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Saturday, September 27, 2003


Another night on call.
This week, I learnt :

that time has stopped. Other blogs appear suspended in stasis, as the blur of nights and days on call passes hazily by. Comments on my own, already rare enough due to the mere handfull of people who read this one, have dwindled, where once before, on a far more public website they arrived daily. emails, where once so bountiful have ceased entirely. Friends appear to have evaporated, lost to marital bliss or career stress. And on another of my blogs, far better and more thoughtfully written than this, far more sophisticated and eloquent, nobody dares comment. Perhaps it is too personal, perhaps it is too sad. Perhaps it is too far to the extreme, to merit more than a shocked perusal, and a determined click to another URL somewhere else. Perhaps it is best put out of mind, and existence.

that there are stars in the sky. so, so many stars. Colchester isn't a large city, and the glow it casts into the heavens doesn't eclipse the constellations and galaxies above, and so unfamiliar to me. There's a bright orange glow that hangs low on the horizon, far larger and brighter than even mars, and it is with some fondness that I remember my host in Scotland telling me that that was the new international space station in-progress, which switched on suddenly one evening as she was looking out the window.

that ducks sleep afloat, bills carefully tucked under their wings, and wholly unconcerned by the frigid waters below them, as I walked home at midnight under a starlit sky.

Pearl Harbour is showing on the mess television. It's all flash bang razzmatazz with a lot of soppy angsty romance thrown in. It doesn't bug me much, I think I've got a really low thresh-hold for movies. I like almost all of them, just watching them and trying to See. Not to See the mechanics, or the screenplay, or the depth of character portrayal, but to see the storyline.
And it does make me wonder if the Americans were really so unprepared, caught pants-down in the middle of hawaiian revelry. If indeed there weren't any wings standing by - but of course, the Japs played dirty and struck without warning minutes after peacetalks broke down. The whole movie centres about the horrific, and almost dishonourable loss of life, the angsty Japanese General pausing to examine his conscience, blah blah blah.

And yet, today. Afghanistan, and now Iraq torn to shreds to avert loss of life, and monthly reports about Saddam's sons being blown up, death from above every time each one of them picks up his mobile, Saddam's dynasty being whittled ever closer to the bone. Honour?

War is dishonour it seems. Winning a war isn't about playing fair, it's about hitting hard and fast. Gone are the days armies stood in ranks and beheld each other before the final charge. Gone are the days when there is time for a last handshake before the massacre starts. Now the first kick under the table is the norm. And the Japanese, as always, pioneered that.

Watching the movie, the dully patriotic flag of human outrage was kindled in myself as well, for a while. The screen-writers poured their hearts and souls into trying to achieve that effect, and it started, just a little, for me. But then, no. I am not that kind of warrior. I do not want to remember fighting with a rifle and a magazine at my belt. I don't even want to remember fighting with a rubber tourniquet at my side pocket on my slacks, and two litres of Hartmann's at my belt. I've been trained to kill.
I've been trained to heal.
I'd prefer my weapons to be my stethoscope, and my mind. And my armour my white coat, and not my grubby camo helmet.

Watching the cliched girl loses boy, girl finds boy, girl find old lost boy, blah blah love scenes also kindled outrage in me. I remember too much, and I refuse. I will not mourn. I will not let my eyebrows gravitate towards each other on furrowed forehead, and my eyes narrow bewilderdly at the corners as vision dims.

I will not grieve.

Damn You.

Friday, September 19, 2003


Fatigue.

