New Year's Eve.

Why is Bridget Jones showing on New Year's Eve? And why am I watching it with a tub of chocolate ice cream on my own?

I still can't dance.

It's so odd, really. Found myself sitting next to this GP partner and his wife at their annual Christmas party, had an interesting conversation about their family life. Empty nest syndrome and all that. And when finally we were all chased upstairs to the dance floor I still found myself observing contentedly next to the bar, diet pepsi in hand. Well the eminently un-danceable Lady Gaga songs certainly didn't help. (Don't get me started on her, or the noise she produces)
No it's just interesting, really, how seven years here haven't changed my basic nature. (Interesting band, that)

Torn apart.

My heart.
It's just being torn apart right now.

Life.

You know the lady that I was on the good side of?

She got progressively more ill the last week I was in hospital. And passed away the day after I finished my placement.

Medicine.

So there's this old lady in the ward right now, who quite definitely has dementia, who's delirious as well right now, for which we're investigating the cause1. She's very suspicious of all the nursing staff in the ward for some reason, and think that they're trying to poison and/or harm her2. She doesn't seem to be too afraid of me though. Thinks I'm nice, apparently, and was willing to take some oral morphine for the pain that she had been having from chronic back pain.
I've heard one of the nurses mention to another that it was because I actually kneel down and speak at her level when I do talk to her, and actually do spend quite a lot of time with her.
It's interesting, this speaking at eye level business. I do it purely for practical reasons when doing odd jobs - there are only so many ways you can protect your back, you can either raise the patient to your level (which a housemate whom I shall not name does - she elevates the patients, them being on those electric beds, to about her arm's height. And remarks without a trace of irony that the poor elderly gentlemen and ladies go "whee I'm going on a journey up high") or bend down, which is particularly bad for your back when you're a junior doctor having to do multiple cannulas/take many bloods, or get a chair, which involves more trouble than it's worth. I've never noticed that I do it consciously though, it just seems more comfortable talking at a similar level, talking to, rather than at patients.
Anyway she keeps talking about knowing the "goodies from the baddies", and as I assume as she's still talking to me courteously I'm on the "good" side I can't help but be smug about the fact that I can put on a 'caring' face when I do care. Maybe it is good, being so transparent, sometimes.
I'm so glad that despite the criminal shortage of doctors on the medical wards (and I do almost mean it literally) and the overload of work I've not turned into a "baddie". Just yet.


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1Delirium, medically, is what you get when you're physically ill, when your mind goes haywire after being bombarded by too many signals from your body when things are going wrong. Which incidentally is a marker of poor prognosis (of life, in general). Which is why you do not actually want to get delirious with joy.
2Actually probably because of various reasons, including the ritual taking of observations at odd times of the night, the administering of drugs in huge trolleys that look like poison shelves, and the eerily colour-coded uniformity of the, well, nursing, uniforms. Probably not the best particularly when you're scared and they put you in a separate room because you're causing trouble for them. Oh and try to give you poisons when they're already sneaking poison into your meals and drinks.

Reflections.

If there is just one sentence (ok two) that I remember from my 4 months in psychiatry, it's this - "there are people who choose psychiatry because they like to analyse others' words. And then there's people like us, who just care."

This was in a conversation with the old age psychiatrist I was working under, when I disclosed to her I was interested in psychiatry as a career.

And then there's people like us.

Fucking psychiatrists.

This is new!

Ooh from scotland, not nigeria, this time! (try googling the number given - quite interesting actually)

--------------------------------------------------------------------------------
Royal Bank of Scotland
Tel: +447 024 092 792
Fax: +447 092 887 134
Group 36 St Andrew Square Edinburgh
Scotland EH2 2YB United Kingdom.


Attn: Beneficiary,

This message is from Her Majesty's Royal Bank of Scotland, we wish to inform you that a Diplomat
by the name of Mr. Audrey Davis, have been mandated to deliver your payment to you in your country
of residence using the diplomatic system of delivery. since we could not complete the payment of your

Compensation Benefit through a bank to bank transfer and been aware that you have pursued these funds
vigorously to be wired to your bank with a continue stop order been plced on the transfer.

