iFlail

La Belle Fille has made the jump to the iPhone. (Other phones are available) As with all new tech, there were a few teething problems.

So, shortly after she signed up for it, and whipped it out of it's box, I received a phone call. This one consisted of a few plaintive "hello"s by both parties, and her hanging up. Another call followed, which she hung up as soon as I answered. Then another, which consisted of LBF simply uttering the word: 'bollocks'.

After a few more abortive efforts, it became apparent that she was struggling with the volume controls.

A text followed, asking me to call her, to check that her phone was working. This call passed off without incident, barring much laughter in the background at her end.

The cause: having taken the phone back, and proclaimed it defunct, the phone guy had taken it from her, examined it and then removed the plastic 'screen protector' see-thru label that had been neatly, invisibly obscuring the earpiece of her new, shiny piece of tech.

The Flail

An unremarkable day at work; started quiet, busied up. The usual. A couple of ectopics being shown round the Dept by one of the Bosses; not sure who they were, or what they do, but I suspect some form of management involvement - another attempt to streamline the Dept, ignoring the bleeding obvious: that we need more space and staff.

At home, my NikePlus kit continues to frustrate me; since my first sensor went dead and I changed it for another, iTunes now seems incapable of linking with NikePlus, refusing me the ability to log my pathetic attempts at running.

I know it's petty, but I need the visual record of what I've managed to help motivate me.

Ah, it's a hard life.

Still no ciggies, btw.

Series Of Dreams

Well, I'm back.

Flail is ongoing, and I've been away for a couple of weeks, which I am proposing as my excuse for my lack of output over the last month.

More realistically, I have to face up to the fact that maybe i've just lost the will to blog; maybe this has run it's course.

I'm not sure, but there do appear to be a few punters still interested in the general gibbering I produce.

So I'll try again; but if I fail again, I may have to face facts.

We'll see. I'm back on nights this week, so may have some tales to tell.

I'll keep you posted.

In the meantime, a few non medical tales?

Flail

I am beset by flail; more will follow. Feel I owe it to my newly swelled battalion of followers

On Flail...

Grand old weekend with La Belle Fille... mild deployment of crossface. I think the honeymoon period is over, and we grump at each other a little more. This is probably a good thing; stops the evil humours building up.

And then... after driving to Kent for a toddler's birthday party, with balloons an' all, then back to La Belle Fille's place, my concentration wavered for a mo'... and wang!
Clipped the curb at 60, and shredded the offside near tyre. Didn't roll it, flip it or get rear-ended which is to be thankful for, I guess.

Swore a lot, the called the AA. Their rep took an hour and a half to find me, and when he did arrive, gave me an earful for not knowing where I was.

Charming.

He recovered me to the nearest services, before gleefully telling me I'd fucked the wheels good and proper, and would not be going anywhere that evening. He then told me the AA wouldn't recover me, as my 'breakdown' was an RTC.

Balls.

Reaching into my oversized wallet, I found my insurance details... missing. A panicked phone call to the Belle Fille, and she was able to surf the Web to the number I needed. My affection for her knows no bounds.

Insurance company eventually arranged for me and the car to be recovered. The following morning, the fattest Oriental man I have ever seen handed over a courtesy car, but kindly refrained from sucking his teeth at the state of the Shroom-mobile. I still wait to hear, and the Insurance will cover it, unless I've secretly written it off.

Details to follow as news warrants...

River Of Dreams

In the middle of the night...

Doing an extra night tonight for a colleague. Normally this would provoke a great deal of grumblage, but as it's because he's a new daddy, we don't mind. I sure as hell am getting old tho'. I used to be able to do a week of these and not feel it, but here I am after three, tired as a wet kitten, and irritable with it. Like a bulldog with a mouthful of wasp.

Anyway...

Further evidence, as if it were needed, that people throw off all sense of personal responsibility when they step through our door. Twice tonight I have had people gesticulating wildly at me, alerting me to the fact that they are bleeding.

Not unreasonable, I hear you think. Well, no, not usually; but in these cases, the bleeding was from cannulation or venepuncture sites. Not from horrendous trauma, or awful limb-falling-off type accidents.

But because the cotton dental roll we place over these pin point hole wasn't taped on hard enough.