Wednesday, September 17, 2003


Casualty has felt very much like... ER these last two days.
First a trauma at the end of my shift; my consultant quite literally picking me up bodily by both shoulders to plant me gently to rest within Resusc, with the gentle but quite incontrovertible suggestion, "you are going to see this trauma". (complete with hypnotic eyes)
Young male motorcylclist, travelling at speed, sideswiped off road into unsympathetic tree.
He comes in and looks, well, dead. (Almost vegetative, after his head-to-tree experience) Unresponsive, GCS 3/15, b/p 90/40 but falling rapidly. Minimal respiratory effort. There's blood coming out of his nose in a trickle and his arm in nasty spurts as the anaesthetist slams home the tube without any meds. (And wryly comments, mortality, 100% in a retrospective study) I stand rooted to the spot, overawed as the ATLS checklist ABCDE is run through, log roll, etc. He's got an open book spinal fracture and reduced air entry on the right; X ray confirms the unstable pelvic fracture and shows a haemothorax. The chest drain slides in guided by the ubiquitous surgical SHO and five litres of red stuff gushes out all over the floor, or the start of it, anyway. Sister has already ducked down into the flow and attached the bottle to the tube turning her rather nice blues into rather fetching purples. I busy myself with pushing in bags of fluids (and tallying the total), but something tells me this man isn't going to make it. Common sense, I think. (Or wry cynicism?)
An hour later, (and twenty two units of blood, five litres of saline, two pools of FFP, three litres of hartmann's and an unspecified quantity of gelofusin) his knackered cardiovascular system finally gives up the ghost. I'm exhausted. (Must have been all that upper arm workout) The boss comes around to ask me very gently if I'm okay, almost as if I'm a medical student seeing death for the first time. What a shame I'm not, and instead, am a world-weary, cynical bastard of an SHO who thinks "dead on arrival" an hour before it's called. I head home. I don't remember hitting the sack, but when I Wake Up, still with my tie on, it feels like the sack's hit me back. Several times.
Next morning I wake up, not-quite-chipper and head in (5 minutes late). Someone says, very quietly, "I need a hand please" and everyone starts running, because that's really the secret code for "Oh Shit! someone's collapsed in the toilet!" or "Bugger me! Mr Blogg's just arrested!!". we run around in circles for a bit then finally head outside, as an elderly gentleman in what looks to be the early stages of rigor mortis tumbles slowly and gracefully out the open door of his neighbour's car to the tarmec below - apparently, we find out as we leap onto his chest and bag him, he approached his neighbour for help, and died on the way in to hospital. We keep CPR up, even as we lift him onto the trolley from the hospital car-park floor, and wheel him in to resusc, with myself leading, pulling at the trolley, and bagging with the other hand at the head. It's a surreal experience; all that's lacking is the theme song or else I'd swear I've just been teleported into an episode of ER. We get into resusc and I hand over the bagging to the anaesthetist for him to intubate (he says, that was good bagging, and I tell him, well that's probably all I'm good at...), and kneel down smoothly to slam home a green venflon someone's been helpfully proferring me (the ever-present resuscitation sister, hovering by my ear in a blatent show of lack of confidence in my measely cannulation abilities, heaves an almost audible sigh of relief and steps back), and then, without pause slam in the adrenaline someone else? Or perhaps the same person... hands tend to look alike from close up - is proferring me, whilst all around there's a flurry of activity, b/p cuff going around, sats probe rammed on, ecg leads peeled and pressed. It's all happening so slickly and so smoothly it's unbelievable.
It's almost an anticlimax when, twenty minutes later, we call it - they don't show you THAT on ER. There the patient invariably gets shocked and gets off the table. Ours just jerks around limply like, well, a rubber chicken. A very dead rubber chicken.

Another day in the ER.
Fade themesong.

Oh and before I forget, I walked into work early yesterday, so I didn't. Instead, I sat outside at the lake that forms the frontage of the hospital and read a little Terri Pratchett. A curious little sparrow hopped lamely (he'd messed up one foot) up to me and gave me a thoughtful look, before settling down next to me. He was so close his feathers were brushing my hand. I told him I wasn't going to feed him, so he got up, rummaged around a bit in the sand, then came back and sat down on my other side. If I'd wanted to, I bet I could have picked him up; but I didn't want to scare him. He was sweet.
A couple of his mates came over to investigate, but didn't quite dare to come as close; I suppose he owns a monopoly of all the local humans.

Friday, September 12, 2003


Doctor's blog
Stardate 11.09.03
*****
And suddenly time has passed. A week of evenings and nights in A&E, followed by four whole days of blissful sleep and dinners-out in good old grey old London, and suddenly it's time to get back on that train for Colchester.
What a shame.
Cocktails tonight on an empty stomache whilst everyone around me lit up.
I guess You and I weren't that different hey; miles apart in different worlds. Perhaps someone should have done a twin concordence study on us. Of course I could never admit to You that I don't drink, no, not really. I mean, I can - and that bottle of bacardi anecdote, you were so ready to take that out of context it left me stunned into silence. But no, and I don't smoke either. Just for the record.
People I didn't know, and did know, and noises - so many noises tonight. One of them I knew, babbling incessantly on her telephone whilst showing off her new, sparkly high-heeled shoes to me. Noise.
Escape, and quiet. I don't mind those. There's a lot of things I wouldn't mind.
I wouldn't mind living far from the Madding crowd, on a beach. With the sunset over the sea as my verandah. And a deckchair, maybe even two? Seagulls, and a sea breeze.
I wouldn't mind working in a big city, I wouldn't mind an hours drive to the city, as long as I had my quiet village-home to retire to. Not a suburb, I would mind that - too ordinary. But somewhere in between. Who says dream houses have to be based on reality?
I wouldn't mind company, but it would have to be a noiseless, quiet company. Not a silent morose companionship, but true company. Easy-going words spoken intuitively, effortlessly, punctuating the quiet bliss. And laughter. And a mutual appreciation of the warmth and quiet splendour of a fading sunset.
I wouldn't mind growing old like that, and dying.
And then again, I wouldn't mind growing old, and dying alone. As long as I had my peace and quiet after the rush of the daily routine at work, in a big city hospital somewhere. As long as I had my sunsets reflected over the sea to share with the seagulls, and to stare at and wonder at my life gone by.
Have any of you ever thought about death? I have. I'm sure at some point all of us have. Idly. I thought about life, and death once, sitting with my legs dangling over a cliff several hundred feet up, watching seagulls floating dreamily back up over the ledge with their wings lazily outstretched. How easy it would have been, just to lean forwards that little bit more into oblivion. How quiet and maybe even peaceful everything would have been after.
I would never have done it of course, and neither, I suspect, would any of you.
That's why we're still all alive, if not sane.

