When you tidy your room you never know what you might find. Found before I left, old thoughts.

• I’m still going to New Zealand. Stop me at your own peril.
• I’m going to have to make some fast friends in the orthopaedics department.
• The airport, and the walking through it, is really going to hurt.
• Research says I may be able to get the cast off soon. I have an unusual fracture that may well require early mobilisation to prevent permanent loss of movement.
• My feet will hopefully recover within a week. If they don’t then they too are fractured, which would mean that there is something other going on.
• The latter scenario is very unlikely.

Basically, nothing is going to plan but I’m hoping that things resolve. I’d write more but typing isn’t the smooth interface you’d hope it to be with one arm out of commission – a lot of things become surprisingly difficult. Wish me luck everyone, because at this rate I’m really going to need it.

And the last thing that the US needs right now is religion messing with its constitution, expansion on its already-rampant isolationist tendencies by scaremongering about the UN, and indoctrinating children with ideas how ‘American ideals benefit the world’.

What kids need is to be taught how to think, not what to think.

I was on amazon the other day, and I was ordering a new external HD to take over the storage of the various media permeating my unfortunately-stuffed 500GB one. On the spur of the moment I also saw that in my recommendations was a new book from an author I’d enjoyed in a previous life, so I ordered it. Hardback, sure, but somehow stuff doesn’t seem as expensive when you order it alongside something that costs a pretty penny already.

It arrived yesterday. I started it this morning, and finished it 5 hours later on the dot, having evidently underestimated the vociferous nature of my appetite for the written word.* A few years of fictional starvation (think about it…) can do wonders for your tolerance for that slight neckache associated with a not-quite-perfect posture as well.

Unfortunately, I fear that shall be the extent of my bookish wanderings for the time being as I need to delve back into the grimoires of my course rather than those more deserving of the grimoire definition. Still, it is good to be reminded, and perhaps I shall be more cautious about watching a film or a TV programme when I might instead fold myself into some contorted shape to cast some light on a good book.

I think forgetting to read caused me to forget how to play with words.

*however, I was shocked to find that my reading speed had dropped off somewhat to a rather paltry 100 pages an hour. Not, of course, that a figure can be put to the infinitely variable page and font sizes with any degree of reliability.

I use my web hosted space for a number of things so continuing it was a given, but I will admit to wondering if this blog should remain. I don’t often feel I have much to say here, and when I do I tend to write half a post and have it sit in my drafts folder and decompose until it is no longer relevant. Ever think there is a lack of substance to my posts or that they simply don’t arrive for a long time? Well that’s why. I don’t really want to turn this blog over to being just about medicine either, as I know that doesn’t interest basically all of you, but it is kind of the definition of my life particularly at this time of my course as the end-of-year storm clouds begin to gather on the horizon. For now, you may have to accept that some of my posts won’t be very good, or frequent, or a combination of the two. Once I get a hold of what direction I want to take I’ll let y’all know…

’til then.

Not, you understand, that I’m complaining. The more I learn the more elegant everything is, and the more I can link things together, understand the consequences of things and the cascade of consequences consequent of those consequences. Why can alcoholic liver disease cause catastrophic haemorrhage in the throat, or swelling in the ankles, or rupture of the spleen, or kidney failure?* I know I’m endlessly banging on about medicine but it’s increasingly an integral part of my identity, for better or for worse. Probably for worse, but hey – in some ways it changes me for the better. Currently I’m on a one-week-on one-week-off routine in sync with Helpful Teaching Consultant’s morning ward rounds. Next week it’s back to Dr. See-no-students-hear-no-students so I’ll revert back to going to a bunch of random stuff, neuro and GI and endocrine and phleb clinic, if I can swing it.

We’ve got some new neighbours, postgrad nurses-to-be; in number, three. We were worried first that there was a family moving in, but they were just the landlords. As of last Sunday we are officially surrounded by students on both sides, which is good news. And we invited them over for cocktails, and they are pretty chilled out, which is nice. That, the discreetly unmentioned valentine’s day and a couple of sunny days and nights with sleep in have cheered me no end, life is better again.

Now, I need to crack on with my essay. It’s a bit of a strange reflection that I want to finish this essay so that I am finally free for the remainder of the year to get down to working on medicine proper. Who’d've thought that the homework-hating me of yesteryear would become so driven…

Essaytime.

*don’t get alcoholic liver disease, kids.

“Everything you do in medicine is a stall.”

And it is. Every disease you treat, every symptom you manage, every wound you stitch or tumour you excise; it’s all just stalling for time. It’s a pessimistic viewpoint, but the universal truth is that everyone stops bleeding one way or another. Fight as hard as you like, but in the grand scheme of things you lose. The bigger picture is a grim one.

The other day on the ward, a patient arrested. Staff performed CPR, successfully, and he was resuscitated. Three hours later, despite the best efforts of everyone involved, he died.

At first glance, we lose, death wins, but there is one more thing to this story. Three hours was long enough for his daughter to come and see him, talk to him, say goodbye to him. Before that I kind of agreed with Dr Cox, but actually sometimes, despite the worst, we still pull some semblance of victory from the jaws of defeat.

And I think that’s enough.

It’s not always about the bigger picture.

As you all may have guessed, there is a stirring in the millpond of my lovelife. We shall call her D, seeing as fancy single-letter abbrev. seem to be all the rage at the moment. It’s at the stage now, though, where we’re beginning to change from the light-hearted, worry-free banter and chat to actually getting to know stuff about each other. It’s a bit tricky as its all still quite new so we’re both treading carefully, but hopefully it’ll all hold together and solidify a bit. I’m very cautious, but I’d like to think I’m cautiously optimistic.

Wish me luck.

And just for you Dickie, ‘Thoughts’.

This is a big problem.*

*possibly exacerbated by the imminent start of my essay.

Alright alright, something about the surgery:

I was a day case so it was a pretty minor op but due to the nature of it I was under general anaesthetic. Turns out, GA is quite cool – I remember that I was going to focus on staying awake, and I remember a sensation of cold (but not in a creepy, scary way; more in a reassuring, refreshing way if that makes sense) spreading out from the cannula where the anaesthetic was going in. And then, voila, I was awake again, and an hour of life had passed me by without trace. In fact, despite surgery, I felt pretty terrific, and a little bit drunk. Not quite room-spinning drunk, but definitely this-bed-is-the-most-comfy-thing-ever drunk. I was also talking to the nurse, which was challenging because I could never quite seem to be bothered to open my mouth despite my best efforts. This did, however, pass. Still, GA = fascinating experience, and a perfect illustration of just how much willpower you’d need to make a little headway against a drug. And, of course, a good illustration of how long it takes blood to move from the arm to the brain. Not long, is the answer.

Sadly, however, the painlessness of GA is gone and the local anaesthetic they also administered at the time has now worn off. The cocodamol that I now have available is about as much use as a cardboard boat against the *doctorspeak* ‘discomfort’ */doctorspeak* and I’m basically trying to be as sedentary and as still as I can. Those of you who know me will realise how much effort staying completely still for a day is costing me – I am not impressed. We roll around to the inadequacy – despite it all clearly not being my fault, I feel like I am letting an endless flood of people down. I’m not going to hockey tomorrow, I can’t go to the gym with my housemates, I can’t walk to the shop with my neighbour. I had to ask my friend to drive me to the hospital tomorrow. I might not be able to do the 3-legged pub crawl on friday night, or go to a good friends 21st.

I hate that feeling. Unreasonable as it might be to blame myself for things that are beyond my control, I still do. I feel the tiniest bit helpless and I just can’t stand it.

Heal.