And they are always stunned when I stroll over and press on the wound with my thumb. Shroom's Blunt Haemostat. Amazing. Quite why these otherwise healthy(ish) and intelligent people can't summon either the nous, or strength, to think of, and then do, this themselves is beyond me. Instead they stand there, or sometimes move around a bit, to ensure even coverage. Oftimes they wave the offending limb, but always held downward, never upward. And they never, ever press on it. Ever.

Folks, I'll let you into a secret. If you can see a bleeder, and you can press on it, it will stop. I don't care how big. If your finger fits over the hole, that's the treatment, right there. But keep it to yourselves...

My favourite patient of the night (so far) was a young girl, visiting family. (i.e. not local... been to several other hospitals before...) Presenting complaint? Total body pain. Another personal favourite. Atraumatic, mind you. Total body pain is quite reasonable if you've, for example, been sat on by an elephant, or fallen out of a plane. But sudden onset, atraumatic total body pain? Well, we do see this, but it tends to be in a certain demographic of patient. For fear of generalising, or being accused of bigotry, I'll leave you to guess.

Needless to say, her first words to the triage nurse were to inform us that only morphine works for the pain, and that's what she always has. Her triage obs were all remarkably stable and normal. Despite several publicly agonising trips to and from the bathroom, pointedly in front of the doctor's bear pit, I explained that without a diagnosis, or any clues as to a possible diagnosis, I wanted to try other analgaesics first. Simply telling me that your previous treatment plan is i.v. morphine and home does not encourage me to give you some. Cruel, cruel Shroom.

Either way, when confronted with the harsh realities of the analgaesic ladder, and need for assessment and diagnosis, she decided to go home instead. Her gait on the way out was markedly free of the tortured limping and groaning that had characterised it a few minutes previously...

Lastly an SVT. This particular dysrhythmia is one of my favourites (sad, sad bastard) because, in my experience, it rarely compromises people, and responds well to a quick blast of adenosine. My SHO, running the case in his inimitable style, opined loudly to us all that he didn't see the point in 6mg as a starting dose as it "never works"; this minor rant against the system, and specifically the part that was compelling him to give this homeopathic dose of adenosine, continued until about 0.8 seconds after he injected the adenosine, when the patient flipped right back into sinus.

I guess protocols sometimes do make sense. Who'd have thunk it?

Oh, and the CherryPicker has started his own blog. Check it out; his tale is well worth hearing, although I can't vouch for his writing style... he did want me to offer more biog details about him here, but I'm thinking he can tell his own tale now. One doctor's battle with booze, and a reminder perhaps, of how close we all sail. Anyway, enough plugging.

And The Walls Came Tumblin' Down

I can not bear it...

Last night was not so bad. Better than my last nights. My colleague with whom I was to share the duty swapped out of it. So, flying solo again. Good.

Not too busy, but enough to keep time ticking over. And I feel like I did a reasonable job.

Until this morning, when an elderly fella with a whopper of a scalp lac provoked a good deal of flail. Turned out ok in the end, but I guess I won't be winning any plaudits for how cool I am.

And I was slightly disappointed with one of my SHOs. You know who you are, if you've found me. There has been an air of disquiet of late, as the juniors feel demoralised. Not getting to do enough, not getting enough exposure; fair enough. This job is becoming service orientated; but when the opportunity presents itself, shouldn't you take it? Or have we broken your spirit so, that you really don't care anymore?

We're doin' something wrong.

I still can't bear it.

Once again, we allowed ourselves to dare to dream. The England football (soccer...) team flattered to deceive, and we thought: 'maybe, just maybe...'

As I write, I see mortar flaking down around my ears...

She Comes In Colours Ev'rywhere

Or... "Flail of The Century"

No medical gib follows. Be warned and stop now if you have no interest in what I got up to in a field this weekend.

Pictures to follow - as usual I took a very expensive camera, and no pics. But plenty of others did, and with luck, thru the magic of digital media...

So, it was the wedding of one of greatest friends this weekend. In fairness, of two of my friends, but the Groom I have known for 20 years, and we've been through a lot of 'formative' shit together (I certainly wouldn't have been a doctor without him), and his fiance - now wife! - I have only known a few years, so although I consider her a dear friend, it is perhaps not the same thing. Whatever.

