30 DSC Day 3

3: Song That Makes You Happy

Marvin and Tammi: Ain't No Mountain...

30 DSC Day 2

Day 2: Least favourite song.

Odd phrasing. The song I like the least, or a song I dislike..?

I choose the former.

I'm still not sure.

Of the songs on my 25 most played list, I think I like this one the least.

Which is not to say that I don't like it. Maybe that's not the point.

Van Morrison: Wild Night

Interlude

Been pre-stacking the blog with songs, so listening to a lot of music; not necessarily a smashing idea in my current mind set, but there it is.

Found this again. Stunning version. Would kill to be able to sing like this.

(Vid not so hot, but bear with it...)

30 Day Song Challenge 1

This is going to be problematic, looking at the list; there's considerable overlap in my choices / options, and i"m not sure I can answer them all.

Anyway.

Day 1: Fave song.

Currently... Joplin's Little Girl Blue.

So beautiful it unmans me every time I hear it.

This Might Be Interesting...

A meme I've only just come across...

day 01 - your favorite song
day 02 - your least favorite song
day 03 - a song that makes you happy
day 04 - a song that makes you sad
day 05 - a song that reminds you of someone
day 06 - a song that reminds you of somewhere
day 07 - a song that reminds you of a certain event
day 08 - a song that you know all the words to
day 09 - a song that you can dance to
day 10 - a song that makes you fall asleep
day 11 - a song from your favorite band
day 12 - a song from a band you hate
day 13 - a song that is a guilty pleasure
day 14 - a song that no one would expect you to love
day 15 - a song that describes you
day 16 - a song that you used to love but now hate
day 17 - a song that you hear often on the radio
day 18 - a song that you wish you heard on the radio
day 19 - a song from your favorite album
day 20 - a song that you listen to when you’re angry
day 21 - a song that you listen to when you’re happy
day 22 - a song that you listen to when you’re sad
day 23 - a song that you want to play at your wedding
day 24 - a song that you want to play at your funeral
day 25 - a song that makes you laugh
day 26 - a song that you can play on an instrument
day 27 - a song that you wish you could play
day 28 - a song that makes you feel guilty
day 29 - a song from your childhood
day 30 - your favorite song at this time last year

Best vs Worst

No further rigors, no idea what the source was. Slightly worried I'm harbouring something nasty... but declined investigation so I guess I have to lie in my own bed.

Increasingly find myself gripped by malaise, and dark feelings of hopelessness, which is somewhat self-indulgant considering my situation versus how it could be.

Anyway, blame that for this post.

In general, I have a low opinion of humanity. Essentially, I don't think we're as far removed from the beasts as we like to think we are. Left to our own devices, I think most people will happily crap on their fellow man, if it's to their own advantage.

Altruism, generosity seem to me to be the exception.

La Belle Fille firmly believed quite the opposite; she does have a bright shining soul though. She may be right.

I suspect my job biases me.

Certainly LBF rarely encounters stuff like this: I was wary of telling this story, because it's sensitive, but I've seen it reported in the Daily Mail, which I think makes it common domain.

A young man died recently, and he probably didn't have to. Maybe it was his time, but he was awful young. He fell into a pond. The Mail reports he had an history of blackouts; I heard seizures. Semantics, really. If you were very uncharitable, you could argue someone with that history should probably stay away from unfenced bodies of water unsupervised. I assume he was alone.

I could be wrong.

Anyway, he fell in the pond, and was unable to get himself out, likely because he was unconscious. It took 25 minutes to get him out. No-one would go in after him.

The Mail is quick to chastise the EMS, whose bosses won't let them go in, in situations like this.

But someone called the ambulance. People stood about and watched. No-one, no-one even tried to get him out.

Stood and watched him die.

Music Nazi recommends Eccentric Soul: The Prix Label.

Chills

Today, I had a full blown rigor. One minute, I was fine: the next felt freezing, was shivering uncontrollably, and, I'm told exhibited pallor. My pulse was up a little, and my BP. My BM was normal, urine dip blameless. I had, and have no other symptoms.

A day spent sweating under a duvet seems to have restored me.

I don't engage in high risk practices.

I didn't enjoy it.

But I don't like not knowing why?

I hate being unwell. This makes only my second sick day in 12 years, but my temp was 39C, so I figured I was due.

I let you know if I die.

"You shall not pass!"

One of, if not the most difficult things I have to do is watch people die.

This, clearly, is never easy, unless you're a psychopath. (I am not)

Sometimes, it is expected; after all none of us live forever, and so sometimes it doesn't feel so bad. Especially if you can make that passing as easy for all concerned as possible, and sometimes you can.

But sometimes, you have to watch people die in the knowledge that they shouldn't be dying, and worse, that you don't know why they are, or that you can do nothing for them.

Because what we're supposed to do, is stand there, Gandulf like betwixt patient and death. Only sometimes, you're not a wizard, you're an impotent old man, with a wispy beard.

This happened once before when I was here before, in a different time, or a different life. We then, and still do, as far as I know, take dive casualties, as we have a decompression chamber on site. It might have gone.

The problem with decompression illness is that usually you are too sick to transfer, and will die without transfer. I don't know if there's a answer. I certainy didn't that day.

The patient was a young woman, with, probably, The Chokes. It's like The Bends, but involving your lungs, or the pulmonary vessels. It's having a massive PE with the only treatment a massive metal tube, too far away for me to reach.

She was blue, with crushing chest pain, hypoxic, hypotensive, dying.

I knew why, and I knew I could do nothing about it.

I've never felt so sick.

Then she got better. It was nothing to do with me. she just got better. I guess the gas emboli in her pulmonary vessels just... broke up.

Maybe God looked over my shoulder, and felt our pain.

