On Politics

It's mostly bollocks, let's be honest.



La Belle Fille has been away, I have been moping. Drank far too much yesterday, celebrating a friend's impending wedding; have to work today, which obviously I am very pleased about...



Was paid a sort of backhanded compliment by a neurosurgeon the other day, when they opined that I broke bad news well. I suppose if you're going to ruin a family's day, you should do it well, but I can't help but feel it's a sad thing to be good at.

Burnout

I'm due a few weeks off; I'm beginning to think it couldn't come too soon. Off the back of a few nights, I worked a single day. It was not a good shift. Busy busy busy.

This is not unusual these days, with the hospital running at 98% occupancy most days. But I did not comport myself well. Over excited, showing off?

i don't know. In the final analysis, it doesn't matter much, but I was in a stroppy mood. Thankfully, no-one takes me very seriously, and they were more understanding of my temper than I deserve.

My last patient on nights was a three week old baby. One so very, very new to the world, but already too much medical history. Today's problem: vomiting. The little fella wasn't clearing his own airway, and for a few minutes I thought he was going to plug off completely. Actually for about 5 seconds, I thought he had. But a little soft suction, and I have never been so pleased to hear a baby scream. In fact, I've never been so glad to hear any sound.

Ever.

Last shift. Busy, busy, busy. But I told you that already.

Mostly in resus. Strokes, trauma, stabbings. Fractures, dislocations, head injuries.

The first was the hardest. A young woman, who had a 'minor' TIA middle of last year. All the right things were done. The proper work up.

None of which prevented a large, disabling stroke in November. Worse today. What little function she had had... gone. She came to us fitting. Easily treated.

The old routine, tourniquet on, hunt the vein. If you can't see it, feel it. A zen thing. It doesn't matter. I never miss these days. (Arrogant, moi?) The cannula slides in, almost a reflex after all these years, and a lorazepam chaser.

The fits stop; I told you that part was easy.

But she doesn't get better, she can't get better, she won't get better.

She gets worse.

I have to preside over it; the MC of this horror show. Her husband knows; he can't bring himself to say it; he tells me over and over how she was, how alive, how vital.

He's trying to do the terminal illness split. To distance himself from what his beloved has become, while staying true to her. When he looks at her, he still sees the love of his life, but he knows it's not her.

He can't do it, and we both have to take a few minutes out.

Burnout.

If all I have is being good at my job, and I'm not doing that well anymore, what's left?

I hope the break will do me good.

(She Acts Like We Never Have Met)

Be careful what you wish for.

First, the suddenness of disaster.

Patients who I see probably give me an unrealistic idea of how ill prepared we are for the end. Our patients are subject to an inherent selection bias. It isn't a true representation of the general populus. I guess. Or that could just be arse.

Anyway...

What I mean is that we often see people at the 'end of life' with diagnoses that seem terminal. It's often those who have a recent diagnosis. So, suddenly, you go from being healthy, to having lung cancer with brain mets. It must be hard enough breaking this news, without having to discuss the imminent prospect of death.

And so it falls to us.

A gradual deterioration - 'he's not been very well today', then, in a flash - 'he won't wake up'.

And so it falls to us.

It's in the eyes. I see it in your eyes: willing us on, willing us to fix it, to do something, anything to buy a little time. I see it in your eyes: they're blank, staring, unfocused. Windows of the soul? In your case, they let me into your skull, warn me of the pressure within. Straining to get away.

An escape we both know isn't possible.

A review of the notes tells me all I need to know; talking to the family, it seems obvious to me that this thought has not been allowed to take hold. They must know it's coming; but not now, surely.

Now.

The CT confirms what his eyes had told me. Bleeding everywhere, pools of angry white on the scanner. Tortured brain struggling to cope. It won't be long now.

And so, finally, it falls to them.

Interlude

I'm in a blue mood today; which is disappointing.

Bad news, bad news, come to me where I sleep.

Had a grand old day yesterday; pottered about at home, actually getting a few things done, which is unusual. Then in the eve, out with an old friend, for a slightly surreal evening. First, multi-national big band jazz, in an historic town. Then we slipped out to a local pub for beer, and encountered an energetic four piece rock covers band. Oh, and a late licence. The pub patrons were an interesting bunch, who really did dance like no-one was watching. Took a bit of getting used to. But a grand old time... except.

My heart is lost. I am infatuated by someone new. Since my beloved left me to the NHS, I have been solo Shroom. It's probably what I deserve. But I am head over heels, intoxicated, can't get enough of her. So, consequently, every time I'm anywhere near her, I fall apart.

I think she knows. And I think she doesn't feel the same way. But maybe...
I guess we're pretty good friends, and I am torn between preserving the status quo, and playing my hand, terrified I'll fall flat, and that'll be all she wrote. But maybe... she's waiting for me to make the first move..? Every time I even think about it, all marrow, all moral fibre deserts me...

I am pathetic. But she is fabulous...

Then today I heard more bad news. It really puts my 'bad news' into perspective. Two of my very good friends have run afoul of the occasional shitstorms that life throws at you. It seems unlikely that either of them read this, but maybe they know someone, who knows someone, etc, who might.

So, no details,

But it's put a real downer on me. I feel oddly disconnected from life. It seems more unfair than usual.

I can only wish them well, and try to be around a bit more for them, for what it's worth.

Lastly, today we remembered the dead. Whether they agreed, or understood fully what was asked of them, they offered a sacrifice beyond what most of us can comprehend. We should never forget.