Sunday, September 07, 2003


On the Jocelyn-ong saga.
Jocelyn-ong.net was, for the unintiated, a website set up by an unknown Singaporean male about the Object of his Desires, a, surprise surprise, female.
I never got to see it first-hand. Thanks to some rather underhanded reporting by the local amatuer papparrazzi / scandal mongers who like to pass themselves off as full-fledged reporters, moral judgement has already been passed by the entire country, which HAS perused his page. And flooded it off the server. All I got to see was a snapshot image from MrBrown's webpage.
It was an intriguing read. On a very base level, part of me felt sympathy for the guy. It's my job to empathise, or, if I can't, to smile warmly and sympathise. That's what I do, and I'm damn good at it. I know it, I'm not proud of it. A&E doctors smile and pat people on the hands and say, you're going to get damn good care from the medics / geriatricians / (pause) surgeons. Nevermind that I've never once stepped onto a surgical ward in this hospital, and the little hovel that is A&E is my home. They'll take good care of you, I'm sure.
Reading his accounts of unrequited love saddened me. Part of me even, for an instant, felt an odd camaraderie with him. The mists of time thicken, it seems, with the years. As I forget the odd but sweet moments We shared, once upon a time, all that remains is the prolonged prelude, when I too felt like the forlorn, tragic-hero. When I, too was unable to step out of my head, and I loved someone who seemed unattainable to the point of distraction.
And then part of me steps back and says, but no. I would never, never have told the world about it; never have painted myself to the world as the Hero, and she the Villain (although, the way this guy writes, it's difficult to spot where one begins and the other ends). Because she was my hero, and I would have thought well of her, no matter what.
And a very integral part of loving someone, is not wanting to hurt her.
Reading his obsessed rants was almost frightening. He wanted her to see him. He wanted her to SEE him. He wanted her to humour him. HE wanted, to Be, with Her. Even if he scared the hell out of her. And he wanted EVERYONE ELSE to see HIM as the hero.
And as he terrorised her, he mused that she was too selfish; too influenced by her so-called bigoted friends to spare him a thought. And finally, he reached the "fuck her, she wasted my time" conclusion, and spewed forth his venom, on her, on the world.

The damndest thing is, there's always two sides to the coin. One of the unhappy lessons I learnt, over the years of playing moderator cum empathy-dispensor was that you can always see two sides to an argument. And when you're not on one or the other end of the stick, you're free to choose one you personally believe in - but also free to play devil's advocate, in case the other party doesn't think like yourself.

And while most of the country is up in flames because 1) He was a very scary, almost perverted, fixated nutcase, short of a case but full of nuts,
part of it is angry because
2) he made several comments about Singaporean society, in general.

I couldn't help but notice that this guy wrote well. As well as I write. Perceptively, dispassionately, and eloquently. (He wasn't, of course, half as funny as myself, or half as humble. Hmm while we're at it, let's add in...)

And somewhere in his rants he flailed out at the bigots that make up Singaporean society, who mumble behind backs, and turn a flock of clueless sheep into a vangard of resentful, hostile bores, with a mere flick of the lip.
And he was right. That is Singapore in a nutshell. We love rumours. We love to judge. Perhaps it's the oriental genes, hongkies seem to do the same. Scandal is in our blood, and melodrama is an artform. The world is always divided into our self-righteous selves, into Us, and the Villains. The Villains, Eee-yer, are the evil aiyo, perverted wahlau, mad fa-feng people, who are, of course nothing like ourselves. We have to protect ourselves from people like Them.
Even our government takes this stance, although on a macrocosmic scale. (We have to protect our Country, from influences, like That.) Nobody is allowed to simply exist, and anybody who does, and doesn't put much stock in the angry little buzzing in the background that tries subtley to shape him or her into its perception of themselves- is bohemian, and by definition, dangerous and subversive.

