Way To Blue

Yes, I'm back. Again.

Again.

A little housekeeping.

Those of you still here, and keeping up, will have noticed all pretence of anonymity has gone. Well, more or less. I cannot be bothered to go back through all of these posts and remove the fungal refs, but all of these posts now bear my actual name. Those of you who really want to can Google me. Or Bing me. Why not Bing that shit? Either way, I am there. For better or worse. The GMC, they who must be obeyed for the registered medical practitioner, have taken a decidedly dim view of the anonymous online physician. You can make of that what you will.  There's an interesting take on it on The Pod Delusion, if you feel it's worth more than a cursory shrug of the shoulders. Anyway; I'm out. It's probably not that important really; I'll take the opportunity to remind you all that any clinical situation I discuss herein is at least non-contemporaneous, and possibly fictitious. Names have been changed to protect the guilty, and me. If you think you recognise yourself, or someone close to you, you're wrong.

Some things, however, never change. I'm still, mostly, gazing at my own naval, overusing the word maudlin.

Debriefing. I don't know where debriefing first took hold. I want to think its the Military, but I couldn't swear to it. It sounds like it should be the Military, though. The After Action Report.

In any line of work, when things get runny, they usually do so somewhat chaotically, running with an energy all of their own. Even when it feels like you have a handle on things, that control is usually fleeting, or illusory. Without accounting for everyone else swept up in this particular tempest. As a contemporary of mine is fond of quoting,

"Good judgement comes from experience, but experience comes from bad judgement."

So we crave exposure to whatever it is we try to do on a daily basis, crave our own experience, and crave that of others. Hoover it up, in the hope that whatever was done well can be assimilated, copied and pasted into our own experience, ready for deployment next time out; and that whatever was done badly can be picked clean to try and remove it from the deck next time. More than that, it offers a chance to meet with your colleagues when everything hasn't just slipped agonisingly through your fingers. A chance just to sit down, and acknowledge what it was you just did. Sometimes, I think, its enough to look each other in the eye, and have a little cry. I don't think I did enough of this when I worked in ITU; I'm pretty sure we don't do enough of it now. Sometimes, we can't meet each others gaze. We (I) aren't so good at the more empathic sphere of what we do.

Recently, we had a tough shift. I can't go into the details, obviously. But most of us, if not all of us, have a 'worst-case' scenario. The patient we fear most; the one that we dread. Even the non Medics among you will have no trouble trying to imagine the clinical situation you would least like to be faced with. This was mine.

Actually, the case was run well; but the outcome was bad. Awful. I don't want to be any more melodramatic, but you get the idea. And debriefing something like this, talking it out, is hard when you're talking it out with people who weren't there, people not in the business. Not because we're special, but sometimes these cases are deeply upsetting, and there may be a reason why the person you're talking to didn't love ER. Or maybe it's a defect of my character, that I don't trust my friends to be able to process the chat in a way that I can; or have to; or think I can. I think there's a danger of casting oneself as the martyr, then. The only one capable of managing the psychic trauma.

Which is bullshit; I'm not that special.

More Melancholia

There follows naught but non-medical jib. Those not interested in the maudlin naval gazing of a small fungus, best look away now.

I am in particularly bleak mood. There are, I'm sure, a number of reasons for his. There always are.

Whenever I feel like this, I get the urge to bloggin'. It often doesn't last, and I let it slide. I do not know if that's for the best or not. We may go some way to finding out in the next few minutes. Anything can happen in the next half hour?

A busy-ish weekend, but still so much to do. I spend a lot of time griping about the passing of time, and how old I feel. If you're older than me, that'll seem ludicrous. Younger... just wait. I feel it in my nights more than anything. I used to do whole weekends on call, Friday Morning to Monday Evening, with whatever sleep we could snatch. Actually, with two of us on the house, we'd be guaranteed at least one decent night's sleep, so it wasn't bad at all. Even a few years ago, I could do four nights, or five, and g out at the end of them; lead a productive day, and fall blissfully asleep in synch.

Now...

Two, or three, and I'm finished. Worked Wednesday and Thursday; tried to stay up Friday, but fell asleep. Managed a few hours then dragged meself out to see The Girl's play. An ambitious reworking of Marat/Sade. Beautiful and talented. I continue intoxicated. Dinner afterwards with her folks who'd come to see the play too. A good sign? On balance, not, it would seem.

