

it puzzles and concerns me. we are NOT who we appear to be.

i glance around furtively in fear that i may at any moment be hoisted into a massive NHS wicker man.

[i am listening to Eleanor Put Your Boots On by Franz Ferdinand]

in other news

i have forgotten to mention that the venial sinner is actually working side by side with me on the wards at the moment. i had not expected his smug face to pass my field of vision in working hours so was surprised to see him rock up to FISH ward 1 looking scared and lost last wednesday.

i am hoping the travails of day to day work will be made easier by the presence of a co-worker who will never say no to cheeky coffee and post 5pm beers.

what japes there shall be! what tricks we will pull! bloods will remain undrawn! investigations will be unordered! results will not be filed! patients will have rasberries blown in their faces! professors shall be mooned as consultants are wedgied! and then together we shall skip merrily down the corridors to medical anarchy. viva la revolution.

when i get back from nights of course.

[i am listening to Hot Fuss by the Killers. dare i say not as good as when it first came out?]

fully operational battle station

i feel i've made a little headway to finding the answers (or at least some of them) to the questions i first posed when i started this 'blog. this has to some extent been consolidated by a long conversation i had with the bishop (himself about to enter into the medical world) on friday night, fuelled by beer in a pub that used to have a bare knuckle boxing ring upstairs.

it is obvious that some things will never change. at least i have a bit of an idea as to what those things are.

a lot of what lies ahead is worrying, some is exciting, some is going to be a fucking nightmare.

still at least i have had the sun in london to help me with my thinking.

a week of nights awaits but i'm actually looking forward to a big breakfast tomorrow.

my foot in green park earlier this evening

[i am listening (and watching) the world cup final live on the internet - thank you the BBC]

as a reminder

i was walking down the stairs to the "mess" (the room that we doctors spend a tenner a month funding so that it acts as a safe haven away from the barking commands of other healthcare professionals) when i noticed this new sign. i broke out in hysterical laughter which then descended into crying and wailing. to top things off my purchased sodexho sandwich disintegrated in my hands moments later "salmon and dill" all over the floor.


[i am listening to regina spektor - buy her new album! it's great! and she seems a bit nuts in a tori amos way]

no expense spared

in these times of massive NHS deficit, you will be pleased to hear that my trust has been investing its elusive budget in worthwhile projects.

last week the following appeared on several wards:

they gradually multiplied in number to the point where most of the medical wards were covered in them.

plastered on the patient board, on the doors to the staff rooms, over the treatment room, etc

what are they? i asked around.

the doctors certainly didn't know. the ward clerk muttered something about management.

the nurses all smiled cheekily and said they couldn't tell me.

the senior nurses/matron all gleefully said "ah ha - you'll find out next week."

i did wonder whether i had wandered into john malkovich's head or perhaps the deck of the marie celeste but instead chose to try and get on with my job as reality decayed around me. i kept glancing around to see if ALF was going to appear.

anyway, so this week i stumbled into the staff room on one of the wards to see the table cleared away and lots of different coloured card, glitter, glue and felt tips replacing the usual array of rotas and handover sheets. using these tools were several hypnotically happy members of the nursing staff engaged in the making of cardboard fish and adding them to a big wall display of more fish where the noticeboard used to be.

yee gads i thought. has everyone been hit by some childhood regression alien virus? has some devilish pied piper character drawn everyone into some sort of strange cult of collage? have people been drinking the hospital Sodexho tap water again?

i still couldn't get a straight answer out of anyone through their glazed, pritt-stick covered eyes and then saw a poster (replacing the antibiotic guidance one) referring to the fish philosophy.

"for Crippen's sake, what the fuck is the fish philosophy?" you may ask, as i did as i negotiated my way through the sea of crayons.

well i suggest you check out the website. (please please have sound enabled)

once you have finished chucking out your guts in laughter/nausea pinch yourself and ask whether the world has truly gone completely nuts.

as far as i am aware, under the fish scheme staff get a "fish" for doing something "great" and once they accumulate 5 fishes they get a free cup of rancid Sodexho coffee.

i don't know how fish define something great. maybe it's... let's see... something to do with doing your job?

this is worrying for two reasons; firstly that nursing morale is so goddamn low on the medical wards (the nurses there are by and large very good but VASTLY overstretched and under supported) that they need some crazy scheme to reassure them that they're doing something worthwhile.

secondly it suggests that someone actually thought this was a grrr-eat idea and was swayed by some tosser in a lime green shirt. i dread to think how much this has cost and how many prostitutes lime green man has indulged himself with for that sum.

am i being harsh? am i completely out of touch with modern management techniques?

or do you also think this smells of horseshit? surely this is not the way to re-inspire a workforce.

i am, as always, open to the view of the blog panel.

in the interim i am not making any fucking fish.