I too was judged relentlessly, once upon a time. The sad tragic-hero wannabe, he should stop wasting his time. SHE wouldn't like someone like him. They're nothing alike, and come on, SHE's so wonderful, whereas he's just.... I wasn't blind, in the depths of my self-protective reclusiveness. I kept my peace, and steeled myself for a lifetime of - hopelessness.

If they only knew how history wrote itself; if they only knew the strange things we did eventually say to each other, countless nights ago, continents and worlds apart, the fondnesses we exchanged, and memories we shared.
And they never will - because I will protect her memory, and her peace of mind. At the expense of mine.
That is the essence of love, Mr whoever-you-were. You can love someone from afar - but you only love her for real, if you love her more than yourself. You can well spend a lifetime pining, and writing about it. But focus on yourself, and terrorise her - and you will always be the Villain. Not just to the babbling bigoted mob you despise - but to the silent auditors and the quiet watchers as well. The people who might have been your allies, if you had had
that little bit of integrity, and intestinal fortitude.

And I take issue with his comments about Christianity - that religion of the upper-class two-faced wannabes, disappointing him.
Christianity is free, and available to all.
Walking past the tiny Anglican church next to my place in London the other day, I noticed a small, nondescript homemade shrine standing by a few heaps of sleeping bags that contained, somewhere within their midsts, a couple of homeless drunks. It consisted of a small cross, fashioned out of two bound sticks, leaned against an assorted collection of wilted flowers nicked from somewhere or other.
A large metallic figure of Jesus Christ watched over it, bound and nailed to his own crucifix on the wall above, watching them in their suffering, but giving them the hope to carry on, through his.
Christianity was not your enemy, sir.
You were.
May God forgive you.

Saturday, September 06, 2003


Something I've always meant to write, but never quite remember to.
Spoke with someone else quite a while back, and we agreed that the difference between us, and most of the world, was that we'd rather live in the Matrix than outside it.
We'd betray Neo.
Even if I knew everything around me was "fiction" - it wouldn't be fiction to me, if I believed in it. All you'd have to do would be to forget about the door to Reality. Which really, isn't that hard to do if you concentrate at it.
After all, we all live our lives, till we die. A life is a life, real or virtual; the consciousness that guides it is the core. Was it De'escartes who believed, and therefore Was?
We all have the right to choose.
And if I were to actively choose a life of lifelong happiness and laughter, what right would some punk in a black shiny trenchcoat and geeky dark-glasses have, to take it all away from me, and replace it with a life I was forced to live - that was seamy, grey, miserable - and above all, ordinary? Even if he could fly through the air, and run on walls. And fire two pistols two hundred times in three seconds without hitting a thing.


