The Big Tasty

Oh, wow. I was about to publish the second instalment of my previous post this evening when I peeked at my stats-counter: blimey.

What’s this bloody traffic all about?

You fancy hunting down every arse or perve trawling the web for bits of smut or any kind of titillating information - you stick a tracker device on your web page. It shows statistics of every visitor that reads your blog including visitor paths, visit length, country, city, state, ISP, recent book bought, shopping habits, etc.

It gives you a mental picture of how sad this people are and it’s quite interesting to see the trend change: whoa, this miserable git who bought Vladimir Nabokov’s Lolita and likes Parliament of Whores at Amazon’s is trying his luck today, especially if you tag your post with words like: death, evil, melancholy, and even the silly word – sperm.

Well, since Monday evening my counter is reeling from hits by all sorts of really nice and decent medical people. Huh? So I traced back the paths and found out that the ever so respectable Dr. Crippen: yeah, the world famous GOD (just a bit) NHS BLOG DR JOHN CRIPPEN has included this blog alongside the august line up of other British bloggers in his First Edition of ‘The Britmeds 2006’.

It’s going to be a weekly round-up of medical blogs where every sentient puppet on God’s stage is given a wider audience.

Or something like that. You may call him a chauvinist he says, but this round-up will have a strictly toff accent. No more Mc Donald’s or French bloody fries… This is the Big Tasty. Although he admits this is not going to replace well-established colonial institutions such as Grand Rounds and Change of Shift. Well…

What are you waiting, lads! Let’s go blogging. As HE said so himself:

“Who could disagree with a sad Pinoy nurse…”

Bloody well done! Doc Crippen. And Happy Anniversary. Oh, he is such a lovely Doctor. Very socially aware and sensitive. “He watches and weeps as the Health Service, slowly, but inexorably, is destroyed.” His own words. I feel the same sadness, really. I wouldn’t mind sitting down with him for a Pint and fat chips in my garden one afternoon underneath a downcast grey English sky.

Amyotrophia

I cringed to the idea that I’m getting two patients at the beginning of the shift even though I was promised that if push comes to shove we would shift my other one to the ward. That means unless somebody pops in the Accident & Emergency after doing something silly like slashing his or her epiglottis in the middle of the night, I’m stuck looking after two babies weaned off from life support and milkshakes of various types of narcotic drugs. I’d rather have one proper ICU patient to be honest, especially at the end of my fourth night.

The unwritten definition of proper patient: attached to a breathing machine, a lot of wires and completely sedated or even paralyzed.

I don’t normally mind having a chatty whingeing patient, but after doing 34.5 of your 46 hours all night before the weekend, you’d wish for a really chilled, inanimate, unconscious patient to cap the end of your shift.

It doesn’t help that you only spent four hours on your bed Friday morning as you find your main electricity supply switch tripping off every time you turn the kettle on to boil water for your cup of tea. Thank heavens for yell.com! I felt all my muscles have wasted and found myself unable to lift our dog-eared cumbersome Yellow Pages book.

Certified electrician came after an hour and a half which I though was quite impressive considering that it takes an hour for the Pizza man to find our door on a clear day. That was 1.5 hours knocked off from my nine hours sleep day before I go back to work in the evening. Routine checks done by electrician in switch box took another 20 minutes plus 10 minutes to unplug all the various appliances stuck in all electrical sockets.

To tell you the truth, I have enough of them to suck out all the electric juices of an entire city and greenhouse gas emissions enough to eat away a big chunk of the ozone layer the size of an Alaskan village.

Electric power is revived after some tinkering but for some reason, every time kitchen power supply is switched on the whole thing trips off again. Fuses are checked and that sorted, the culprit was eventually found: hiding deep inside a socket box of the cooker was a loose wiring. Another 15 minutes spent fixing the problem and 15 minutes having that well deserved cup of tea until electrician left. Total time lost so far 3.5 hours.

Gave up another half an hour or so to watch day time television as brain still spinning around from all the adrenaline, never mind the biologic clock thrown completely off a maelstrom of bad work schedules and unpredictable eccentric English weather. Tired and sleep-deprived, I can’t help turning up at work feeling like a toilet roll.

To be continued...

Nurses Taking the (chokie) Bickey

From the other side of the planet where I schooled and trained, the doctor is god: an omnipotent, autocratically patriarchic kind of god. Nurses are relegated as angels or cherubs. Angels are people of exceptional holiness. Like nuns or sisters. When some nurses holiness become nonpareil, they become Sisters. Cherubs are also special. They are an angel of the second order. They are most loved by patients because they coo and smile. In fact they smile a lot they grow their wings by smiling.

