Reality (vs) TV

Pretty much every doctor in England likes nothing better than a good piss-ripping session about the medical dramas that proliferate daily to fill our TV schedules. Whether it be the upside down x-ray, the incorrect management plan or the fact that the fresh-from-med-school house officer has just been left to perform open heart surgery on some old dear while the consultant nips out to the bogs to self-medicate with another hit of stolen pethidine, it does sometimes all conspire to make you think that no amount of medical advisors will ever stop them getting it all so horribly wrong.

To my own mind, however, the truly amusing thing about the medical soaps is how wonderfully glamorous they make medicine seem. If it’s not the fact that everybody is hotter than a page 3 hotty, then perhaps it's the fact that they seem to pass their whole day making end-of-the-bed, life-saving spot diagnoses or cutting people back to health without breaking a sweat and all in time to grab that quick beer after work with the fit patient whose entire previously-insoluble life problems they sorted out earlier with a few well-chosen words!

But O the reality of it! And O how it bites tonight!

‘Venflon needs doing for bed 5 and 26 and there’s a drug chart needs rewriting for bed 15’ was the greeting I received when I stepped onto the ward tonight. Not even a ‘how-are-you?’ or ‘sleep-well?’; just straight down to the nitty gritty of it. I answered my bleep a little later to have ‘dhere’s pus needs took to the lab from t'eatres’ barked into my ear by Ms McFeisty, the leprechaun of neurosurgical registrar on call with me tonight. There’s something in Ms McFeisty’s manner that tells you she didn’t get to where she is today by battering her eyelids and smiling coyly; no, I see scalps taken and the scrotums of enemies crushed beneath a stiletto heel. Think less Goldilocks and more Martin McGuinness with tits. (Oh, I'm sorry: I temporarily forgot that Mr McGuinness is now a noble statesman committed to the peaceful release of his country from the shackles of its colonial oppressors, and not in fact a murderous terrorist in a balaclava who'd have your kneecaps off at the drop of a hat.) Anyway, I entered theatres to find the McFeisty energetically sucking the pus from a young man’s brain whilst simultaneously berating the scrub nurse for not handing her the gauze fast enough. Without looking up she quickly spat out ‘19. IVDU. Cerebral abscess. On cef and rifampicin. Urgent Gramm stain. Results to ITU’. I waited a moment until I was sure the staccato list of instructions was over before I picked up the sample and left. So this is it – the culmination of six years and tens of thousands of pounds worth of education: ferrying pus around the hospital in the dead of night. Isn’t it just faaaabulous, daaarling!

Oneiromancy

Sleep has all but deserted me these days and even when it comes it is spasmodic and punctuated by nightmares.

The masochistic element of my mind has once again taken to its duties as my own personal torturer with a zeal. Chief among the tools of its trade is sleep paralysis. After a break of several months, these terrifying episodes have slowly crept back in to torment me.

It is as if, suddenly and without any warning, a part of my conscious mind breaks the surface of the murky waters that have so far shrouded it in sleep and is again aware. Aware of the position of my body; of the feel of the sheets against my skin; of the give of the mattress beneath me. Aware, in sum, of all the things that you might know if you were lying on your bed awake but with your eyes closed. Yet still, the rest of my mind sleeps on and I cannot move. I slowly mounting feeling of panic rises in whatever part of me is aware as it, and I, struggle to move a body that feels like it is floating in treacle. I cannot move. I feel my heart beating faster and harder in a chest constricted by the grip of fear. I cannot move. And yet I must move; for there is someone or something in the room. I do not know what this thing is – I cannot see it – but I feel its approach all the same. The mattress bends and gives under the weight of its body as it crawls up onto the bed. I strain to cry out: no sound but perhaps muted and pathetic whimper escapes my throat. I struggle to pull myself up from the bed: still I cannot break free from the viscous air that smothers me. The terror becomes overwhelming as the thing’s progress towards me is mapped out in the shifting imprints of its weight on the mattress. It is so close now. Almost over me. Bearing down. My heart feels like it might burst, my limbs tense with mental effort, and my throat tightens with the scream I cannot emit. Suddenly there is give: the treacle evaporates, the constricting bands of fear around my chest break, my body lurches up, my eyes spring open…I am awake and only the pounding of my heart remains.

