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Friday, June 30, 2006

Young girl, don't cry

Examples of why some children cry:

1. I would never hurt my child. But I will jump out of a window into a vat of paint whilst holding him in my arms. And then I will forget his name and that he was even with me at the time. What is that creature over there? It's dripping emulsion all over me, get it away!

2. I would never hurt my child. But I will cut myself in front of her and refuse to stop even when she cries. When I lie bleeding on the floor, I will scream at her because she has called the ambulance, the little bitch. Next time, I'll make sure she isn't around.

3. I would never hurt my child. But he is a weak, sickly boy, and he needs his rest. He shouldn't be out there, in the cold wind, with all the germs and the mud and crawly things. He should be indoors, all the time, where I can keep him safe. Why don't you tell him that he shouldn't be playing so much football? Doctor, you must tell him!

4. I would never hurt my child. But she is sometimes such a horrid little girl. Look how fat she is. I can't get her to stop eating rubbish. Chips and sweets and chips and sweets all the time. I tell her the sweets aren't for her, but she eats them anyway. I just can't stop her. Can you give her something? She's so disgusting and fat. Greedy little piggy girl.

5. I would never hurt my child. I'm right there with her, making sure she doesn't get too drunk, you know. You gotta be there for your kids. I was younger than she was when I started to drink, and I turned out alright. Yeah, I let her have a spliff now and again. It makes her look cool at school and it doesn't hurt her. I'm the 3rd graders' favourite mum - they call me 'Mrs Cool'.

Thursday, June 29, 2006

Lakeside

I realise I haven't yet written about my trip to the Lake District (because I haven't even finished writing about my trip to Germany).

I did have an enjoyable time, despite the fact that I packed for warm, sunny weather and the rain clouds decided to have a conference in Cumbria that week. I did have an enjoyable time, despite the fact that I suffered from a terrible bout of catarrh and had to tote wads of tissue paper everywhere. I did have an enjoyable time, despite the fact that I got turned down from yet another another job interview the week before.

The Lake District is lovely - it is impossible to have a rotten time in the midst of all that beauty.

For anyone planning a self-catering holiday at the Lakes, I highly recommend Lowthwaite Cottage in St John's In the Vale - a cosy little place with two very comfortable double bedrooms, a stone fireplace and furnished with all the modern conveniences. You can book it online from Cumbrian Cottages.

This picture is taken in the cottage garden on a sunny Friday afternoon. You can't see from the picture, but I am observing some bumblebees are are busy bumbling in the rose-and-foxglove patch, and I am smiling, because I have just had a nice cup of tea and a chocolate cake.

There are chickens clucking in the yard - this means organic free range eggs for breakfast every morning, fresh from the hen. There is a calico cat lurking behind the dry stone wall, and a family of wrens nesting over the garage. In the distance, the sound of lambs bleating and young calves bellowing, and bells ringing from the church carillon.

And there is MDH, shouting at the TV, watching the World Cup.

Wednesday, June 28, 2006

Eating out

Not so long ago, MDH and I stood on the balcony, watching the sun rise over the mountains.

I had several plates of buttered bread, cheese and sausages in front of me and I was making sandwiches. MDH took the crumbs and poured them out on the balcony ledges. We watched quietly as the chaffinches came, male and female, chirruping.

MDH held my hand and we walked from our apartment to the town centre. There was the grey sky above, the gravel below and the two of us walking, walking, walking and whistling.


Meatball zuppe?
Originally uploaded by
Sunshine follows me.

For lunch, there was a bowl of savory meatball soup for me, shimmering hot in orange and red, and garnished with chives and a sprig of mint.

We sat outdoors with cold noses and cold hands, nibbling on vinegary bread. I slurped my soup. MDH had a cup of coffee with a tower of whipped cream spooned over it, overflowing into his saucer. He sipped it slowly and afterwards I wiped off a dab of cream from the tip of his nose.

The wind blew gently in our faces and brought with it the scent of pine trees from the nearby parkland.

We bought pastries at the bakery - creamy cakes stuffed with brandy soaked cherries and crunchy almonds, encased in hard chocolate shells.

Up the nordic hiking trails we climbed, the sun peeping shyly at us momentarily before hiding behind the clouds. Polished wooden benches shone invitingly and we soon put our feet up and sat back, pastry in hand (or in mouth), looking into the distance. Afterwards, I wiped more cream off the tip of MDH's nose, and we continued our walk.

