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...

Going sentimental all again.

Listening to I Am Kloot's Northern Skies, never fails to make me cry.
Remonstrating to myself the mindlessness of it all, the salty sweetness as they fall.
Rubbish I know, but just didn't want to go all mushy on you again.

Why oh why.

A patient of mine suffered from an acute alcoholic withdrawal episode yesterday. Broke his shoulder. (That was the least of his concerns) Also now diabetic - his pancreas's given up on him.
He confessed to me this morning that his wife had smuggled several beers for him on the ward over the weekend.
This guy had been admitted with pancreatitis caused by alcohol excess - 2nd time in 3 years.

Yes he could have died.

I really don't know whether to pity his poor wife, who either didn't know better, or loved him too much to say no, or to try to smack some sense into her.

I just don't know what to think, sometimes.

Sai Gang.

You know the term that was so popularly used when we were back in the army? Sai(2) gang(1)? Well I'm starting surgery next week and have been arrowed to do bowel decompression on this patient once/twice a week. What you do is you stick a tube up the poor person's arse to allow faeces to flow out, said person having difficulties emptying his bowels¹, obviously.

So, literally, sai gang.

¹Due to a long-standing medical condition - shall not bore you with the details. Or disgust you, for that matter.

Oxford Brasserie - Southampton

Horrible place - horrible service, horrible food.

Obviously what follows is a totally subjective review based on my first (and last) visit to this place.

First impression was not too negative indeed - reached the place an hour before we were expected, and were ushered in despite the staff still having their dinner in a corner of the restaurant.

I guess the downward spiral started when my dad asked for the waitress's recommendation for his starter. She didn't seem too familiar with the menu itself, but credit to her, some quick-thinking ("not a fish dish, since you're having a fish platter for your main" - then, on discovering more than half the starters eliminated, nailed down the smoked duck, perhaps her favourite dish?) saved her blushes somewhat.

Then the bread and the starters arrived. The bread was hard, and cold; the octopus salad that mum and I had ordered had bits of octopus, assorted vegetables and wedges of tomato, all soaked in oil, like a diassembled DIY model car someone had left abandoned on the porch. Interesting concept, with random flashes of inspiration (beetroot surprisingly goes well with octopus - pity they'd probably run out of it, with the meagre piece in mine) but I don't normally associate playing with food at the table as particularly flattering, to food and individuals involved.

Oh and the calamari dad eventually ordered for his starter was so salty I had to douse my pieces in the tartar sauce provided¹.

Plates eventually cleared, mains arrived. We had ordered rabbit, fish and fancy-named chicken, and they looked rather decent, if not impressive². Real pity, then, that the legs of my headless chicken were pointing ominously at me, when the chef had plainly intended otherwise³.

Small complaint, really, when compared to the atrocious taste of all our dishes.

The twin themes running through our dishes seemed to be salt and oil - someone had obviously thought that copious amounts of oil could make anything taste good, and stimulating the tastebuds in any way was good enough for most people. That was the pre-dominant complaint from my mum; dad left his dish unfinished, which says a lot, really. And my chicken - well it seemed as if the chef had thought 'exotic' influences from all over the world could somehow all fit in a dish, but failed miserably, resulting in the confused chicken drowning in its multiple personalities. Oh and the vegetables - someone had obviously failed to mix in the salt properly, sullying what could have been a highlight of the meal.

And so half the plates were still full when the mains were cleared. And still the waitress had the cheek to ask if we wanted dessert. And had the cheek to say there was no discount provided, when it clearly was stated in our brochure that we (as serviced apartment guests) were entitled to. And then when I clearly indicated my displeasure by pressing "no gratuity" in the payment machine had the audacity to ask if I was from southampton⁴.

Thinking about it, the ironic "thank you" I had said upon leaving the restaurant was perhaps lost on them.

Please, if you ever go to Oxford street in Southampton, avoid this place. (It's separate from the 'oxford restaurant' situated next door, which in contrast is a decent place with quite decent food.)
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¹No the tartar sauce wasn't particularly good. Yes it really was that bad.
²Dad's platter of fish consisted of, well, various species of fish (and "king" prawns) drenched in oil, and placed unimaginatively on a plate; my fancy chicken was laid spread-eagled on the plate and smothered in sauce; mum's dissected rabbit was placed on a rather inviting bed of mashed potato. Vegetables came in separate dishes.
³There was an oriental-style carved flower placed near where the head might have been, together with some sprigs of parsley - even an amateur like me would have figured where that might have featured on the dish.
⁴Perhaps hinting that I did not know the rules of tipping - hell yeah like I would pay for rubbish service. Oh and in case you think I'm over-reacting, she had made no attempt at idle chatter right until she asked that question, after I had paid the bill.

The Anatomy of Melancholy

If you find my posts rambling and incoherent at times, you haven't met the master. Saying that,http://www.blogger.com/img/blank.gif it is really a monumental work, worth reading - even if just a tiny selection of it. Spent a really fruitful few hours in the Wellcome library trawling through the abridged version. Probably not the most conventional way to spend part of a trip to London, but hey I did walk down to that cheap ticket office in Leicester Square, only to find that there weren't any good matinee shows on today. And this was after covering the bits of the British museum I'd missed the last time I visited. Enough walking, I think you'd agree, for a day.

Oh the reason for reading said book? It caught my eye, nestled craftily amongst the huge collection of (fake) books lining the walls of that gallery in above-mentioned museum.

In the British Museum

I found it quite odd that I was not the only Chinese guy in the Chinese section of the museum - indeed, I found it very disconcerting, the fact that there was a group of Chinese tourists wandering around, led by a tour guide who was describing the exhibits in detail in mandarin.