[i am listening to Creedence Clearwater Revival - Lookin' out my back door]
[DISCLAIMER: this does not represent the views of my NHS trust... oh dear, i may get fired]

why so mean?

so ok i'm not hitting the 30 days. but then i realised visiting the site that several infinitely more talented people are producing real works rather than babbling on a blog.

i am currently a bit dazed. i have just returned from the Ritzy having seen Paul Greengrass' United 93. i'm not quite sure how i feel about the film. i shall have to sleep on it. certainly there was no ben affleck to save the day. very harrowing.

the canadian embassy has closed down for a few days so i am back in my home. it has been a wonderful weekend, partly because the sun has allowed for lazing with the papers and picnic food in the park.

i also went to the wedding of a friend from med school on saturday night. a great day and a chance to catch up with old buddies. a bit nostalgic really. the best man was talking about our first year and all the hilarious shenanigans in residences. everyone was smiling and laughing but 8 years older and i (one of the few who isn't married or a homeowner) couldn't help wishing for happier, simpler, less responsible times. ah! the wonders of ageing.

roll on 30.

[i am listening to the rapture]

Gah!

i have failed at the first hurdle with regard to the 30 days project.

there are several reasons for this - there are always reasons.

i have firstly been trapped in bed feverish for the past two days. a bit of a cold or perhaps the imminent HIV seroconversion illness. i'm not sure.

secondly i am not even at my flat! once again my canadian outreach project has meant i am putting up the mum of one of my friends. decamping at my special lady's has also resulted in a disconnection from my lifeline to the internet. and as the trust won't let me connect to blogger this has lead to the fucking up of my "participation."

anyways to resolve this i shall continue for 2 days after the end of 30days to make up for dodgy circumstances.

[i am listening to the kooks]

30 days

i've decided to sign myself up to this 30 days project. this is all in an attempt to update this blog a bit more than "occasionally".

whether i succeed is another matter.

please join too fellow bloggers! prove to yourself that you are not professional procrastinators!

[i am listening to the zutons]

take your performance feedback and shove it up...

... because my good friend in wales and i have both passed our exams (membership of the royal college of physicians 2: die harder).

i was foolish enough to NOT opt for getting my marks published on the web so i had to wait till today for the stupid envelope.

anyway it is a massive relief for us both (failures the first time round) and so we are kicking back and relaxing this weekend. he is paintballing for a stag weekend and i am going bowling tonight lebowski style.

i nearly stayed in again last night but managed to pull myself off the sofa to go for a few beers with an old friend. it is tragic. i can't drink as much as i used to by any stretch of the imagination and i was almost content to veg on the sofa overnight.

but i pulled myself up and moseyed on out (well just locally) as i think if i become the sort of person who works, eats and sleeps that will be a non-existence.

i have a couple of incidents at work to report to you all. but i shall leave that for the next post as i am too excited and relieved at the moment.

sometimes you hit the bar and sometimes the bar hits you

[i am listening to Romeo and Juliet by Dire Straits]

you're a lightweight. you're fired.

dr D&C was skiving on friday.

that's not strictly true. i'm going to be unemployed in august and so i said to the house officers that i would be in at 9.30am because i wanted to hand in a job application at another hospital. i also said to them bleep me if there are any problem because yes ladies and gentlemen my pager not only works in the hospital, it also works at home, it works at my friends' houses, it probably works abroad and when i have left this corporeal existence and ascended to a higher plane of consciousness/the afterlife, i am sure that it'll still be putting through the crash calls at 3am.

anyway i left my friend the bleep/pager switched on and sure enough at about 9.15am it went off. i called the phone number displayed and to my suprise it was the voice of the clinical director that answered.

being called by the clinical director is a rarity. it is also quite frightening. you feel a bit like the generals in that scene on the death star in Star Wars when darth vader announces that the emperor will shortly be arriving. "the emperor is coming here?" reply the assembled generals, terrified faces, poop in their pants.

actually our leader is quite a nice guy. he tutored me as a student and i quite liked him. what on earth could he want though? i briefly scanned my mind of the medical activities i'd been involved in over the past few months. no, i couldn't think of any obvious malpractice.

he asked me if i had a minute. i was buying a coffee so i guess i did. he proceeded to ask me of my thoughts on a radical shake up of the way the hospital works. yes he was asking me about hospital at night.

i won't go into HaN in detail as i have ranted at length about it here. also refer to Dr Crippen for more details. in short the idea is that you only need a skeleton crew to run a hospital overnight and at the moment there are too many doctors doing far too little work.