Anyway, I woke at 3. This often happens to me now after nights, but I could not get back to sleep. These days I interpret this as a symptom of low grade depression. I'm tired but my mind won't let me sleep, and I sit, or toss and turn, or pace. All miserably.

I eventually got back to sleep around 8, meaning to get up for 10, and go shopping. When I finally surfaced at 4, it was time to go see some old friends of mine. One bright moment in my fundament. More insomnia was to follow, but at least I managed shopping today.

I can only hope sleep will not evade me this evening. Work awaits, and that usually centres me.

A Night of Two Halves

Busy Busy Busy.

Interesting. The department was, once again, heaving when I came on last night. Patients queuing to get off ambulances, and mustachioed doctors groaning under the workload. A full hospital. I note that when this happened to the Norfolk and Norwich, they declared a 'code black' and made the news...

Two incidents stand out for me. Firstly, there was the delightful lady who seemed to think that because she had taken an overdose, she could behave as she wished. She took the opportunity to subject everyone within reach to a torrent of the foulest, most bilious abuse imaginable. She topped off her performance with a fine array of spitting. A command performance.

Having determined that her overdose required little in the way of acute management, we disabused her of her ideas about entitlement by having her arrested.

Next I once again had the pleasure of double bunking in resus. In a sort of homage to Steve Martin in the 'Man with Two Brains' I simultaneously treated 3 teens from an RTC. Single vehicle vs tree; they were all in reasonable shape, which was more than could be said for the car.

After this, the night fairly flew by. By six, all was quiet... for about 3 seconds. It was then that the patient handed over to me, with the fateful words "He'll be fine, you won't need to do anything", started fitting.

The fit subsided fairly promptly, but the spreading petechial rash, and frank blood in his catheter bag did not ease our minds. To compound matters, just as the possibility of meningococcaemia was rearing its ugly head, a young woman 2 weeks post chemo was wheeled in.

Now, for those of you unsure, chemotherapy, for all its many benefits, rogers your immune system good and proper. So, once that's happened, one becomes subject to all sorts of previously harmless infections. The hospital often beckons. But next to a patient teaming with meningococcus is low on the list of places you wanna be.

A bit of juggling later, we had achieved isolation. Of sorts. But the department had backed up sufficiently to give the morning crew the impression that we'd done buggerall over night.

Ah well.

On a lighter note, I was able to review some CT scans. These were of the cervical spine of an elderly patient. It was this patient whose condition I was afraid I had misdiagnosed. Had missed.

The CT supported my original diagnosis.

This is good for a number of reasons.

1) The patient does not have a broken neck
2)The patient does not have a spinal injury
3)I didn't miss a spinal fracture.

The altruistic Shroom is clearly glad that this means the patient is well.

(But it's quite nice to know I didn't make a mistake, for the sake of not having made a mistake...)

Flatback Caper

I think, more or less, this blog is a year old today. Woo-Hoo.
There's probably some naval gazing to be done about this... but later.

Nights are almost done; for this run, anyway. Although I'm on again next weekend. My rota has seem me working a one in two lately. I'm not sure why, but shit happens I guess. Next weekend will be my fifth on in eight. Old school. Love it.

I think I've kinda missed Hallowe'en, although we had a few freaks in last night, including one young lady wearing the shortest skirt I have ever seen. I know I'm getting old now, because my first thought was: My belt is thicker than that, followed by: I bet she's cold. I was impressed by how adeptly one of my SHOs worked the board to ensure he ended up seeing her...

Continuing my musings on parents, I saw a fella, who I'm guessing was in his 30s, admitted after a fight. He had sustained mostly superficial wounds, and I think the damage was more psychological than anything - certainly his life was never in danger - but his dad, a man of 72, sat with him all night. Possessed of quiet dignity, this softly spoken man sought me out often to enquire after his son, and I did my best to reassure him. I was struck by the way he would quietly step aside from time to time before returning to his son's side. He used these 'asides' to surrender to his own feelings, small tears breaking through his defences for a few minutes, before he'd cuff them away, recover himself and go back to his son.

I guess we never really grow up while our parents are still around

On My Own... (Again)

I've taken the Queen's Shilling - again. And at what cost? A return to solitude.

