back to reality

I’ve just been back from my holidays and even though I’m still struggling with jet lag and physical unease from exhaustion, I went straight back to four straight twelve hour shifts last week that I feel the need for again, another two weeks holidays. Back to life and (trying hard not to make it sound like a sing-along) back to reality.

No more lobsters in England!!!

I’m quite sure there’s a cheesy pop song like this one in the early nineties. Work as usual is pretty much as dull and boring as the weather. Since coming back, I have only just looked after bog standard post-operative patients monitored overnight, woken up the next day, extubated then discharged to the wards.

Kayaking is not for the fainthearted quite literally. You can flip over and you need at least half an hour of cardio warm up before you step inside the lithesome vessel.

I wonder if patients with complicated problems which we often think are more interesting also go on holidays. Say, somebody with Addisons disease that had been going on for years undiagnosed could be admiring the works of Gaudi in the quirkiest streets of Barcelona until he/she has a crisis. That’s a pretty morbid thought and not a very good example, so I will slap my wrist and change my topic. Of course, patients that actually get better are way far more interesting and rewarding.

My holidays went really well. I enjoyed the picnics and the barbecues.

Soaking up magnificent late afternoon sunshine petting the maple leaves as barbie gently sizzles in flame.

That’s Canada. Quite simply, the most glorious place on Earth.

Oh yeah? Remember this?

They get really stroppy when you disagree. Next they’ll be telling us all evil villains are British and a bald head really is a solar panel to energize the brains.

More holiday pics here.

Oh yay. Poutine.

Nope. Those are not swear words. I just couldn't think of an appropriate title for a blog coming off a night shift and still feeling a little bit coldy. I went to work even though I had this cough that started off as hay fever ish/type/thing few days before the weekend that became a full blown flu by Monday. I would like to think that I'm forging to improve my work ethic by running my burnout limits to the max. But really, no. I only did just the one night. I was sent home from work a few days ago for concerns that I may actually infect the whole workforce. Oh, yeah. Blimey. Pathetic... I'm really inclined to add a bijillion exclamation marks here. But somebody actually told me that excessive use of exclamation marks is pretty retarded. What every self-respecting blogger should aim to do is leave the impact of what one has written to speak for itself. (Take Note, Tala. Ha.ha.ha.)WTF.

I'm off to Canada this week. My flight's on Friday.

! ! !

By Friday evening, a few hours after touching down Lester B Pearson International Airport I would have chugged down every drop of Canadian beer off cheap cold bottles whilst partaking a massive bite of pommes frites drowning in artery-clogging gravy and cheese they call Poutine. I have yet to find out whether Poutine - a Quebecoise dish of fries is the French equivalent of the Italian Putanessca. Them Europeans associate comfort food with depraved debauchery. And Canadians are pretty touchy when pushing the superiority of their beverage that side of the Atlantic. They would actually describe American beer as like: having sex in a canoe which innocently, may sound pretty flattering. But having perhaps, inherited the British humour more than the 'other' colonial cousin, this actually means that American beer tastes so f#%!ing close to water.

No offence meant to all my American friends as I would in all honesty prefer New York City over Toronto anytime of the day, but Canadians are just so damn funny.

#1. Who can resist the Royal Canadian Mounties? Remember Benton Fraser's dry humour in that early nineties TV favourite called Due South? Don’t forget his sidekick lip-reading deaf wolf Diefenbaker. And imagine jumping along BBC's ‘Monty Python's Flying Circus’ as they sing the chorus to that silly Lumberjack Song.

very old pic of young howling's first trip to canada
still with his old pinoy passport. prancing along moose dressed as mountie.

#2. Celine Freaking Dion. Okey, in fairness, they also have ‘Feist’.

#3. They are bilingual. Therefore, it’s quite easy to pretend that you don’t understand English. The French street signs don’t leave you with an excuse for bad driving, though.

#4. They still allow themselves to be ruled by the Queen of England. Where were they when The Sex Pistols played "L'Anarchie pour l'UK" in two concerts at the Peter Street venue during the summer of 1976?

#5. Despite #4, they ditched the English and gone for the Metric System. I know, it's the bloody French.

camping with big sibs.

#6. The angel Michael protested when God created Canada. ‘Don’t you think you may be giving these smug Canucks a little too much? Upon which God manifestly said: ‘Wait until you see the neighbours I’m giving them!’ And He didn’t mean the Russians. No kidding. Lookie here.

#7. They call their dollar a 'Loonie'. Reminds me of the people from a lunar colony that lead a revolt against Earth in that silly book 'The Moon is a Harsh Mistress' by Heinlein. Funny dinkums.

#8. Their Prime Minister Stephen Harper is already a wax figure that even Madame Tussaud doesn't need him in her cheesy museum. Apparently, Egyptian mummies at the Royal Ontario Museum are more life-like compared to him. See for yourself here.