(Tourist) Trapped

I should have noticed the signs. Italian-looking cafe located right outside the British Museum, with signs advertising CHEAP MEALS (PASTA + SALAD + SOFT DRINK = 6.95) and an over-enthusiastic italian crew greeting customers on arrivhttp://www.blogger.com/img/blank.gifal. And the 'chef' making a beef sandwich from (admittedly good-looking) sliced beef on white sliced bread.

I guess I was hungry. And I had spotted a comfortable-looking chair, at a decent-looking table, unlike the stools and plastic table at the cafe inside. And there wasn't a queue. (Which on hindsight should have been another clue, I admit, but then the presence of several customers packing the rear fooled me.)

So I sat down, and ordered a pollo e asparagi rice dish under the authentic-looking heading 'risotti', and a cappuccino.

I must admit my doubts started to surface when I noticed the microwave located behind the sandwich counter (and what appeared to be liberal use of it¹), but the cappuccino, which had arrived with typical italian efficiency, had allayed them² somewhat.

But what greeted me when the rice dish arrived was beyond my worst imagination. Obviously microwaved (it looked like it had been emptied from a cheap inverted microwave container) it looked positively depressing, with several cubes of a decimated chicken vainly swimming against the tide of dyed³ basmati grains engulfing the dish. Oh and I spotted one lonely piece of courgette amongst the sea of red. No sign of any asparagus, tinned or frozen. At least they'd tried to add a twinge of authenticity by sprinkling some forlorn-looking parsley around the well-defined edges of the rice pile.

After that assault on the eyes came the inevitable battery of my poor tastebuds. I have to say, I was expecting a horrible concoction of indeterminable mashed-up flavours - but surprisingly, it didn't taste that bad. The chicken was rubbery, as expected, and the grains of rice anonymous, but taken together they tasted just as a microwaved ASDA meal might - cheap factory-produced muck that kept you alive in times of famine without too much distress.

Problem was, a microwaved meal might cost me 3 quid, while the price of this was more than double that.

So trapped as a tourist I had been, silly hungry fool that I was. You would do well to miss this restaurant - the only 'cafe' facing the museum that's somehow survived despite its food.

But then again with starbucks as its only competitor in the street...


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¹Judging by the 'ding's we're all so familiar with sounding out at regular intervals.
²On a score of 1-10, where 1's starbucks coffee and 10's the best you've ever tasted, it came in somewhere between 3 and 4. Which isn't much, come to think of it - but I'm so used to the Maxwell House coffee provided in hospitals (-1) now that anything greater than 1's a bonus.
³Dyed red. Why red, I really don't know.

Psychosis.

Just a little note here that I wrote a few months back about psychosis.

It all starts with an innocent thought.
A naive, half-formed notion misplaced,
Mis-appropriated,
Misguided in its quest for resolution.


It's how delusions start, I believe. A mis-reading of actions by others, where gradually the usual mechanisms that keep our wild thoughts in check get eroded, re-programmed, if you like, sometimes knowingly, sometimes not. Then layer upon layer the mistakes accrue, till you get something so barmy nobody can understand - it's that little disconnect, that differentiates an odd but comprehensible thought process, and a pathological one.

For those of you in the know I know psychosis is much more than delusions, but note I'm just trying to demonstrate how delusions can be explained in a biochemical model (imagine thoughts as neurons 'aligning' and firing in synchronicity) here, just as how the occipital cortex gets activated in auditory hallucinations.

Fascinating aren't they, our brains.

Power!

Apologies for the lack of posts, life's been just a plodding journey of baby-steps so far.

Once in a while though, you get re-energised by songs such as these. Check out Vintage Trouble on Jools Holland, if you're in the UK - preferably on iplayer; the youtube one just doesn't do it justice. Marvellous album, btw.

Going Home.

On Melancholy Hill.

Stories.

Why do we hold back, sometimes - why do we let go?

I don't know.

Maybe we all have these little spiels nestled in the depths of our minds - directing our thoughts, our actions, the words we use so casually, yet so deliberately.

There's this scene in The Weather Man which has stuck in my mind somehow. Closing scene, I think, where the protagonist explains how his choices in life gradually diminished; his paths converged, and he ended up as just 'the weather man' on TV. Interesting how little, reading the synopsis, I remember of the rest of the film.

Maybe I really should go into psychiatry.

Disaster.

Note to self: Some things in life just cannot be meddled with.

Just tried making some beef noodles with dumplings, seeing as I had spare minced beef, mushrooms and flour I needed to use up. Accidentally put a little too much water into the mixture (had turned the tap a little too vigourously) and realised I had not enough flour to compensate for it. And then remembered I had cornflour - half a packet, in fact, a relic from years past that I had to use up as well - and made a spur of the moment decision to add it to the mixture. Thought that since it looked similar and had a role in thickening stuff up it'd work. Somehow.

Seemed like a good idea, at that time.

Obviously it wasn't, and I ended up with a semi-gooey texture, similar to that of sweet-and-sour 'sichuan' soup from dubious Chinese restaurants. Yes I do mean semi-gooey, it occupies that middle ground between an ill-meaning suspension (well technically it is one, isn't it?) of unidentifiable constituents¹, and goo². Like a food play experiment gone very wrong.

Eww indeed.

Am not looking forward to eating it.


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^1.I didn't add any oil - if I did would I have turned it into an emulsion, perhaps? Need some chemists' input here.
2. Interestingly, type 'goo' into yahoo search and google dominates the search results?! Wrong on so many levels, isn't it.