My beloved and I have gone our separate ways; can I philosophise about it here? I'm not sure; she might read it, and I don't know how fair that is. Suffice to say, I failed in my duty as 'significant other'. Much as I wanted to, I couldn't give enough of myself to do her justice. I am become a self-fulfilling prophecy, afraid to commit, because I fear the end, but bringing about the very thing I dread most.

For right or wrong, I have allowed my work to dominate who I am. It's difficult to feel good about that a lot of the time, especially when you wake up lonely and alone at two in the morning...

Feathers Stevens, Big Beak O'Reilly, and Jimmy the Penguin

Still finding it hard to write.

This morning I can smell blood, sweat and tears; remnants of quiet horror seem to have invaded my nasal passages.

How's that for melodrama? or histrionics? I'm pretty sure there's a word for it...

I've been at Big Hospital for 4 months now. I'm kinda settled in. Always takes me a while, whenever I move. This feels longer than usual. Give it another two? I dunno... I've no choice either way.

Big Hospital is a grand hospital, but I have felt less part of a team, of a family than in previous departments. Sometimes I feel less valued, and less worthwhile. Unfortunately, we both think we're cleverer than we are. I guess I've reached a stage in my training where I feel I can, and should be allowed to do things my way. It's not like that anymore, and I'm sure that's for the best, even if I can't see it sometimes.

I guess the next stage of my development is to learn how to be a team player again. especially as I seem to think I don't have to.

Jimmy? Oh, you're a penguin... so, fuck it.

Mr Bojangles

Is everybody in..? Is everybody... in?

Let's have at it then. Yes, I'm back; for what it's worth. I've been suffering an extended period of writer's block, and haven't been able to summon the energy to blog for a while. I think I started this whole thing when I was unhappy, as a way to vent. Maybe I haven't needed to do that as much recently.

Anyways, sitemeter assures me a few of you still check in daily, tho the number is fallin'. I've no idea whether it's the same old crowd, or a bunch of randoms, but I guess I'll keep at it for a bit.

I'm increasingly convinced life moves in (?ever decreasing) circles. Just this week I've seen a fella top my list of 'colours I'm glad I'm not', and held a man's hand so he wouldn't die alone, when I couldn't do anything else...

And now, to work. More in a day or two, if you're interested.

Slainte

Unbending, Neverending Tablets of Time

The storm has passed; the bad news that has haunted me these past few days is getting better. If that makes sense.

I haven't told anyone else about it; they've all got their own problems, and I'm not sure I was strong enough to do it anywhere but here. I'm sure it's not emotionally healthy to bottle shit up, but it's sometimes I can keep from being overwhelmed.

Whatever; things could have gone really down the shitter, and they haven't. Sometimes you have to cling to the little details.

I think I might have some good news, too, but more of that later - probably.

The Lonesome Death Of Hattie Carroll

Well, I've moved hospitals... this is in general a pain in the arse, for a whole host of reasons. This is what I wanted to blog about, for want of a better, more pertinent thing.

But today I had some bad news... The details should remain obscure. Although it's my bad news, as it were, it belongs to other people more than it does me; and they have no real desire to see it plastered over here. Suffice to say it has knocked me for six a little.

Pain sure brings out in the best in people, doesn't it? Thus spake the philosopher Zimmerman. I'm not sure he was right. I guess it focuses everyone. When something like this happens, you wonder. Is this my fault? Could I have done something different, something that would have made a difference? I think the answer is mostly "no"; but I wonder... it continues to show my selfish side to the max.

This is someone else's pain, and around it are circles of despair, each one a little further removed from the next. Where mine is depends on who's pain it was to start with. I know it's not about me, but somehow I still find a way to make it about me.

Time after time, I have put things off, signing up to the theory of 'there's always more time'
I'm sure you all know it, but usually there isn't. Right now, I have never felt more regret for the lazy way I have abandoned my life for my work. Somehow it feels like I have abandoned more than just my own...

You Can't Always Get What You Want

Thus spake the philosopher Jagger.

Musing over my previous post, I am reminded of something that occurred when I was a HouseSurgeon at another DGH. The details are less well known to me, as I was just ScutBoy, but it illustrates the same principles well. I'm beginning to think that foremost among them should be "don't believe what you're told", no matter who tells you.