And later, in the evening, there was fondue.


Fondue to you
Originally uploaded by
Sunshine follows me.

Tuesday, June 27, 2006

Death and regrets

I haven't really been writing much recently.

This is because I have not really been able to process some of the events of the last few weeks.

One of my patients died - very suddenly and very horribly. And I feel very responsible for her death. At some point, when I have stopped seeing her face in my dreams, I will write about it.

But for now, I have guilt. And it plagues me.

I could not face her family. I felt compelled to write them a letter expressing my sorrows and my regrets.

Now, I wait.

What can I do?

With 6 months of 'spare time'?

1. Study for exams
2. Work locum doctor shifts
3. Get involved in church
4. Take up singing lessons
5. Learn to play the guitar
6. Actually iron MDH's shirts
7. Join a choir
8. Write
9. Go swimming regularly
10. Take a photography course

Any other ideas?

Sunday, June 18, 2006

Sail away

Going to the Lake District with the Out-laws.

Be back in a week.

Saturday, June 17, 2006

There can be only one

Patient: (screaming loudly) You gotta help me, doc, I'm in pain! I'm in terrible pain!
TSCD: Okay, tell me where your pain is.
Patient: (points to head) Here.
TSCD: How does this pain...
Patient: (points to chest) Here. (points to back) Here.
TSCD: Er...wait...
Patient: Here, here, here, here....
TSCD: Wait...stop...
Patient: And here, here, here and here.
TSCD: Wait a minute..
Patient: And also here. And here.
TSCD: Wait, I said...stop..
Patient: And I have shooting pains down here too.
TSCD: I said, STOP!
Patient: But...my pain!
TSCD: You can only have one!
Patient: One? One, what?
TSCD: One place to have pain. Choose one!
Patient: One?
TSCD: Yes. Where is the worst of the pain?
Patient: Everywhere! I have pain everywhere! Everywhere! All the time!
TSCD: NO! You cannot have 'everywhere' pain! You have to choose the worst one!
Patient: But...but...
TSCD: NO! Choose one! Only one!
Patient: Ummm...my small toe.
TSCD: Your small toe.
Patient: Yes, the worst of the pain is in my small toe.
TSCD: What sort of painkillers have you tried?
Patient: None at all.
TSCD: I see.
Patient: Can I have some morphine now?
TSCD: NO. You can have some paracetamol.
Patient: Okay. (takes paracetamol and leaves)
TSCD: (bangs head against wall)

Thursday, June 15, 2006

Eyebags

I need sleep.

My sleep patterns have been so erratic lately, that I can't sleep at night because it's too dark.

This cannot be good.

Monday, June 12, 2006

It's a day

1000: Get up after 5 hours sleep, get washed, call Faraway Northern Hospital to let them know that I'll be attending the interview on Monday, call MDH at work and wish him goodnight.

1030: Check the MRCP (UK) website for my exam results. Name not on the pass lists. Shrug shoulders. Prepare breakfast.

1100: Take out trash. Leave the house to go downtown.

1120: Visit
Scholl's, Clarks and Office whilst on the way to the post office. Post letters. Pay in checks at the bank next door.

1150: Visit
Next, Barratts and Marks & Spencer. Buy white socks and overpriced chocolate coloured sandals from Marks and Spencer.

1210: Visit
Gap. Roman-style sandals are prettier and going for £5! Buy sandals. Look longingly at overpriced patterned socks. Return to M&S to return overpriced chocolate coloured sandals.

1225: Visit
Accessorize. Try on floppy summery hats. One of them actually fits and makes me look more like LIttle Bo-Peep than Little Brown Mushroom. It's on sale! Buy hat.

1240: Visit
BHS cafe. Buy stuffed jacket potato for lunch. Sit on a bench outside, watch small children terrorise pigeons.

1310: Visit
Waterstone's. Lots of good books going 3 for 2. Pick up 'Anansi Boys' and 'Cloud Atlas' for MDH. Can't remember the name of the 3rd book MDH wanted. Call MDH. Where is my phone? Where is my phone?

1318: General panic. Still can't find phone. Where is it? Empty bags onto floor of Waterstones. Wallet, keys, no phone. Darnit. Panic some more.