And see ya all guys after two weeks!

Gastro-porn

The French are pretty shameless when it comes to public display of affection especially when they are dans le feu de l’action ( in the heat of the action ). One particular girl didn’t care that the crack of her derrière ( ass ) was aiming to eat the brioche au chocolat in my hand every time her boyfriend shoved his face on her. And not the least bothered that the sound of their spit as they exchanged it - put me off eating a favourite French roll: croissant packed with chocolate and hazelnut. No wonder I couldn’t give two lardy arses about Saint Valentine's Day. I was too tired coming home from the trip and had enough of this soppy lovin’ feeling to last me a lifetime.

People in France go nuts with their chocolate and hazelnut spread. Not only as a substitute for Viagra but also for Prozac. Apparently, a jar of Nutella sits alongside the weapon of choice in a suicide scene of every French teenager and jobless graduate who had a nervous breakdown.


The bus we took during the tour is packed with plump middle-aged tourists and young fit Parisiens like a tin of sardines but the view from the window was oozing with vitality, intrigue and appétit just like a Bernardo Bertolucci movie. I don’t know why, but every time I think of Paris, I remember that doggie style scene between Marlon Brando and Maria Schneider using butter as lubrication. Could be the reason why I got this very funny mental carnivale de l'erotique thing going to any food that I ate whilst I was there: Crème Brûlée, strawberries, cheese, crêpes and even a sandwich.

I’m not surprised about this Freudian fascination with the most celebrated landmark – The Eiffel Tower. Like the rest of them tourists, I was transfixed to the romantic view. Then I suddenly had butterflies in my stomach. Or more like worms clamouring for food. We got off at Champs Élysées and took a lovely long walk in the most beautiful avenue in the world.
Dining in a restaurant is really tricky. The waiters can be a real pain in the derrière. Most can speak English but they have this weird view that most people, even tourists can also speak French. You must at least know how to twaddle a bit no matter how unintelligible it is just to get their attention:

"Répondez blah-blah, s'il vous plaît." ( I know it means respond if you please -that RSVP note they usually put at wedding invites, but if you mumble it rather quickly, the waiter may take it that you would like to see the menu, please. ) Otherwise, your bum will bleed quicker on a chair waiting for them to serve you than you would if you swallow and crap a dozen Big Macs. Then there is the nightmare of actually reading the menu. Whatever you like just avoid the word: "escargot". It’s better to eat lumps of green grass / things drenched in olive oil than a row of terrestrial snail in their shells swimming in yellowish goo of butter. I had it before. Not very pleasant.

The wine list is another. The girlfriend was quite good at this. Like a true connoisseur she read it aloud punctuating her words with oh’s and ahh, I’ve tried this before and that, or something: it was like watching Chinese movies - I didn’t understand a word but I liked it. I noticed she picked the second cheapest bottle. Uh, huh. I bet she was bluffing. The steak was a bit dry but not bad. I’d preferred it if they drowned it in gravy though, and not piped a silly heart-shaped trim of sauce around it.

The dessert was scrumptious.

The rest of Paris pics are here:
City of Lights, Gastronomique, Disneyland

Pardon, Je Descends Ici

Tried to cram in all the best bits of Paris in one day, but failed. I really thought I already mastered the Metro (the city's own version of underground tube or the subway) from the 2 other visits I did of Paris in the past, but still got lost and almost ended up in an unknown town very far from the city. By just scuttling off the intricate rail transport network ad libitum, we unwittingly got on Réseau Express Régional - a commuter train that takes you to unpronounceable faraway French suburbs.

After nearly memorising all of Ooh La's pretty, pretty loops and jangly guitars from The Kooks 'Inside In Inside Out' album, we managed to get back to Châtelet Les Halles in the heart of Paris - apparently the world's largest underground subway station, and arguably the world's busiest: second only to Shinjuku in Tokyo. By the time we got out of the tunnel and seen the light, the weather is already a bit grumpy and temperamentally unsympathetic. Good thing that the five day travel-pass allows you to just hop in and out of any form of transport: bus, subway, boats etc. Otherwise - my carefully messed up hotel-room-dried fringe would have wilted, and I would have ended up looking like a wet salmon soused overnight in bad marinade.

"Whoa!" That robot stuck on the glass panel is supposed to clean the museum. "I can't wait to get in!" Then I noticed the sign. The Louvre is apparently closed on a Tuesday. The girlfriend was amazed I could read and understand French. She didn't see the English small print. "Oh, darn!" Just what we needed. Not that I've not seen that famous muse of da Vinci yet - but after reading the Dan Brown novel, I just so wanted to see her again. Never mind the long queue and the horrible eau de cologne tourists had a bad habit to slap their mug with. Web geek abbreviation of the day: MALPT! "Merde A La Puissance Treize!" which is "Shit to the thirteenth power" in unsophisticated Anglaise chav-speak. We also didn't have the time to see:

Le Musée d’Orsay
Sacré Coeur
Le Pantheon
Sainte-Chapelle
La Conciergerie
The Eiffel Tower

Actually got to the four legs of the Eiffel. Then the skies pelted us with hailstones the size of pitted prunes. What a shame.