It is not always a good thing to be god, so most angels are quite happy to stay as angels. In other words, doctors are doctors and nurses are nurses. If a nurse wants to become a doctor, he or she goes to medical school. Yeah, he or she carries them heavy books and burns the eyebrows. You don’t become a doctor by being struck by lightning from mount Olympus.

Oh, the good old days. Nurses nowadays apparently don't smile, and I didn't notice this until I stumbled upon this blog by The Angry Medic. No! They don't.

Good Nursie! Here, Have A Biscuit.

I was so busy writing about The Melancholy Death of Evil Sperm I forgot stuff that really matters. I know that this will not generate as much comment as the previous post, but what the hey.

NHS Trust Offering Nurses Chockie Biscuits – to encourage them to smile at patients. This is actually quite funny.

In this part of the planet there are no such things as gods and angels: you are made to feel part of the team. This is a good thing, really. Most nurses are happy to stick to their roles and doctors do their own bit to achieve the goals of the team. Some nurses are given roles that obscure the demarcation between each role, and as long as they work within a framework that protects them i.e. defends them from danger, injury, loss, lawsuits etc., and with a fair amount of compensation for this added role, he / she is happy to oblige. Whatever the reason is:

To save Trust money – as it pays peanuts to hire nurses to do the job or to recompense for the shortage of doctors, the latter being highly unlikely, added to a lot of confusion and mayhem that bedraggles the modern NHS.

“In recent years there have been growing concerns about nurses who are “too posh to wash” and prefer to spend their time on administrative and technical tasks rather than basic care. Two years ago a resolution at the annual congress of the Royal College of Nursing proposed that nurses were now “too clever to care” and suggested that the compassionate part of their job should be delegated to healthcare assistants. The provocative motion was a reference to nurses increasingly concentrating on technical duties.”

The way that language * in bold italics here* is used in a country where political correctness is the order of the day, along with the rest of the article, I find it really naughty. Absolutely demeans the value of nursing and I suspect the reason behind the culture of disdain to what is now being perceived as old-school or traditional nursing:

Washing or feeding a patient is not posh or clever.

I have to admit, I have met quite a few nurses with this kind of mentality and they are usually not the clever ones. They don’t see the theory behind the importance of hygienics – the science concerned with the prevention of illness and maintenance of health, or nutrition, but see it merely as hands on activity not worth wasting a few brain cells with. They are also the ones who always like to nip out for a ciggie all the time as if that doesn’t waste a few of their brain cells but that is just my stupid theory, and I don't mean to diss people who smoke. Everyone's got a right to have cancer. As long as you get your work done, it's a free country.

I also see really brainy nurses who don’t wash patients. They only assess and make diagnoses (and debate with doctors) like Nurse Ratchet. They are a pain in the ass.

Fortunately, there are still a lot of proper nurses, especially in ICU who are very, very skilled, technically savvy, they could set-up a Galileo Ventilator and a PICCO machine blindfolded, line a Haemofilter in under a minute and still back –up all the data files of the main computer server, yet would be happy to do mouth care, eye care every four hours, make everyone a cup of tea, wash a patient at the end of the shift, then recite Shakespeare’s Sonnets backwards from 154 down to 1. But that is in Critical Care where if possible, patient to staff ratio is kept at 1:1.





In the wards, you see an entirely different picture. A Picasso painting of an abattoir where more than 30 patients are lying in their own filth, relatives curbing a fantasy to kill and one single nurse running round like a headless chicken.

So yeah, no smiley face here.

The Melancholy Death of Evil Sperm

Peter is a young boy. Like all naughty boys his age, one night he had a ‘humpy pumpy’ dream and woke up in the morning feeling wet but rather feeling good about himself. He quite liked that dream so much that he started doing it even when he was awake. One day, he learnt that doing it all the time is evil. He was told that he was killing all the sperm. He had no idea what they were talking about, so one day he looked it up in the library and found out what it looks like. He thought they were cute and felt extreme guilt that he had been killing them all this time. He promised himself not do it again. The following night he had another one of those “dreams”. In this dream, he decided to keep them all alive. He tried so hard to save them, but in the end, all of them but one died. He kept this special one in his aquarium.