In this case, a patient was brought to the A&E (as was) having been 'found down' on a railway track. There was no suggestion that he'd been hit by a train - i.e. he was in one piece - but he was under a bridge. My understanding is that he was first assessed by a rapid response team. Two basic options present themselves:

One - he has jumped / fallen from the bridge above. Classification: trauma. Plan: rapid transfer, eager doctors waiting.

Two - he was walking along the railway track, and passed out here. Classification: Not Trauma. Plan: call some other guys to ship him to hospital; tell no-one he's coming.

The on-scene assessment was the latter.

He duly arrived in hospital labelled "collapse ?cause". No bother he can wait his turn. This was, of course, back in the 'good old days', when waiting really meant waiting.

He duly waited. After some time, the duty Senior HouseSurgeon was passing through the Department, and spotted said patient. She was of the opinion that he was entirely too white a shade of pale, and stopped to give him the once over.

One quick primary survey later, an open book pelvic fracture was discovered.

Much later an history of attempted suicide by leaping was discerned.
My memory does not extend to exactly what assessment this fella received on arrival, but it evidently didn't extend to routine re-assessment. Or did it? I genuinely don't know, bu somehow he slipped through the net, mostly because his initial label was along the lines of "he's o.k.", and it stuck.

On a lighter note, it was while working at this hospital that I had the pleasure of working on call over Christmas, and the A&E staff all dressed up for Christmas Eve / Day. Nothing beats the look on a patient's face when he opens his eyes post resuscitation, and the first thing he sees is a blond nurse dressed as an angel.

Bryter Layter

And so it goes on...

I still can't seem to find anything to write. For various boring reasons, I haven't really been in the mood. At least partly I'm stuck between the desire to write intelligent relevant comment - not least because I want to impress my small readership - and what feels like my need to just witter inconsequentially...

So what follows is mostly the latter. Be warned.

I've been off a few weeks, sort of, but I don't feel any more relaxed. Work continues to bug me. Which is shit, frankly, because sometimes it feels like all I'm good at. I think it speaks of a deeper self loathing because I'm so disorganised. Laissez-faire, you might say, if you were as pretentious as I am.

My best friend has returned from Africa t get married. I was honoured to be asked to be one of his best men (3rd time as a double act for me... is this fashionable, or am I not quite good enough to pull it off alone?) Clearly I'm pleased about this, but so far haven't really contributed anything... I'm actually embarrassed at how little help I've been. This isn't helping my self esteem.

On a lighter note, I discovered another medical blog today, which has brightened my day a bit. Especially a post about the dreadful habits men have of observing their female colleagues a bit too closely during CPR. (However, I'm confident that scientists will discover a gene that codes for looking down tops, and then we can blame it all on that.)

I'm going to try and ease my aching brain with a visit to my God-Daughter. Lunch with her folks always helps ground me a little, which can't be a bad thing. Then, this evening, I think I'll get drunk somewhere and make a fool of myself. Another great leveller.

I'm moving jobs in a couple of weeks, so expect exciting drivel about my scramble to pass my end of year assessment, and then the crap inherent in moving hospitals.

Oh, and I've gotta dress as Puck for the wedding. Costume ideas, anyone? (I quite want to wear an 18th century frock coat, but can't quite seem to make it relevant...)

Your Life's Waiting Like A Goddamn Fool

I seem to have an increasingly hard time 'putting pen to paper' of late.

I still feel a bit pressured at work; I'm guessing that's not helping. Also it seems like an increasing number of people I know keep finding this blog. I know this is ridiculous, because I haven't really made any attempt to anonymise myself, so should have expected it really; but I didn't. I guess I thought too little traffic wandered over to my little corner. Ah well.

So where are we at?

MMC / MTAS continues to fall apart around our ears, taking with it the careers of so many doctors. Just thinking about it makes me alternately furious and depressed. And I've got a job.

My yearly assessment draws near. And my paperwork isn't up to date. Ask not for whom the Bell tolls; it tolls for Shroom

Emotionally, work has been fairly shit the past week or so. I've treated several patients whose diagnosis appeared deadly obvious to me, but who seemed oblivious to the possibility themselves. It's like being the worst kind of fortune teller in the universe. I'm sure all the medics out there know the world know the feeling...

Patients present with what seems, to them, to be an innocuous collection of symptoms. To me, coupled with the inevitable signs they haven't noticed, or are denying, it's anything but innocuous. The knowledge that around the corner awaits the instruction to "get your affairs in order" fills me with nausea. I realise I'm being selfish, because at least I don't have to hear that about myself. But for a few moments when I'm certain of my dreadful diagnosis, I feel shit because I have to bear it alone. No-one can share my burden.