1323: Visit BHS. Panic. Visit Gap. Panic. Visit M&S. Panic. Visit Accessorize. Panic. Vaguely recall irritating teenage boys bumping into me and then giggling hysterically. Darn kids!

1350: Visit 'Phones4U'. Call up phone company and get them to bar SIMcard on phone. Haha! Phone company checks my account - realises that I'm due for a free upgrade anyway. New SIMcard and handset dispatched FOC. Yay!

1400: Return to Waterstones 3 for 2 sale. Pick up
'Anansi Boys', 'Cloud Atlas' and 'Eragon' for MDH. Decide that today would be an appropriate day to start reading 'A Series of Unfortunate Events' - get hold of first three books as starters.

1440: Return home, carrying spoils.

1510: Talk to parents on Skype phone. Show off purchases.

1600: Prepare dinner and supper.

1700: Nap

1750: Leave for work

1800: Darn football hooligans! Ready self for a night of stitching drunken brawlers.

The hand that feeds the sparrow

A video from our excursion to the park.

I love feeding the sparrows, but I hate feeding pigeons. I'm not sure why - any ideas?

Sunday, June 11, 2006

Get some Ubik today!

I take back everything I said about Philip K. Dick. He is not boring or a torture to read. I am now reading 'Ubik', and it is good. I may even try re-reading 'Do Androids dream of Electric Sheep' again, just for kicks. (wahj, you'd be so proud.)

Conversation in the park

TSCD: What's that?
MDH: It's a nettle plant.
TSCD: Ooh! Ooh! Like in Enid Blyton!
MDH: No, like in England.
TSCD: England is so cool!
MDH: Because it has stinging nettles?
TSCD: Yes.
(pause)
MDH: What are you doing? Get away from that! Don't touch it!
TSCD: Ow ow ow! The nettle bit me! Ow!
MDH: Well, it's a stinging nettle, you silly.
TSCD: Ow!
MDH: If you had grasped the nettle firmly, it wouldn't have hurt so much.
TSCD: Ooh! Ooh! That's what Enid Blyton said!
(pause)
TSCD: It still hurts.
MDH: Oh, come along now and I'll find you some dock leaves.
TSCD: But...but...Enid Blyton never wrote about dock leaves.
MDH: Be quiet.
(pause)
TSCD: If I'm good, can I still have ice cream?

Thursday, June 08, 2006

Who makes the decisions?

I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. (If I had insisted that you stayed in hospital instead of listening to your opinion, would you still be alive now?) I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient. I am the doctor. You are the patient.

Tuesday, June 06, 2006

Medical Grand Rounds 2.37

This week's Grand Rounds are up at The Medical Blog Network. Do have a peek!

Monday, June 05, 2006

Conversation

(6 years after 'Harry Potter and the Goblet of Fire')

MDH: Oh! Pensieve! That's like pensive!
TSCD: Yes.
MDH: Oh, oh, that's really clever!
TSCD: Did you only just get it?
MDH: Er...yes.
(Silence)
MDH: You still love me, right?

Sunday, June 04, 2006

Toothsome business

There was blood on his hands, blood across his face, blood spattered on his vest and trousers. His little face looked worried, and he sat silently on a little stool as I examined him.

He had been playing with the new puppy which had gotten overexcited and had bitten his face and hands.

And bitten off his earlobe.

He would need plastic surgery to reconstruct his ear. Stitches to his face. Dressings over his fingers. Antibiotics.

He winced as I cleaned up the wounds over his cheek and nose. His parents hovered over us, anxious.

"I think you will have to get rid of the dog."

His parents gasped in surprise. "Why? It was only an accident! It's never bitten anyone before!"

I informed them that the dog may attack their son again, and who knows how bad the bites will be next time? Besides, he probably won't want to play with it anymore.

They grumbled.

"But it's pedigree!"

Saturday, June 03, 2006

Secret languages

"Wawa wawa wawa!!"

Her angry babbling crescendoed as the nurse and I approached, and she kicked her legs wildly in our general direction, rattling the cotsides. She had been crying constantly for two days, refusing to eat or drink, and her black eyes had dulled and sunk far back into her head. Efforts to tempt her with tasty sugary drinks and savoury purees had failed miserably, and she was losing weight rapidly.

I tried to distract her with some shiny bright toys whilst examining her, but she was not fooled.