He woke up the next day feeling the same wetness in his nether region, but was relieved that he had at least saved the life of one. Hastily, he removed all the fishes from his aquarium to keep them from eating him. He couldn’t think of a name for his creation so he just called it Sperm. He knew it’s a stupid name for a pet but that’s how he called him, anyway. He thinks it’s a boy although he’s not quite sure. It is the sperm that fertilizes the egg that will determine the sex of the baby. Some sperm carry the X-chromosome and some sperm carry the Y-chromosome. If an X-chromosome-carrying sperm fertilizes the egg, the baby will be a girl. If a Y-chromosome-carrying sperm fertilizes the egg, the baby will be a boy. The egg is a nonentity. Although they may share the same number of chromosomes, the egg has no influence whatsoever in the determination of gender. He felt smug knowing this.

Each day coming home from school he felt really happy that Sperm was growing really well. All his effort to compete with around 200 million other sperms paid off, and made him really fit and healthy. If he is going to run in the London marathon he would certainly win, only he couldn’t run. What a shame! But he sure could swim: hell, he’d swim the length of the English Channel from Dover to Calais without breaking a sweat. His tail gave him the ability to swim at utmost speed. As weeks and months passed by, little Sperm grew up from teensy tadpole into a whopping malacopterygian monster that Peter decided to take him off from his tiny aquarium and chucked him into the lake where he could swim freely. As always, he would visit him everyday to check how he is and if he is happy with his new home. Peter was balled over one day to learn that Sperm could speak. It knocked his socks off:

“Boy, how did a single tailed coelacanth with hydrocephalic head ever learnt how to talk?”

Peter boy may not know it, but the witty, witty Michael Moore, the scholarly author of “Stupid White Men” and creator of “TV Nation” wrote in his book “Downsize This!” that the sperm can put the best computer chip to shame. He said: “The sperm’s head is densely packed with a ton of genetic information. His midsection, like our bodies, contains the life processes that allow him to stay alive, to move, to do his work.” Wow indeed. Peter had never been happier. Now, he was able to discuss American gun culture, corporate politics and why it’s time for a regime change at Number 10 with his genius pet. One night, he woke up from the wailing wah-wahs of police sirens: there had been reports of sightings of a whale-like monster by the lake. Scenes of terrified women were shown on telly.

A woman alleged that this evil monster jumped off the shallow waters of the lake and chased her.

Early next morning Peter went to the lake and looked for Sperm. He couldn’t find him. He went in the afternoon crying whilst searching for him, but he wasn’t there. Nope. He simply disappeared. In the end, he just presumed his beloved pet died.

It is quite possible that Peter recovered from his depression after a few trips to a head-shrinker and some happy tablets, but the story of Sperm did not end here. As you may all know, millions upon millions of tiny little sperms are helplessly massacred by men. Snuffed out and smothered in tissues, then mercilessly thrown in the bin.

* Silly story inspired by Tim Burton in “The Melancholy Death of Monster Boy & Other Stories” and by Shelley Jackson in “The Melancholy of Anatomy”.

Colonial Dumping Syndrome

- To drool over stuff whose enjoyment stems not from its perceived necessity to remain physically or mentally viable but rather from a bizarre obsession with brand, signature, origin and class connotations.

Girlfriend and I always find ourselves literally in each other’s throats every time we are out to stock up the fridge, the cellar or the wardrobe:

“I reckon this will be great. It has baking soda and it promises shiny white teeth. And uhhmm, it also is dead cheap", to which she’d say, "don’t believe anything that’s printed on the packet, silly. We’ve always used Colgate.”

Background info: Those who grew up in the Philippines know that the stuff you clean your teeth with is not a toothpaste but a colgate. A carbonated drink is not a soda pop but a coke. Imported American branded products are more superior to generic local ones.

“Oh, wow. The nanotech textile on this cool Gap shirt ensures that it will be stain-free forever. This is NASA stuff. Only astronauts wear this type of kit.”

“Well. You don’t drink red wine and don’t tell me you’re going to wear that stupid shirt forever, she quipped. Where is it made from? To which I lost all the energy to even look: Uh-oh. It’s made in the Philippines.”

This should never be confused with IMSCF [ I’m Spanish Chinese Filipino ] Syndrome. A supposed phenomenon of identity crisis amongst overseas Filipinos resulting in a unique form of institutionalised ethnic forgery .

This is purely physiologic in the sense that people who suffer from this affliction often have a low blood sugar from hyperventilation, hyperexcitedness, and weakness every time he sees anything shiny, metallic and small. Especially if it is visible from a window of an Apple Store.

People who have this syndrome also need to have small frequent trips to cafés, preferably Starbucks and little treats of simple sugars which again, preferably Hershey’s or Ben & Jerry’s.