Then you divest yourself of your dark suspicion, your foetid information all but stinks up the room; a miasma of misery. Now it's their burden, not mine, and I don't have to shoulder the weight anymore.

I don't feel any better. Just a little more selfish, for trying to ease my pain with theirs.

Some days it seems all you do is ruin people's days, and, by extension, their lives.

Under Pressure

Some days, I feel like buckling...

More on this in a bit; I'm not really in the mood for navel gazing. I'm in the mood to vent. I often get to work early. It gives me a chance to have a coffee, catch up on e-mails and generally ease myself into the day.
It also makes one a target for people who say things like "As you're here, would you just..."

Of course, the argument runs, if you don't want to be asked questions, hide. (Or don't go in early..?) Either way, I accept this is going to happen, especially in this business. But I reserve the right to say that I'm not on duty. If the fuckers are going to treat me like shit, they can't expect 110% from me. Which I know isn't very caring, but there you go. We're not talking about life and death shit here.

So, there seem to be two ways a person might approach the early Shroom at work, while he is quite clearly attending to personal business, and not at work.

--- Firstly, you might bid the Shroom good morning and ask if he wouldn't mind reviewing a patient, as the SHO is tied up, and it'll save delays, etc.

Unless I'm in a really bad mood, I'll do it.

--- Secondly, you might march up to the Shroom. Do not say hello, do not introduce yourself. Instead, start moaning about the grief management is handing out about The Situation. Demand to know what Shroom is going to do about it. Look aghast when he explains he's just walked in, and doesn't know anything about The Situation. For extra sympathy, walk off while he's talking to you.

Whatever mood I was in before you started, it's now bad.

Of course this sort of thing could never happen in the NHS. Managers there value their Doctors, and more importantly, their patients as humans, not numbers, or targets. And God forbid that such a situation arose because the Management couldn't get the Department staffed adequately overnight.

In case you were wondering, the situation here might have been, for example, that waiting times had reached three hours. They hadn't, of course, so I'm sure that wasn't it.

Take A Little While To Grow Your Brother's Hair

Pure nostalgia tonight.

My experience of blogging strikes me as odd. While the process of writing is cathartic (although you could argue I could achieve the same thing by actuall talking to people), I have found myself inevitably drawn into the Blogging community.

I start to wonder who is reading this nonsense, and of course, I've started reading other peoples blogs. There are millions out there, so I'm sure I'm missing millions of great blogs; but those that I do read attract my attention, smetimes because they comment on my blog, sometimes because someone else recommends them.

Anyway, those that I try to read regularly I find well written to a fault, and all have something worth saying. Many of them express sentiments that I share much more eloquently than I could ever hope to. Variety is the spice of life, I guess. Like good books, these blogs can start to feel a bit like old friends.
Or new friends;
or whatever.

The point I'm rambling toward is that sometimes these folks go missing. Everyone has they're own reasons for not posting. None among us are doing this professionally, as far as I can gather, so life gets in the way. But... you can't help but wonder. Part altruism (are they o.k?) part selfish (I was reading that!)

Well, a couple of the blogs I follow had been silent for a while, and are now going again. Which is nice. I'm glad you're both posting again. Welcome back, for what it's worth.

I was watching an episode of TV Medical soap Holby City tonight. (If you're not aware of it, think Chicago Hope; if that doesn't help, then Nuts to you.) The entire episode was set during the late / night shift. It made me quite nostalgic for nights on call, if you can believe it. Then a number of glaring technical errors became apparant to me, and rage became my dominant emotion. I've self medicated with alcohol, though, so it's ok.

It does bring me to my own peculiar rose tinted specs. Hard and sometimes frightening as my nights on call were, I now look back on them with fondness, both as times when I was happy, and as a macho badge of homour. (I've been prone to use "In my day..." - type aphorisms since I finished my Pre-Reg year. (And, yes, I know, I'm an arse. But thanks, anyway.)) It makes me wonder, though... was it really any beter? The prevailing wind in medical politics at the mo' is that things are worse now than they were a few years ago.