Doctor's Blog,
Stardate 05.09.03
*****
Today dawned bright and sunny, and most importantly, warm.
Went to the Colchester town centre in the company of The Hogfather (trusty old Terry Pratchett) and took a bit of a wander. It's considerably larger than I remember it being from my med school days. Is it just me or are the girls out here in Essex more beautiful than the ones in London? Sharper features, less pug-nosed, more curvaceous but less pudgy. Taller, smilier, slimmer. Hmm. And not quite as pregnant as I remember, either.
The castle grounds were extremely scenic. After toying with the idea of actually going into the castle, I decided to leave myself something to look forward to in Winter, and just get myself a tan, and take a bit of a wander. Parking, we used to call it. I watched a father playing with his son on the side of a steep slope, kicking the ball energetically up towards his kid and charging the hill, then running back down in mock dismay as the little rotter chucked it down for his father to chase. And it struck me that if You'd been there we'd have glanced wordlessly at each other and shared a quiet laugh.
Leaned against a fence atop the Castle Hill and looked out over most of Colchester, and wondered to myself. So now I'm a doctor. So now what? What does one really want in life.
I guess, all I have left to want now is a career progression. Exams, and more exams, and the steady climb towards consultancy. What in? I'm not so sure anymore, but most of me can't stand the thought of another medical ward round. Ever. In this life. Or the next.
Once upon a time, I guess I'd have liked the thought of someone by my side. Someone to share it all with, after all, what does it all mean? What is there to live for. Were we once the best and the brightest? You seemed to be. Me, I dunno. Just one of the crowd; isn't that all I've ever really wanted to be.
And now I am.
It'd have been nice to walk alongside someone, but it would have had to be someone I could walk with. Someone whom I could laugh with, and laugh at. Someone who didn't clutter up the empty moments with meaningless and stressful Noise and Friction, someone good-natured with a sparkling sense of humour. Someone easy-going enough to accept me with my numerous flaws and idiosyncracies. She wouldn't have had to be overly pretty (but it would have been nice), or curvy, or sleek or sexy or any of the other bollocks the Real World teaches us to crave after. Athletic sex hanging from the banisters - as Terry Pratchett puts it, the athletic, tumbling, count-the-legs-and-divide-by-two type would have been unnecessary. Kids, would have been un-necessary. Not unwelcome, not unpleasant, just un-necessary for a fulfilling life. Just someone to laugh with, at, and someone who'd laugh at me through life. Someone whose loss I'd regret, till the end of my time.
I wished I could have shared the day with you, for a moment; scenic Colchester, Britain's oldest town. Then I figured that You've seen your share of pretty places down under, and that this would probably just have been another ordinary day, and place to You. And I guess, I'd just have been another ordinary guy, and what on Earth would have been the point of that, then.
Anyhow, The Hogfather was a different kind of Pratchett to the Pratchett of the Discworld. Sure there were the usual compulsive puns and the double / triple ententes, and it had the same grip-the-book-by-the-dogears and read-every-word-twice feel to it, lest you miss even one innuendo or sideways snipe, but somewhere in there the humour vanished, and it was suddenly a dark, enthralling roller-coaster read; Suddenly it became a true fantasy novel for the brave of heart - instead of a light hearted rough-and-tumble. One could almost feel the snow on one's skin, the smell of blood in the snow, and the frenzied scrunches of snow underfoot as we, Susan, Death, the Hogfather and I ran together through an entire chapter. Then, abruptly, the tension eased and the humour returned as the hogfather slid off into the sunset, and the book glided gently to a conclusion. And I was left dazed and somewhat in awe of the man's genius. The man can Write. And he can kid about. And unlike most other authors - he can do Both, all in one book.
22.00 hours. 1 hour to kill, before I transform into Carter, minus the good looks and floppy hair.

Friday, September 05, 2003


Doctor's Blog
Stardate 09.04.03 22.18hrs

It is Q***t. Almost too Q***t.
Things have ground to a halt. The waiting room is empty. There are no Voices. (except the voices in my head, and you're just jealous because you can't hear them)
Suddenly I feel like I've been transported into a film remake of the Langoliers. There's a steady gnawing noise in the background of doors swinging open and closed. Oh wait that's me grinding my teeth. It's so quiet you could hear a three foot highlander blade drop. Sorry, shades of Scotland are rising from the putrid floor of the ventricles of my underused brain.
And of course there's the usual loony woman who has made three serial A&E admissions three nights in a row. The first night I saw her she had a new diagnosis of "leukaemia", made, according to her, by her doctor, who turned out to be a retired paediatrician. As blood tests and blood films were all normal, I saw no reason to admit her and sent her on her way.
Last night she had a "seizure". After twelve hours on the medical admissions unit she was discharged uneventfully by the medics, who noted dryly that she had a psychiatric history of pseudoseizures.
Today, apparently, she has "diabetes", with a completely normal HbA1c.
One wonders why she is bothering to come to A&E for attention. I suppose you take what you can get, and if it means a sympathetic ear...
Strangely enough when she saw me today she tried to bolt out of the A&E, trailing her catheter leg bag behind her on the floor rather pathetically, and looking like a disembowelled chimpanzee. I suppose her cerebral palsy doesn't help her cause.
What on Earth does an emergency doctor do when he has nothing to do? Help. I've never faced this situation before. It's not in the user's manual. Cheese not found error. Divide by cucumber overflow.

Wednesday, September 03, 2003


Two days into the job, and already it feels like I've been doing this for a lifetime. Leave? Was that me, on leave? Left? Did I ever.
It's not a bad thing, mind. Work is mindless. Or rather, mindfully mindless. There's no time to think about anything, or anyone, aside from the steady trickle of patients flowing through the main doors. Except for the moments before the next shift, when you have a whole, unspoilt morning to wonder what to do. This morning I discovered a forest behind the hospital with a fairly large lake in the middle of it, and spent a pleasantly quiet morning laughing at the Hogfather, Death, and the Death of Rats, and bathing in the insipid English summer sun. It wasn't Loch Ness, that's for sure. But it was enough.

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