New York City. Somewhere in Fifth Ave. Capital of capitalism and crass materialism.

People with severe cases need expensive holidays.

I wanna go to Peru. I want to see the Nazca lines. The lines are geometrical figures, trapezoids, triangles and animal figures etched on the rocky Peruvian mountains thought to be the remains of an ancient giant extraterrestrial airport. But nah, she will not have any of that crap:



“Christmas shopping is best value in New York.”

I was tempted to suggest Angkor Wat in Cambodia. We could spend a few weeks there en route to the Philippines. I heard it is quite interesting and probably much cheaper of which she would probably say:

“I had enough of these trapezoidal, triangular monuments of gods or aliens and all these boring star gate theories.”

I'm sure, she would.

I’m getting my intestinal tract gashed if she won’t.

Also. Next time you hear stories of children dying from salmonella from surplus milk products dumped to the third world or people from a cracked heart valve, be very scared. This is a more evil form of dumping syndrome.

* Cautionary Advice: Without understanding the finer nuances of this author's amateurish attempt at humour there is a bit of concern that he may be taken in earnest that would altogether defeat the purpose of this ( tongue-in-cheek ) banter. The girlie's words are intentionally hyperbolized to evoke sardonic wit and not a blatant representation of her values or character. She is inherently down to earth and not a vacuous evil reactionary of stiff bourgeois upbringing. And we are not always at each other's throats, really.

Day After Night of the Living Dead

Woke up rather dazed and confused this morning. Been out the whole night before Halloween Day partying: “Deadman’s Party - Come As Your Favourite Contraceptive”. Lots of aging hippies in inappropriate Goth get up. Cheap booze and bizarrely, expensive grub. Not exactly haute cuisine but rather a bland mish-mash of terribly hideous and greasy vegetable samosas, chicken fritters – the type you’d get from a cheap Indian takeaway. And onion baji as hors d’oeuvre. Yuckity yuck.

Wrong: What’s the point of the theme? I’ve never seen anyone wearing a pill box boob tube to pop your fingers with whilst dancing to “Let’s Go To Bed” by The Cure. Or anyone brave enough to wear a condom over his head. Where’s the pounding yet equally depressing Heavy Metal music?

Right: It was indeed a Deadman’s Party. Everyone is either dead or a zombie. I was sitting next to an apathetic bore or asshat without any sense of imagination. Or a smidgen of humour. Dead or alive. Simultaneously.

Wikipedia

Like Schrödinger's cat:

“A paradox of quantum mechanics. There’s a cat in a box with a pointed gun at it and the shot is triggered by the weight of a single atom. If the gun doesn’t go off, the cat lives. If the shot is fired, the cat dies. But quantum theory says every atom exists simultaneously in decayed and undecayed states. So the gun fires and the gun doesn’t fire and the cat exists in two states, simultaneously: alive and dead.” Got this from “Electric” a book I was reading last week.

Or a vegetable:

A rather derogatory term most people self-consciously try to avoid to label a long overdue patient dependent on life support - hospital geeks would like to call as ‘breathing machine’ waiting to be freed from a life of opiate induced stupor, torture from chemical restraints and being forced fed with blenderized complex compound of gooey stuff through the tube wishing for a merciful anaesthetist to do a brain stem test. A rather sad, sad state your conscience constantly wrangle with in silence. Is life or death worth fighting for?

Or a job burnout:

You love saving lives but there’s just too much death. You end up getting depressed and frustrated and confused. So many people perhaps don’t realize just how demanding the life of an ICU nurse is - that everyday you are routinely involved with life or death decisions literally. Death is what you have for breakfast, lunch and aftenoon tea. You will eventually succumb to being powerless and helpless. This is interesting:

"We must believe we are potent, that we have the power to influence what happens to us. I say "believe" because how we see the world exerts a significant impact upon one's susceptibility to burnout. Believing that you can't control what happens to you and feeling helpless is one of the most threatening human experiences. Any time you believe the world uncontrollable, you are in trouble. Research suggests, for example, that Voodoo deaths may be caused because the victims believed they were helpless. Many concentration-camp prisoners seemed to have died of helplessness. They were told and believed that the environment - the guards - had total power over them. Based on his own experience, Bruno Bettleheim, a renowned psychologist who survived one of the worst Nazi death camps, says that it was when people gave up trying to influence what happened to them that they became walking corpses."

[ Causes of Burnout ]

I drank quite a lot of lager. No red wine, as I had gout. I asked my self:

Why on earth am I here?