The funds valued for US$2.8 (Two Million Eight Hundred Thousand United State Dollars Only) has now been
repackaged in one diplomatic boxes with you as the beneficiary of the funds following details contained
in the documents attached to the transaction, a letter of authority was signed by Mr. Michael Gerald of

the Financial Services Authority mandating the Royal Bank of Scotland to move these funds via the
diplomatic means to you in your country.

To enable the diplomat carry out the movement of this package to you without complications do contact him
now on his email: marvin.grant15@yahoo.com or his direct phone number in the United State :+1 (607) 795-7578
the diplomat is stranded at the Raleigh-Durham International Airport North Carolina and he is waiting for you
to contact him so you are required to reconfirm to him your.

details thus:

1. Full Name
2. Address where you want delivery to be made
3. Direct Telephone Numbers
4. Date of Birth
5. prefered time of visit


We also advice that you send a copy of your identification to the diplomat through his email which we have
confirmed to you. After verification of the information which the deplomat have on file, he shall contact you so
that you can make arrangements on the exact time he will be bringing your package to your residential address
or any address as mentioned by you in the process of this delivery, we do not require a post office address.

For safety reason we will advice that you keep the content of the box to your self and not to expose it to the
diplomat, and the key to the box is (Number: 2078) you are also advice to keep this key confidential.

We await your quick response to this email to enable us carry out the process of delivery.

Regards

Winter David
Executive Chairman
Diplomatic Department

Update.

Sorry my dear readers, wherever you are (erm who's in Seattle right now?), I've almost forgotten I still have a blog.

I'll just give a quick summary of what's gone on in my life from the last blog post till now.

1. Spent 4 months in surgery. Quite enjoyable, actually, quite like working with people who are straightforward, deal with things efficiently (relatively) and work really hard. Though I can't imagine myself going into surgery - I really wonder how long surgeons' wicks are, and how they cope with next to no time for family life. And really admire their dedication despite the lousy pay here even at consultant level.
And I still am reminded of the BBQ when I enter operating theatres, so it's a definite no no for me there.
Oh and most memorable thing - was in theatre helping out in a patient who had been admitted with a perforated bowel, and saw the surgeons squeeze some faeces out of some bowel they had split open. No fan involved¹ but it was oddly fascinating, even satisfying, almost like the sensation you get when you see a blister being burst.

2. Have now done almost 2 months in psychiatry. Am in what is technically known as an organic illness assessment unit in old age psychiatry, which translated simply means dealing in general with the nice granny in the corner who believes she is back in the 1960s, and if she could would dress herself to match.
Within these few weeks I've seen a former head teacher hit a flirtatious (almost to the point of lecherousness) guy with a wet floor sign, an ex chief fire safety officer lie under the table trying to fix a non-existent pipe (I think???) and (I wish I had more of them) a nice elderly woman who owed me a few hundred pounds a day just for being nice to her.
Did I mention the youngish lady who keeps repeating the few lines of Abba's Dancing Queen so often that I miss it now she's gone on leave?
Dancing queen... young and sweet, only seventeen... Don't we all wish we were seventeen once again? (No I did NOT watch that movie.)

Will blog more about dementia and what I think of it, within the next few weeks, I promise.

Will pencil it down in my notepad, anyway.




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¹Now I realise this reference might be a bit obscure for most, so let me try to explain this briefly. Our intestines are basically quite good at stretching (think sausages made in the traditional way). Rarely do they burst (perforate), but when they do, it is usually a serious matter indeed - up to 40% of people can die from it, and this from a hole say, the size of a 5 cent coin. And perforation usually doesn't occur until late on, IE it may mean that something (quite a lot of things in fact) was missed by quite a lot of people.
So although we no longer use ceiling fans in operating theatres...