[ more of my lovely pics of Paris here ]

One Flew Off The List

Another year is over. In theory, I should be looking forward to one whole year of bingeing on 12 plump looking fruits, constant travelling, and ticking people off the list of friends. Once I decide to be superstitious and think Chinese just like my woman that is. She makes sure that we have an assortment of fruits on New Year's Day. The fruit thing actually meant a year of prosperity or abundance. Pardon my fundamentalist stance on the matter, but if some people can annoy you with their own literal interpretation of “The Good News” when they knock your door whilst you’re basking in your mid afternoon tea, I suppose you can apply the same principle to your own brand of opined notion.

Shivering from the cold weather and frantically flying off stairs and platforms to catch the train to London on New Year’s Eve would mean a year off exotic holiday locations which isn’t bad really, if you think about it. Stevie Wonder must be having a laugh when he wrote the lyrics to ‘Superstition’. It helps if all you wanted to do for the evening is sit in your comfy sofa dipping huge chunks of Brie and Camembert cheese to dollops of cranberry sauce whilst watching a raucous showdown of indie bands in Jools Holland’s Hogmanay New Year music show.

Ticking off friends from the list is when the events of that evening turned a bit uglier and darker. We were knocking down glasses of chilled Bucks Fizz – a sparkling blend of wine and orange juice: according to the hostess and watching Jools Holland. Good grief! Not too exciting compared to what we would have had anyway, minus the skyline view of the Big Ben and House of Parliament of course, but still I wouldn’t trade in the comfort of our own house in the ‘chavvy’ village to that posh apartment where you are all cramped in one corner of that post-modern-type-box building sat uncompromisingly and craning your necks to the direction of the flat TV screen on the wall whilst a spring was poking your ass from that geometric designer chaise longue.

I thought my girlfriend looked a bit red when I threw a glance at her. It can’t be that cheap booze she took a fancy with. I know you can turn into funny shades of colour when you’re drunk. My humble clinical training taught me that the liver is in overdrive when you've consumed obscene amounts of alchol. That means a drop in your blood sugar - making it hard for you to concentrate, then the heart pumps harder, that shoots up the blood pressure and the really rosy cheeks: I thought she looked really pissed. Peeved, if you take alcohol out of the equation. My hindsight still 20/20 at that time, was telling me it can’t be the booze. The drink she was holding on was only 4% vol. alcohol. I know her liver is capable of metabolising that smidgen of intoxicant even if she took 4 gallons of it in an hour. This was very unlikely considering the slow traffic lane the drinks trolley was traversing our way.

Amidst the noise of fireworks and rock n’ roll from the telly she mimed: “I am so pissed off with Clara!”, whilst she is pointing to her mobile phone. “She will definitely be deleted from my address book”, at least that was how I gathered it: trying to lip read what was coming out from her potty mouth. Nope, I was wrong. “She is sooo permanently deleted! You won’t even find a trace of her in the recycle bin!” This was whilst the ‘Arctic Monkeys’ are trashing their guitars in the middle of ‘I Bet You Look Good On The Dancefloor’. It was surreal. And very funny. And very serious. Her expressions spelt trouble. I wouldn’t have expected it coming from a technophobe like her: venting her anger in the latest version of Windows media. I wouldn’t be surprised if she will suddenly speak in Hyper Text Markup Language and be the Time’s Person of the Year by 2008.

She showed me a text message from Clara: “Sorry, but Twitty Bird is not ready to face you lot yet”, or something like that. It became apparent that we should skip her place as we go on with the New Year house-hopping tradition because a twit is in her building. Twitty is one of the Talentless, Witless, Irritating Toad ( TWIT ) friend we dumped last year whilst on holiday in New York. He is just one of the other two TWITs ( Ant and Dikey ) who constantly whined about the absence of lifts in the subway, how dirty New York is and think they’re too posh to climb the Empire State building. You could put them all in a box along with what she calls overseas-workers-trying-to-be-bourgeois with typical nouveau-riche mentality who believes that it’s posh to wear shirts with heavy designer labels, whose idea of culture is trawling the shopping malls down Fifth Avenue and think that museums are dreadful places to be seen with. A Pinoy version of Chavness, if you ask me.

Clara is her almost posh friend who spices up her English with Spanish and would never look chavvy in top to bottom Chanel outfit, but quite daft in relationships and choosing her own friends. No matter how hard I tried to convince my girlfriend that beneath the finest lamb’s wool of Clara’s skin is a pig’s entrails, she would never listen to me.