Thursday saw me at a dance / drama performance, a first for me. A slightly alien media to me. It was interesting, and a good evening, for a variety of reasons. Maybe it could have, or should have gone better. Only time will tell. Anyway, Friday found me pretty pleased with myself. Festivities were due to kick off on Saturday, but as the whole thing was essentially being held in a field (a place called ColdBlow Farm, which I can highly recommend), quite a lot of organisational flail was required. As Best Man, I was in the frame... so after a late night of modern dance / drama, I roused myself from my pit and packed up to deploy to a field in Kent.

My friend has never been even remotely conventional, so this was a fancy dress affair. As I may have mentioned, I was to be Puck. Puck is an interesting character, but not easy to define in terms of costume. I had found a production where Puck was dressed in red furry trousers and blue body paint. This was I had intended to go with, but singularly failed to find any red furry material, and lack the required Adonis like figure to make my torso my costume. Instead I cobbled some black furry trousers together, and paired it with a ruffled shirt, gold cravat and coloured waistcoat. Topped off with pointy ears, horns and some greenery, I just about passed muster. Still, at least I wasn't Bottom.

Lunchtime on Friday found me and the Groom alone on the Farm, drinking beer and shooting the shit. We were supposed to be erecting a marquee, but there was, inevitably, a delay. At some stage, about three beers in, I acquired my first injury of the event. Clinically this appears to be a mild ankle sprain - the bruising and swelling are minimal, but it gave me something to moan about. Eventually the Marquee and PA arrived, and we set everything up. A few pioneers were arriving by this stage, and it was agreed that we'd all have a quiet one, in honour of the big day on the morrow. The best laid plans...

The next morning saw a few die hards drinking on through, and Bottom (the other best man, resplendent in full ears, and a magnificent tail) pinning a nervous groom into his costume of Oberon. We left good and early, since there is always great flail potential in anything involving these guys. Lemons may get the job done, but sometimes it's hard work getting there.

We arrived at the Registry Office in good time, which was handy, as on our arrival, Oberon announced that he'd left the music behind. Despite being accompanied by Wonder Woman, and Zorro, it was left to me to make a madcap dash back to the farm. CD in hand, if you were in Maidstone this weekend, you might have seen a hairy legged hobgoblin scampering breathlessly through the churchyard adjacent to the Archbishop's Palace. 'Twas indeed I. When I got there, with literally minutes to spare, all I could see were regular getting married folks. There followed about a minute of panic while I wondered whether I'd taken a wrong turning, and weighed up the pros and cons of gate crashing a straight laced wedding dressed as Puck, when fortunately I saw our crowd of freaks, flying the flag... and the freak flag flew proper high over Maidstone - I don't think the Registrar had seen the like before, as Oberon and Tatania, Prospero and Queen Mab, Wonder Woman and Zorro, and even the Jolly Green Giant (ho! ho! ho!) all crammed in to celebrate . Fucking brilliant. The Bride and Groom exited to the sounds of Steppenwolf, and were driven away in a Black Pontiac Trans Am. (If this means nothing to you, you're too young)

The Reception was a blast. Fancy dress is indeed hilarious. The weather wasn't brilliant, but wasn't dreadful either. Speeches went off with only a little flail, and much fun was had engaging in jousting and Maypole based antics. Some of our friends had come as the Three Musketeers (which, incidentally, always seems a misnomer to me, as they were renowned for their swordplay, not their musketry) which gave me some concern as they were all wielding proper swords. Sure enough, one of them stabbed me in the foot (injury number 2) and then sat on me(black eye, injury number 3).

Suffice to say plenty of fun was had by all, especially me, in a most unexpected way. Funny how things seem to come in patches, complicating stuff unnecessarily. Or maybe it's me that complicates things. Anyway; it was good.

The next morning was a bit like a scene from Morning of the Living Dead, and the obligatory prank was played on Spuds, by hiding his car in the field. And now, we've all gone our separate ways, and I just about feel human again. My fourth injury appears to be classic tenosynivitis, of my left great toe extensors. Part of me is in thrall of the classic signs, most of me wishes it wasn't so fucking painful.

Anyway - Tatania, Oberon, Bottom, Jolly Green Giant, Michael Knight (and Kitt) and all the others, Lemon and non-citric alike. I salute you all. We may get older, but damn, we still know how to burn one down. (although we haven't worked out how to recover afterwards)