Every day I go behind a curtain and ask various different people to remove their clothes so I can touch them.
I’m just saying it’s all a bit weird when you think about it.
Why has this taken so long to come out. That, as suspected and lots of people have said oseltamavir (tamiflu) doesn’t work. Our government has spent 500 million so far on these drugs and a commitment to spend another 500 million.
Channel 4 and the BMJ questioned the veracity of the claims that oseltamavir would have efficacy in influenza – based on 10 drug company funded studies (only 2 published in peer review journals).
None of these studies actually dealt with the at risk groups (immunocompromised, pregnant, under 5s) who we have actually been giving oseltamavir.
The royal college of GPs went against Department of Health recommendations back at the beginning of the epidemic opting for a much more considered view, suggesting doctors use this old fashioned thing called clinical judgement instead of blanket prescribing. Other specialities (including my own) have followed suit.
I have prescribed it to one patient in the past 6 months. And they were critically ill. I don’ think it helped him but I figure if you’re sick enough to cost £1500 a day in ICU then you grasping at straws is perfectly justifiable.
So as usual the major shocking revelation is this:
Drug company buffs results from its own trials to make it look better than it is.
Oh wait, that’s not revelatory at all actually…
The only skiff of snow that was left. Still it’s a start
Christmas is upon us. Like a runaway hippo in a downtown metropolis.
Which means I have lots of christmas dinners and nights out to prepare/look forward to.
Topping the list is Festive Fun and Frolicks. The now famous institution of bringing people together to eat and be silly while I publish all to the world.
This thing only works if you have an act. If it’s just the Tates boys and Edinburgh St fighting it out for the top spot it won’t work. I’m throwing down the gauntlet to see if anyone will be able to match the Garvaghy massive in our prolific talent and boyish good looks.
So given a few hours on a wednesday morning with this:
I present FFF 09…
Most people wouldn’t go to Waterford for a night. We’re not most people.
But it was very nice all the same.
Cheap hotel, good food and a pub that was more like someone’s front room than anything else.
Watched Hunger on the laptop in the hotel room. Stunningly shot. The single shot scene lasting almost 15 minutes is sheer class. Not exactly a laugh a minute but worth watching.
Let the morning pass from breakfast to lunch to the afternoon in the same wee coffee shop taking silly photos of the missus.
Drove to Kilkenny and took more cool photos and sat in a fancy hotel drinking coffee and sneakily using their wi-fi. Found this ad for wedding planning.
It kind of implies that someone has stolen my dreams and is now selling them back to me. No fair.
Come and behold the first Nylie family purchase.
The Pepparami baby Jesus
I really should watch more movies. But i’m always reluctant too. It seems like a whole two hours that i could spend reading books or making brownies instead.
But when I do manage to quell the restless hyperactivity I do tend to enjoy it.
Dosed with the cold I watched Cidade dos Hommens. A further feature film from a series of TV shows that began original in the film City of God.
I find Rio the most intriguing city in the world. I loved my time there (all 5 days of it) and the geography of the place blows me away. And where in the world are the worst poverty stricken residential areas the ones with the best views?
Movies are so full of purely western cultural ideas and contexts. Movies like this are a useful reminder that the rest of the world actually exists. Even if it only reminds us that it exists in poverty and violence.
I got baptised and engaged to be married to the wonderful transfarmer all in the same day.
Surely there’s some kind of special prize for that.
In lieu of an engagement ring I decided just to scribble reserved on her left ring finger with a biro.
Unfortunately this means we have to plan a wedding. Part of that really excites me the other part wants to elope to Vegas and get married by a guy doubling as an Elvis impersonator. We’d even get $20 of free chips for the casino too.
For the doctors out there – I am a little bit dubious about the use of thrombolytic agents in the treatment of acute ischaemic stroke. I am not alone in this, though I am in the minority. My particular beef lies with the evidence base behind that and the drug company involvement in its promotion.
This poster isn’t helpful in so many ways.
Firstly – I would suggest against calling an ambulance unquestioningly for anyone you see with trouble walking. It only takes an ounce of common sense to realise that most people by midnight on a saturday night are experiencing most of these symptoms.
The suggestion to call “911 immediately”is neither practical nor helpful
Secondly – the assertion that treatment within 60 minutes can prevent disability. The whole medical debate is about treatment within 180 minutes – the vast majority being closer to the 180 mark.