This isn't quite the same thing. There is no doubt in my mind that that Bitch Hewitt has fucked the NHS royally. But it has pretty much been the aim of every Govt since 1948 to break the power of the medical profession. As to the idea that Doctors earn too much, I say Bollocks. Yes, we earn good money, but compare the amount a surgeon gets* for removing your cancerous intestine, and potentially saving your life with the fee a Solicitor gets for conveyancing your house.

They started it.

Nye Bevin promised to choke our throats with gold, and no-one stopped to think that good Health Care would become increasingly burdened, no less so.

I did have a point to make. I'll try to come back to it when I can think straight.

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*(about 600 quid in Pa Shroom's day ( I know the bill will be more than that, but 600 is the suregeon's fee, and it includes all the post op care while your in hospital, which might be two weeks.)

She Has Robes And She Has Monkeys

She lives on Love Street...

So I've reached halfway point of my leave.
Rather lamely, I don't feel I've achieved anything. I worked last Sunday night, so last Monday was a right-off, and then I worked Wednesday night too, so that ballsed up Weds / Thurs, and I've been fairly vegetative since. However, I am on track to have got things done, which is an unusual change for me. Details to follow at the end of the week. If Colossus is still out there, I know he's expecting much inertia. We'll see.

As an extra task, I'm going to try and hook up with a few old friends. Guys I went to school with, but don't see very often - both distance and the NHS get in the way. The problem I usually have is that they've invariably organised something to do- which is not unreasonable. I believe it's called having a life. I can almost remember when I had one myself... (cue violins, droning in the background)

But it's frustrating to find out all your friends are up to something you can't get involved with - usually because it's a ticketed affair, or whanot. A painful reminder of how far out of my old social circle I've fallen. Time marches on for all of us, I guess. I can't remember if I've mentioned this before, but Pa Shroom once told me he was meeting a friend of his, whose Best Man he'd been, but had hardly seen since. Naively, I used to wonder how such a thing could happen.

It's all too clear to me now.

Well, you pays your money, you takes your choice.

If any of my dear readers share my affection for Bruce Springsteen and the E Street Band, I urge you to invest in a copy of his live performance from 1975 at Hammersmith. But I imagine most of you won't be interested. Shame on you.

Thought For The Day

"Sometimes you have to sink all the way to the bottom, before you can begin to climb back up..."

What We Did On Our Holidays

Actually, what I need to do. I'm on leave, except for the odd night here and there. I've got a post or two brewing, but I thought I'd leave an electronic record of stuff I need to get done over two weeks, so we can all see how rubbish I am...

In no particular order....

1. Visit Dentist

2. Visit optician

3. Get hair cut (6 months goes by so quickly...)

4. Get hot water fixed in my house (it's been two years, I think...)

5. Fix my fence

6. Tidy my house

7. Sort a new mortgage

8. Get my suits dry cleaned

9. Paint my house (!)

10. Finish an interminable amount of paperwork

11. File said paperwork

12. Write up 2 audits

13. Prepare 2 presentations

14. Re-submit a case report

15. NOT spend all day surfing the net.

Wish me luck. Update to follow in 10 days. Some photographic evidence may be submitted...

Fishlady, Oh Fishlady....

I've struggled to post the past few days. I'm not sure why. The computer at work was being frustratingly slow, and I guess I get discouraged easily. Another of my enviable character traits. Not much has happened either, which doesn't help...

So just a few random thoughts, I guess.

I think I've had another hard week; I'm not sure why. I'm due a break - in fact, I'm on one now - so maybe I'm just tired. Snappier than usual, which didn't endear me to my colleagues, I'm ashamed to say. What's done is done, unfortunately. We've seen a lot of overdoses this last week. Maybe more than usual; maybe not.

Feels like more than usual tho'.

In general, we do see a lot of this presentation. My experience of the psychiatric services in the U.K. has not been good. This is not an implicit criticism of the people that do the work; I don't know nearly enough to start down that line. It's merely an observation, and I assume the problem is an overstretched, understaffed service.
Part of the side effect I feel from seeing so many of these cases is that I start to become unsympathetic. This not a good thing; but I have to admit, I find it hard, when I see so many people who lie about what they've done, or what they've taken. People who seem to be in it to abuse the system, or, God forbid, for the attention.

Let me repeat - this is not right. I am not trying to justify myself. You just need to know. Well, as much as you need to know any of the drivel I'm prone to vomiting forth.

