Wild Night

Morning everyone; I am, once again, at the mercy of insomnia in my post nights hangover.

So, here's what's occupying my thoughts:

1. I think I'm disappointed that the identity of 'The Stig' has been revealed. While I really wanted to know who he is/was, now that I know, I think I'd rather not. If you see what I mean.

2. I'm not sure Hillary Clinton has aged well.

Casa del Shroom - the place to come for insightful commentary

Singing The Body Electric

Hacked off.

Lethargic, a bit febrile, and with, as ever too much to do, and too little motivation.

Spent the weekend with La Belle Fille, but was so intent on trying to make her proud of me in front of her friends, rather became a show off, and then something of a penis. Just once, it would be nice if I could cut loose without being an arse; mea culpa, mea culpa, mea maxima culpa.

Have found sleep hard to come by the last few days, so increasingly ratty at work. I always resent being tired ad grumpy at work; it makes me short with people who don't deserve it, or at times when more could be achieved with less acid on the tongue. Particularly frustrating to me today were the efforts of some of my surgical colleagues to avoid admitting an old boy with a dental abscess.

I fully recognise that I am, at times, less than the most conscientious doc, but I always try to do my job. I do not turn away from what is difficult, because it is so.

So, when confronted with a patient labouring under the ravages of a dental abscess, it would be nice if this was greeted with pleasure; not at the illness, but at the opportunity to make someone better.

Not with excuses, and lame promises to treat the patient "as an outpatient", while at the same time suggesting admission under an alternative team. To say that, as a doctor, you do not know how to treat someone who is confused, should really be too embarrassing to contemplate. Instead it seems to be a valid reason for not treating the patient.

I find this increasingly among the surgical specialities, who seem set on returning to the days when they were not Doctors, but tradesmen. One of my orthopaedic colleagues, when referred a patient who had, with a sharp knife, opened her wrist into the joint itself, declined to take on the patient because she had also taken an overdose, That the OD was non-lethal, and over 12 hours old meant nothing to him. He was genuinely afraid that the patient might become unwell in a way that was beyond his ability; and was quite prepared to neglect treatment of her semi-severed wrist to avoid such a possibility.

I sometimes wonder if we all really did go to medical school...

Whiter Shade Of Pale

First:

STOP whatever you are doing. (Actually, since that'll be reading this, wait till you've finished the paragraph). Immediately find yourself a copy of King Curtis Live at Fillmore West. Press play. Your life is now immeasurably better. Trust me. Go on. Do it. Now. Then come back. I'll be waiting.

See: Told you so...

Not much to report. What follows is mostly non-medical jib, so feel free to sign out and tune in for my next installment of medical derring-do.

Nights were unbusy, which is unusual. Managers are prowling around, trying to avoid any breach, at any cost, in the final push for Foundation status (ein, zwei, ein, zwei, build an empire...). We are becoming even more unpopular throughout the hospital. It's just as well that we don't care.

Well, to be honest, I do care. The ED has ever been the sick man of the Hospital. Fine. But now our reputation for slipshod work, hasty workups and premature referrals is becoming deserved. Which, frankly, sucks balls.

In other news, I'm back to being insomniac again. A long series of lates and then nights has left my brain refusing to fall asleep until six a.m. I wouldn't mind s much if I could do something productive with the time. But I feel exhausted, so end up spending hours trying to sleep. I'm on a random day shift today and tomorrow, before re-embarking my mission to work only late shifts this month. Something's gotta give.

Lastly, in case you were wondering, I have discovered the worst cup of coffee, in the Universe. My standards are pretty low anyway. My North American cousins sneer laconically at me when it comes to my appraisal of coffee. What seems like perfectly reasonable java to me, barely classes as dishwater to them.

So for me to dislike coffee is rare. While a student, I drank revision specials that sent me into SVT, but kept me awake for two weeks prior to my second year exams. When I was on the House, I'd cane cold coffee to perk up at night. Hell, I'd even mainline freeze-dried granules. Discerning, I am not. I jive on caffeine.

However, Burger King supplied me with the worst cup of coffee I have ever come across. Yes, Burger King. Now I say it out loud, I'm not sure why I was surprised by this. But seriously; it was shit.

All Wang-Eyed, And Nowhere To Go

Further confirmation, if it were necessary, that i can, on occasion, function on bugger all sleep. But the drive back was... interesting. And although I feel dead on my feet, I'm very fearful that I will elude the arms of Morpheus again tonight. I don't think I can do it again.

And so to work; it's man flu season. Even some of the female nurses were admitting to it. I'm sure that's 'bird-flu', but anyway...

I guess I must have looked more pasty than usual; I sure as hell felt it. It was all I could do to not throw up when I got in. Sure, I can work on no sleep, but it ain't clever. Domperidone sorted that out. Resus was in full swing when I arrived. Baby blue pyjamas knows. He was there. I missed all the action, but did get a chance to relocate a posterior shoulder dislocation, something I haven't tried before. It seemed simple enough, and one of my SHOs and I produced a satisfying clunk. Smug mode all round.

Nope. Apparently, one clunk does not a relocation make. I'm sure it went back, but slipped out again, while we were assessing stability; or when the Radiographers were X-Raying it. Yes, that was definitely it...

So.... the Boss asked me to check out a fella who had had his legs unpleasantly squashed in an RTC. As he put it, when the car in front stopped, he stopped about six inches too late. One bust patella, and a mashed radius. As luck would have it, this was today's lucky combo for an Ortho admit.

Meanwhile... the Boss reattempted the shoulder. I was quite pleased to see he appeared to struggle with it too; until BBP stepped into the breach. Before you could say 'counter-traction' there was a distinctly lesser clunk, but a whole lot more reduced joint. Next time for Shroom, I guess. I just have to remember to take BBP wth me...

I have more wisdom to impart (well, true for a certain value of the word 'wisdom'), but I really am tired... So, until I edit, a reminder to myself - wang-eyed, end of the night shift and nursing scut vs doctor scut.

If I Didn't Have Bad Luck...

Nope; managed about an hour tonight. Finally gave up at 4, and got up. Mean to try and do something useful, but difficult, because my brain is so fuzzy, and it's too early to do much noisy.



So... surfing



Found this, which I'm lovin'.