This may happen several times in one night. Sometimes there are voices too: children laughing or just the insistent sound of my name repeated slowly again and again. I do not know why they happen and I cannot stop them.

Last night I dreamt I was in a tin bath full of the putrid and filthy water. From the bath I can see into two other rooms. In one, I see my family sitting on a white sofa facing away from me. Around them, like a court jester, cart-wheeling and dancing, is the Australian with all his hair shaved off. The more I stare at him the more he seems to be two people at once. The Australian and my first ever boyfriend rolled up in one. I can feel the happiness they radiate and hear their riotous laughter echoing about. After a little while I turn to the other room where enormous, snorting, wild-eyed horses rear up at each other as if in the throes of brain fever. These are truly gargantuan beasts and watching them thrash and crash about the room fills me with fear. I decide to get out of the bath. I pull the plug and the water drains away slowly to reveal that I have been sharing my bath with a joint of raw meat. I sit naked and stare at it impassively. The dream ends.

I mean what on Earth is that all about? Any budding Freuds want to give it a go?

Money Makes The World Go Round

I haven't written for a while. There have been too many other competing interests for my energies of late.

A rather substantial portion has been devoted to work. I am not one to rally under the flag of medicine-as-a-vocation. Nor would I wish to sarifice my own life on alter of altruism. Nonetheless, I do take pride in doing a good job by the people I look after. As a system the NHS is inherently inefficient and I find that, in order to get a recent result out, you have to put a disproportionate amount of energy in. At times this can be truely exhausting.

Still, whatever its failings, the NHS cannot be said to be as inefficient as my boiler. It is effectively nothing more than one big, unclad kettle, sitting in a cupboard at the back of the flat. When it's on, it is scarcely possible to open the cupboard door without risking third-degree burns from the incredible heat that radiates from its thin metal body. I have come to suspect that this beast-in-the-backroom has single-handedly run up most of the energy for which London Electric are currently demanding blood money to the tune of a ludicrous £900.

In addition, several other companies and organisations' claims on my money have become so persistent (and menacing) as of late that I have been forced to remove my head from the sand and review the situation. The situation, alas, is bleak. £1000 council tax unpaid. £400 of arrears in my student loans. Tiresome, irksome affairs of which various voices on the other end of the phone speak to me in comically serious tones. They seem to find it beyound belief that I have no records of account numbers or am unable to give precise details for a direct debit on my account; personally, I find it beyond belief that anybody could to be bothered to waste time memorising such banal trivia. My dealings have led to the conclusion that I'm not one for the crass business of finance. I earn it and I spend it - that is the limit of my interest in money.

Thankfully, I can escape all these mundane concerns in the clubs of London. So long as I have the money in my pocket to buy the next round, who care's about bills and deadly serious debt collectors. Let them wait - I'll pay...eventually.

Lolita And The Elusive I

I am being sexually harassed by one of the patient's on my ward. Bad, eh? Want to know what's worse - she's only 16 years old!

It's a bit sad really. According to her family, just a few months ago Lolita was a happy, normal 16 year old girl. One day she complained she felt a bit unwell. She stayed at home and slept for 48 hours. When she awoke her personality had been altered completely. Gone was any trace of inhibition; in its place a mind focused only on the pursuit of 'fit men' and her newly found habit of smoking rollies.

It looks likely that Lolita may have had encephalitis - a infection of the brain tissue itself. Though it seems to have resolved spontaneously, it has left its mark on her brain. The damage it has caused is too subtle to see on even the most detailed scans, but we can pick it up as changes in the electrical noise from parts of her brain. This damage has also left its mark on Lolita's personality: she no longer has any appreciation of what is socially appropriate.

She has taken a bit of a shine to me and has decided that we are to get married. She sees nothing wrong with walking in while I am speaking to another patient, introducing herself and explaining that I am her husband to be and that the honeymoon will be in Spain. "Only joking", she winks at me coquettishly as I usher her out of the room. Once I've gone, Lolita is always the first to meet and greet the new patients.

Mainly she wants to know about their love life: are they single? do they have a fit boyfriend? are they gay? do they wanna go for a smoke? To the uninitiated this barrage can be a little bewildering; to the experienced, a lot annoying.