I really felt sorry for her. She was utterly devastated to lose a best friend who she now realized is also phoney: a few hours before the New Year.

Bah, Humbug!

I walked into the unit and wondered why we don’t have a Christmas tree. Around this time last year, we already had enough blinking lights to trigger grand mal fitting to a photosensitive epileptic, and with alcohol hand rubs placed strategically in every nook and cranny, I thought it’s rather rich the hospital is still standing and hasn’t burned to the ground yet. I really hope it’s not the thought police at work here. I heard the Royal Mail is stamping out true meaning of Christmas by issuing stamps without any trace of the Bible story and instead featured little harmless cartoons that will not offend other faiths. I only hope those cartoons are not Danish. The same is true with greeting cards:

“One 'offensive' card risked provoking Christians by suggesting the shepherds only saw the angel appear on the hillside because they were hallucinating after smoking drugs. And another card ignores Christmas altogether - wishing the recipient a "Happy December". Other designs include a pan of Brussels sprouts, a shoe, a woman pointing a gun at 'chavs', a moonlit bridge and, bizarrely, a line of meerkats.” What you get for reading sucky papers like the Daily Mail . LOL!

#10 Reasons why this year’s Christmas is really sucky.

1. Our health care assistant who I learnt today has worked in our unit for more than eight years handed in her notice of resignation last month, so maybe she can’t really be bothered to put up the tree. She did it every year, and was really good in keeping our patients and the unit clean. With the current crisis in the NHS, she may never be replaced. Who’s gonna wash the teacups?

2. They also say the tale of three wise men paying homage to baby Jesus may not be really three at all. The Gospel apparently refers to them as merely wise men: no mention of actual number whatsoever. But I don’t give a toss, really. I’m more concerned that three more wards closed this month. That means we’ll be stuck with wardable patients in our unit. More tea-drinking, weetabix-eating patients as opposed to patients on Galileo, Lidco, Bis, Prisma and all other binary code speaking gadgets that you could ever find in Critical Care. What a shame. I quite like my toys. Even more so at Christmas.

3. The NHS froze the hiring of new staff due to budgetary constraints. It is quite ironic though, to find that the Trust is advertising a post for a high salaried monkey * Smoking Advisor. Salary that’s large enough to pay two more nurses in ICU. I say: “leave them smokers alone!” If they can’t read those death threats / warning in bold alphabets in cigarette packets, maybe what they need are free eyeglasses for Christmas. Shoo them off to Boots or Specsavers.

4. I learnt that the abbreviation Xmas is not really irreligious. The letter X is actually a Greek abbreviation for Christ. And obviously, Christ is not a swear word.

5. I’ve seen in the Biography Channel that Santa actually used to wear a blue or green tunic until Coca Cola matched it to their trademark colour. And Rudolph the red-nosed reindeer was just invented for a US firm’s Christmas promotion in 1938. It’s quite traumatic to learn that they have been lying to you since you were a kid. They are a bunch of utter crooks and liars.

6. Jesus was probably born in a cave and not a wooden stable, say the Biblical scholars. It’s not posh enough to be born in a wooden stable and to learn that he was born in a cave is pushing.

7. I’ve read somewhere that before turkey, the traditional Christmas meal in England was a pig’s head and mustard. More like what we have in the Philippines. Bring back the good ol’ days!

8. The only greens we have in the Christmas Party do are what I would call junk food: chips and crisps. I didn’t realize that some people’s concept of veggies is limited to potatoes and corn. Although apparently, many parts of the Christmas tree can actually be eaten, with the needles being a good source of Vitamin C. That is, if you’re really peckish.

9. Also, in the Czech Republic they enjoy dinners of fish, soup, eggs and carp. The number of people at the table must be even, or the one without a partner will die next year. Good way to control population, I think. This might be useful to people at immigration. Although, maybe I should heed the NHS Blog Doctor's advice: We must behave ourselves. Medical Bloggers in Britain are suspiciously disappearing into thin air. Scary. What has happened to free speech? The most recent one is also my friend: HospitalPhoenix - a very witty and strongly opinionated doctor. I for a while enjoyed being in the Top 4 of his Blog Links like a “myspace whore”.

10. In Greece, Italy, Spain and Germany, workers get a Christmas bonus of one month’s salary by law. The NHS on the other hand is taking the Dickensian Scrooge’s stance of being a tight fisted miserable old fart.

* There are more monkeys like this one in Doc Crippen’s Blog.

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Thank You's:

To all those who greeted me on my Birthday.

To NHS Blog Doctor for another mention in Part 3 of Britmeds 2006

And to Airway Control for including me in Change of Shift Vol. 1, No. 13

Check out!!!

See you all Next Year!

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?