the wonderful thing about HaN is that it is marketed (in the labour spin world) as something to help us doctors have a smoother time on call. bollocks i say! it is about cost cutting and meeting working time targets. that is what it's about.

at present in my hospital we have two junior doctors covering the wards, splitting the hospital geographically down the middle. what the clinical director was asking was why not get rid of one of the doctors and provide an advanced nurse practitioner with advanced skills (he said advanced twice) instead.

what are advanced skills? i'm not sure really.

bow hunting skills? computer hacking skills?

anyway i said i'd let him know on monday because delight of delights i was to be night shifting across the weekend. and off i scampered into work that night.

the weekend was fine as it happens. people weren't very sick and the stuff i had to do was quite basic... for me. initially i thought about writing back to mr clinical director with "bring on the nurse practitioners and screw you guys i'm going home."

but then in retrospect i thought about the activities i'd got up to overnight. for example prescribing fluids. this is relatively easy but then after three years of medicine i can very quickly assess someone's hydration status, their requirements, factor in their cardiac/renal status, correlate this with their electrolyte results and give them the right fluid at the right speed so that their organs get adequate perfusion and they don't drown in fluid. though it has taken me a long time to get to that level.

so i am a little perturbed at a nurse practitioner rocking up and ploughing 3 litres of gelofusin into a tiny man whose heart has the equivalent pumping function of a small clementine. that could be a disaster.

similarly i had lots of people with chest pain. again you have to worry about the heart. even if you take a careful history and look for (what can be subtle) changes on the ECG it can be a very difficult call. do we want nurse practitioners with no cardiac training to be doing this? i'm not sure (though having said that the CCU nurses i worked with were superb.)

anyway i sent my email back to the big boss saying that i didn't think that we were ready for this scheme. if the nurses had years of medical training and experience (ie were doctors) it would be fine. knowing my hospital they'd do it on the cheap and employ someone who was all talk and no ability.

did he reply? yes he did.

"thanks for the email. take care."

who says i don't make a difference?

[i am listening to the specials]

Escapism

a quarter of my patients have cancer of some kind.

i've spent the last few days taking them into quiet rooms, sitting them down, asking the same question over and over.

"what have you been told so far?"

they go on about how they came in with a chest infection/fluid on their lungs/etc and then i have to launch into the splendid bullshit.

"that's right. now that scan we did yesterday. well it's shown a lesion/mass/abnormality/cyst/shadow/irregular feature and we need to do a few more tests and speak to a few specialists before we can tell you exactly what it is and act accordingly."

what i want to say is that it looks, smells and tastes like cancer. you have cancer. and the pains we'll put you through to get the sample of tissue to prove this isn't going to change the fact that you have cancer.

of course we're not supposed to say that. in fact i got a telling off as a freshly qualified boy doctor for saying to a patient that although we weren't sure yet what we were concerned about was the possibility that his mass (in his pancreas) may be cancerous.

bad Dr D&C. go and kneel before the GMC with your trousers down.

don't you realise, i was told, that if you even MENTION the "C-word" then it will do more damage than the diagnosis itself.

quoi?

the word will do more damage than the cancer? somehow the word will metastasise and infiltrate all his organs? the word will cause him unbelievable pain and nausea and diabetes in a cruel twist?

no, i was told, we must wait for a tissue diagnosis.

of course said tissue sample took four weeks to get because the procedures (cameras down his to his duodenum and the probing around with a brush in various sphincter) ran into problems each time. anyway, we did finally get the biopsy, we told him he had cancer, he said he had expected that it was going to be cancer and then he died the next day.

but of course it was not the adenocarcinoma that killed him, it was the word.

anyway i must now bite my tongue. i shall wait the time it takes to get Mr K's pleural fluid back from cytology, i shall sit in patience as the lab slices through Mrs G's gastric biopsy and i shall make sure everything is ok after they've had a wash around Mr P's lungs with the bronchoscope. and then, one week on, EVEN THOUGH WE ALL KNOW NOW THESE PEOPLE HAVE CANCER, we shall tell them that they have cancer. in the meantime i shall lie every day to them, through the veil of " we need to do further tests" and "the lab is still processing the sample you poor cancer riddled bastard" before calling in the palliative care team who can start the syringe full of morphine and hasten their discharge to Rose Cottage.

excuse me, i have to go and put on my best used car dealer outfit in preparation for a day full of mendacity.

[i am listening to Primal Scream's new single. i saw this on the web today and it made me very geekily excited]

do you mind if i do a J?

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

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

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

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

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

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