The real problem, of course, lies in what will happen when she is outside of the safety of the ward. Whereas I normally greet her screeches of "nice arse, doc!" with a roll of my eyes and flush of the cheeks (on my face, that is - you dirty bastards!), how will your typical sex-starved teenager react? How will they respond to her flirting? Will they stop if she changes her mind? I often see her as I arrive in the morning talking with random (male) passers-by as she smokes her rollies outside the hospital gates and she likes nothing better to go trawling the hospital in searh of 'fit men'. Alas, the only real threat that Lolita poses is to herself. With her new disinhibited, forward personality, there is a strong chance that she will quickly fall into sex and drugs and out of education.

So much for the soul as the seat of our essence. Everything that we are resides solely in the organic structure of our brain and nowhere else. An organ more complicated than anything we have ever dreamt of. Some 100 billion neurones forming an estimated 500 trillion connections with each other, suspended in a web of around 1 trillion glia: these are the building blocks of the brain.

And "I" is the more that emerges from the sum of these parts.

When a kidney is removed or a liver damaged, "I" remains essentially unchanged. Yet, even with relatively mild damage to the brain, the meaning of "I" may be profoundly altered. For Lolita, whereas "I" once embodied a happy, stable child, it now describes an oversexed, irresponsible and socially-inept stranger. At times it is funny to watch, but mostly it's just terribly, terribly sad.

Braziliana

If all goes to plan, I'll be off to Rio de Janeiro in June. Rio is one of those places that has always fascinated me. It has a reputation as one of the most disinhibited cities on Earth, jam-packed with effortlessly sexy party-people living lives of unending hedonistic delight. Ideally I'd have liked to go in February when the Brazilians’ bacchanalia reaches an orgiastic climax in the form of Carnival, but fixed annual leave does not allow for any choice on the timing of my trip.

After a brief inspection of my body in the bathroom mirror, I figured some work might well be needed in order to avoid the possibility of being harpooned on Ipanema beach when accidentally mistaken for a beached whale. Consequently, for the last week now, I have been following my Rio Hard-Body Regime. This consists essentially of the Atkins diet and three 45 minute cardio sessions at the gym. Yes, that’s right – the Atkins diet. I know it’s tragic but a gayboy’s gotta do what a gayboy’s gotta do to get into his Aussiebum swimming trunks. For the benefit of anybody who’s been off the planet for the last few years, the Atkins diet allows you to eat whatever you want so long as it’s protein or fat; no carbohydrate-based foodstuffs at all. That means no bread, no pasta, no rice, few vegetables, and no fruit. Yet, strangely enough it does work, though not, it seems, because of anything to do with ketosis or reduced insulin release – as its designer originally claimed – but because people eating high protein diets just eat less. Whether this is due to protein’s effect on satiety or just the unappetising nature of a pure protein diet is difficult to say. In any case, I plan to stay on it until I go to Rio so I’ll let you know if it actually produces the goods before I succumb to scurvy or rickets.

Last night I joined in the celebrations for The Greatest Dancer’s 27th birthday, which were held, appropriately, at Guanabara, a Brazilian-themed bar just off Drury lane. The tone for the evening was set when four of us went to the bar to buy a cocktail, realised it was happy hour and so bought twenty-eight of them! The highpoint of the evening, however, had to be the concoction colectively purchased by the group with the express intention of completely destroying the birthday boy: some hideous mix of cachaca, Baileys and the puke-inducing liqueur, midori. Having been part of the football team at med school, The Greatest Dancer has had considerable experience in downing disgusting concoctions, but there was a moment when I thought this one might prove to be a step too far. Just when he was insisting he could manage no more, two random physios – one quite pretty who we shall call Porsche and the other less so who we shall call Minivan – intervened to egg him on to the bitter end. I couldn’t help wondering whether Minivan, who had attempted to disguise her ugliness by caking her face in orangey make-up, might not have had an ulterior motive for her sudden concern that he drink up. Perhaps in that Belisha beacon of head of hers the realisation had dawned that only someone on the verge of an ethanolic coma would be likely to find her attractive enough to kiss. With this in mind, we escorted The Greatest Dancer back to the safety of the herd where he could deteriorate into a dribbling, giggling wreck in safety. I should imagine it’ll be a birthday that he’ll not remember for a very long time to come!