Death passed us by that day, and I still don't know why; maybe that's best?

What song best describes your life right now?

Darkness on the Edge of Town - Springteen; or:
Beast of Burden / Fool to Cry - The Stones

Couldn't pick one

Ask me anything

More MGCTv

Some problems with the previous link..?

You can find my chums meandering rambles HERE

MGCTv

Attention!
For those of you with an interest in movies, games, comics or TV series, let me advert you to an up and coming podcast. The cast of 3 fellas and one girl provide pleasantly informal reviews and attendant banter. While their tech occasionally betrays them, it's early days, and the general vibe - of listening to some good friends chat about stuff - is just what this Doctor ordered. You can find them HERE, or search MGCTv on iTunes.

Get involved; you won't regret it.

The Black Dog Returns

I once again find myself wrestling with the Black Dog; posting may be affected

I Believe I Have Transcended...

Irony:

The best thing about living alone, is living alone.

The worst thing about living alone, is living alone.

Funny, eh?

Hard Times...

Sometimes shit just happens.
I know this to be true, and mostly use it as a defence, to protect my fragile mind, but sometimes, sometimes, things leak through. No man is an island, and this man certainly isn't a rock.

The Christmas period was as horrendously busy as I've ever seen it, and I've worked a few Christmases. The rest of the hospital seems to operate a fingers-in-ears policy; interestingly, a few weeks after Christmas, when all the patients we'd seen had been admitted, and the burden of care was shifted up a level, 'they' sat up and took notice.

Suddenly we were flooded with extra staff, and, as is so often the way, they came on a day when we had precious little to do, having admitted all the sick patients in the area.

Until, of course, after 6 p.m., when everyone goes home.

Except, me.

We've seen a lot of very sick folks in their 20s and 30s, with awful, awful pneumonias. At first I though it was all 'flu related; the histories seemed to fit, and indeed some of them tested positive, but more of them are testing positive for strep. pneumoniae, which I haven't seen before.

Anyway, this shift, the BatPhone went off, twice in quick succession, forewarning of 2 such patients; one slightly older, one younger. The older of the two arrived first, and looked o.k-ish, just confused, in a lights-on-no-one-home sort of way.

The second, a young 'un, looked really sick. All numbers awful, half-dead in the bed already. I had to take no. one to CT, so left her in the more than capable hands of my Registrar and the ITU team.

No. one's CT checked out ok; I'm still not sure what was going on there, but when I came back, no. two had active CPR ongoing. The guys had been trying to site a central line, when her BP dropped from bugger all, to fuck all. A subtle, but important distinction.

Well, we worked as hard as we could, for as long as we could, but nothing worked, not even a flicker.

I hate losing the young ones, especially when I'm not sure why.

The conversation with her dad, was as hard a conversation as I've ever had.

Cases like this leave no-one untouched. They spread ripples of shit everywhere; they can destroy families, and ruin perfectly good clinical staff, like the Reg I left in charge of the case, who is more than capable, but will be asking himself what more, what else he could have done for weeks.

Maybe it's selfish to think of ourselves, but we can't help it.

We're not supposed to lose these ones, and it hurts.

It hurts, but I suppose it's not so much the falling down, as the getting up again afterwards.

Do you ever regret choosing Emergency Medicine? Does the quiet life of a GP ever seem more appealing?

Never; I wanted to be a General Surgeon (or a trauma surgeon) but since the K doesn't really have dedicated trauma surgeons, and general surgery is effectively an historical speciality, EM was the obvious next choice for me.
I'm not clever enough to be a GP

Ask me anything

In your capacity as a doctor, what's the most unusual condition you have seen?

Toxic epidermal necrolysis, probably. Though I have, of course, seen the usual complement of objects lodged in body cavities

Ask me anything

formspring.me

Ask me anything http://formspring.me/DrShroom

Laws of Large Numbers

Every now and again, something unusual happens.

Of course, this, at least in part, depends on your definition of unusual.

One-in-a-million?

Sounds pretty unusual, but in the UK, that might be as many as 60 times a day...

So maybe it just seems unusual; or maybe, as a great philosopher once wrote, "It's not unusual"

Nonetheless, it is a truth universally acknowledged that patients collapsing in Radiology have,usually, just fainted, sometimes as badly as Gillian McKeith. (Or, "Gillian McKeith" to give her her full medical title.)

So, today, when the Resus doors banged open and he was wheeled in I was not unduly concerned.

Shows what I know.

To be fair, he did look worse than the usual fainter, and his thready pulse and agonal respiration pattern did little to reassure us. Even that meagre effort didn't last long, and his light went out. There was surprisingly little fanfare.

His history, gleaned in shouted snatches between the requests for adrenaline and flushes, demands for pads and tubes, added little. But we did get him back, and after a prodigious bout of vomiting, he declared himself better.

Well, he didn't know he just survived a VF cardiac arrest brought in by a substantial STEMI.

In fact, one almost wonders how he'd have fared if he HADN'T gone to the pub and fallen over.

But he came back. I still don't know how long he'll stay this time, but he came.

Unusual, eh?

Something...

I want to say that sooner or later, everybody reaches a crossroads in their life. But actually, I guess life is all about the crossing points.

When it gets difficult, where it gets runny is when you realise not everyone is pulling in the same direction. In this respect, I seem to suffer from intermittent empathy failure. Work has been really tough of late; really tough. And it continuously feels like we're being left to get on with it as a Department, to do whatever we can, and take all the blame when shit hits the fan (which it increasingly does), and should there be any goodwill to dole out... well, let's just say it doesn't come our way.

Abandoned Luncheonette; Track 4

I believe I may begin again.

Reasons may, or may not be obvious.

More later