"Wawa wawa wawa!!", she wailed, struggling feebly and scooting backwards away from me. She batted at my stethescope with her fists, glaring at me from under a shock of curly hair. There were purple bruises all over her body.

"Wawa wawa wawa!!"

Her parents had died long ago and she had been sent to us from a care home. Nobody had thought to accompany her. Her clothes were dirty, sopping wet when she arrived at the department - she did not even have a diaper on. When I rang up the home, a bored voice informed me that her personal carer had left. There was no way I could get any more information about her condition. I made a mental note to fill out a concern form about the atrocious behaviour of the care home.

Fortunately, her older brother arrived. At the sound of his voice, she grew still and the furrows in her forehead smoothed over. She put out a wrinkled white hand and he clasped it in both of his.

His face was somber. His hands grasping a sturdy walking cane, he looked at me with sad grey eyes.

"She's never been the same since the stroke."

In a soft voice, he spoke to her quietly, gently, whispering in her ear. "Wawa wawa wawa," answered she, "Wawa wawa." He nodded and replied, "I'll find you another place to stay, don't you worry."

Later on, I watched as he fed her spoonfuls of orange juice and then tomato soup. Afterwards he sat by her, holding her hand and they talked.

"Wawawa."
"I'm fine, don't worry."
"Wawa wawa wawa."
"Stop apologising, I'm your brother."
"Wawa wawa."
"I won't let them hurt you anymore. Don't worry."
"Wawa."
"Don't mention it."

Friday, June 02, 2006

Like father, like son

"Will it hurt?"

He held his son's hand tenderly and looked at me in expectation.

I looked at into the boy's deep brown eyes and saw the tears drying on his long black lashes. His finger was swollen and painful, the nail protruding out at an impossible angle, held in position by clotted blood. I would have to clean his finger, check the nail bed for cuts and then reinsert his nail.

"I will put some local anaesthetic into the finger first. This will be painful, but afterwards, the whole finger will go numb, and there will be no more pain. You will feel me pushing your finger but it will not be painful."

The child nodded, his dark eyes wide. He was seven, but he understood what needed to be done. The muscles in his jaw tightened as he gritted his teeth together in anticipation. He bravely put out his hand towards me and shut his eyes, saying to his father, "I don't want to see the blood."

I began my work. Little Brave whimpered very quietly when I injected the anaesthetic into his hand. A few seconds later and his hands relaxed as the pain ebbed away. I could hear his father breathing stertorously behind me. The two student nurses who were observing the procedure began shuffling around, trying to find a good viewing point.

As I removed Little Brave's fingernail, I heard Big Brave gasping behind me, "Oh God Oh God Oh God." I turned round in time to see the Big Brave's eyes rolling back into his head and his body beginning to sag to the floor. Quickly but silently, I stuck my shoulder out into his chest to support his weight and motioned to the student nurses with my head.

He was a very heavy man to be leaning on my back. Very, very heavy.

As soon as the nurses helped Big Brave to a chair, Little Brave opened his eyes, saw his father's pallid complexion and began to cry and shake in fear, jerking his hand away from my grasp. At the sound of his son's sobbing, Big Brave's eyes flew open and he said loudly, "Don't worry son, everything will be fine." Immediately, Little Brave quietened and lay still.

Then he took another look at my bespattered gloves, blanched visibly and keeled over.

As soon as his head sagged back between his legs, he jerked awake again and yelled, "Don't worry, the doctor's nearly done!". Another glance in my direction and his head lolled to one side as he slumped back in the chair in another faint, only to recover five seconds later to holler, "It's all okay, son, I'm just napping! Everything is alright!".

I finished up the repair of Little Brave's fingernail, whilst Big Brave continued to pass out in the corner, occasionally waking to shout out more encouragements.

After the offending finger was safely swaddled in a mass of bandages and the student nurses had cleared away all the bloodstained swabs, Big Brave recovered from his swoon and took his son's hand.

His smile was bright in his ashen face and he said, "There, there, now that wasn't so bad was it? Say thank you to the doctor lady."

And I said, "Better thank your Daddy. He helped me alot."

Thursday, June 01, 2006

Makeup stories

The Aged Ps have left and the house is empty and quiet and very very sad.

I haven't written in ages and my fingers are itching.

In the next few days there will be makeup stories about elderly siblings, children who bite and dogs who bite, pierced teenagers and missed fractures and mistakes I have made and will never make again.
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