Well, I saw a couple over the last few days who really got to me. Regular people, not serial offenders. People whose lives had taken a series of turns leading them down an alley so dark they couldn't see the way back. Couldn't even see that there IS a way back. Neither of them had taken ODs likely to cause physical harm, so I referred them on the way. I'm not sure I was any help at all really, tho'.

On a lighter note, I was getting my hair cut today, and the place was awful cold. I became acutely aware of the temperature differential caused by the hairdresser. It's amazing quite how much heat a body radiates. Or not. Maybe you had to be there.

Maudlin Rambling

More jibber...

--- More about drugs (and the arrival of a fictitious Editor - Ed.)

I said in a comment a while back that I had taken a few liberties with the timeline of events herein. Allow me to elaborate. While I am writing this now, some of this had been going on awhile. It may appear more immediate than it really is. I'm actually regretting bringing the whole thing up, but it is something that gives cause for concern. (No shit, Shroomy - Ed.)
I know a little about drugs from personal experience - booze and fags (and coffee, I guess) being my poisons of choice, so I feel like I know a little about the addiction that makes them so ruinous. Medicine is renowned for being stressful, and some medics almost wear it as a badge of pride. Mostly the more macho end of the spectrum, but you get the idea.
Nonetheless, what is less braggable about, whatever your frame of reference, are the accompanying high rates of substance abuse and dependence that stress seems to generate. It doesn't help that it's so damn easy to, for example, divert narcotics. (I've borrowed that phrase. I hope that's ok, and I hope you don't feel I'm making light of this. I've already touched on the damage booze inflicted on a good friend of the Shroom)
In this specific case, I think my first draft of the post in which I started this was written badly. But I am concerned about a colleague. I've spoken with X, and there is a lot more going on than I thought. In a very real way, it's none of my business, and I hope people will understand if I don't elaborate further. In another very real way, it is my business. We have to look out for each other, right? If the Shroom was in trouble, he'd want to know folks were looking out for him. I have gained some reassurance that drugs do not lie behind what was worrying me. I hope I'm as right this time, as I was wrong before. I'm sure we've all seen how easy it is for something to spiral out of control, and end up the dominant, destructive force in a life.

Drugs are bad, m'kay?

---A bit more maudlin navel gazing.

I occasionally find myself contemplating my place in the world, and who I'm sharing it with. Which is no-one right now. This is fine by me, most of the time. A fella's gotta be happy in his own company, right? Well, maybe, but just at the mo' I'm lonelier than usual. In my first (draft) post about getting yer ya-ya's out, it was this I was referring to, crudely, when I wrote that I wasn't getting any. (Classy - Ed.). Not the drugs (still classy - Ed.), in case you were thinking I'm more degenerate than you had at first guessed. I'm still fighting off the nicotine, and can do without another addiction, thanks.

So, I'm footloose and fancy-free, but a bit miserable with it. But I could probably get my ya-ya's out, at a push.
Well, today, I set out to rectify the situation. The Shroom has been sweet on one of his colleagues for a while; we don't work together all that much, the shift system being what it is, but we were on together today. Now was my chance! Those who know the Shroom will not be surprised to discover that he deployed his usual charm , and flailed about, failing to broach the subject at all. However, I did find out my mission was a lost cause, after she'd gone home for the day, by discovering she's already seeing someone. I'm fairly certain I managed this clumsily enough that she will already know I was asking about her.
So: to summarise, no date, and I managed to make myself look clumsy and gauche. (Result! - Ed.)

--- Final minutiae of The Shroom
You can see what I'm listening to, so to complete your multimedia profile, I'm reading Redcoats by Richard Holmes. If you're so inclined, you can pretend to be in my head.

I'm not sure I recommend it right now.

Sex, Drugs and Getting Yer Ya-Ya's Out

The edited version. Part the first. The drugs.
One of Shroom's colleagues has been concerning him. X is increasingly prone to mood swings, and sometimes seems irrational. I have an idea that X is using opiates - maybe just codeine or tramadol - for their occasional euphoric effects, rather than their analgaesic efficacy. Morphine is very easy to come by in the ED. It would be a relatively small jump... or an huge one, depending on your perspective. Maybe I'm over-excited. I know my duty lies in confrontation if my fears are that strong, but I don't want to charge in. Maybe something else is going on. I shall talk to them. Simply voicing my fears here isn't good enough.
I'll let you know.