We have no real idea if treatment within 60 minutes is good or not – it is virtually impossible to start having your stroke, get to hospital, get seen, get a CT scan and then decide on treatment within 60 minutes.
My advice is – only have your stroke in hospital. And even then 60 minutes is pushing it.
I have been surrounded and involved in Christianity since i was born. It was in many ways the air i breathed.
As much as being a middle class protestant in north armagh, with a good dose of rationalism and the growing critique of modernism…
I am everything I am because of everything I am – to try and simplify faith into a simple indoctrinating process shoots away the ground you stand on.
I remain surrounded by and involved in Christianity. And lots of interesting and exciting and lovely and horrible things have happened along the way. I plan to live a life surrounded by and involved in the Christian faith.
I cannot put a definite time on the beginning of my faith. I remember feeling strongly about it and praying with my family shortly after one of my child hood friends was killed in an accident. That meant something. I’m not sure what.
I’m not sure a distinct point of salvation means anything. I imagine time looks different from the perspective of infinity.
I grew up in a Church of Ireland church but was never baptised. My parents were unclear about baptising babies and so they figured they’d let us grow up and decide on baptism ourselves.
And I suppose I did decide about baptism – about 14 years ago about. Yet I only just got round to it sunday past.
It was cool. Not that covers the theological aesthetics of it all. But it was.
Our place mainly baptised babies but has been known to baptise adults when the need arises.
I figured me and Simy would go for the baby option and he could scream through the service and I’d wet myself and vomit over the minister.
Standing at the front of the church with Simy was weird. Just the two of us and a minister. I felt we should be holding hands or I should be wearing a dress. Maybe next time…
We each got a minute or so to introduce ourselves and a bit of our story and why we were getting baptised.
Then we knelt and got slightly damp and I cried.
These are powerful things. The church – this disparate bunch of legalists, sinners, lovers, haters, bored and zealous – this church is the most powerful thing in the world. Broken and ugly GOD loves his bride. This makes me cry.
Da was not there. Understandably. And most people there knew it. And most people there felt it. They’re a good bunch to cry in front of. I’m grateful for them.
So I went to London.
To see friends of Transfarmers. American people. But nice Americans
I’ve had to come to terms with my latent racism against Americans and the English, and I suppose even with those lovely people I’m trying my best to distance myself – the white anglo-saxon Protestants.
It turns out – yes I know you’ll be shocked – that there are lots of nice and wonderful Americans and English out there. Perhaps my scathing dislike and crass sarcasm if unfairly directed in their direction.
That’s what happens when you make sweeping generalisations. Life is going to become bloody difficult if I’m going to have to stop making sweeping generalisations about people. I’ll have to actually be gracious and kind and get to know them.
Anyhow.
These were nice Americans. They all seem to have lived in Ireland till the country in its wisdom decided to kick them all out. So now they all live in London. Which is at least accessible on a short flight.
The main issue was not the short flight but the incredibly long journey from the car park to the airport. I’d have been better leaving the car at home and walking. So it goes.
I still love airports – the over priced, below average coffee, the mediocre book shops (i only bought two…), the uncomfortable seats. But they still appeal.
On the way through security my bag got x-rayed and then emptied looking for stupid things people put in their hand luggage like bombs and knives. The lady opened the bad and pulled out a nice shiny pen knife.
I told her I lost it about 6 months ago and hadn’t been able to find it – which was true. I bet everyone says that though. I didn’t feel bad about her confiscating it, as far as I was concerned I lost it 6 months ago.
And when I say we went to London, i really meant we went to Ealing. Which is about as far from central London as the car park was from the airport.
So there was no sight seeing, no shopping, no “minding of the gap”.
Instead there was food and drink and good chat and a comfy bed and a good kip. Quite the rock and roll lifestyle I know.
My only suggestion to the Americans is – screw London, come and live in Ulster, the last, best bastion of British imperialism in Eire. That way you could just sneak over the border and no one would ever know.
Though I suppose you thought of that already. I’ll lend you a passport if you want.
… the practice of love is nothing if not personal. You cannot simplify it into a function. What is dangerous is not ideas but the academic mind that abstracts both things and people from particular relationships into concepts.
and what is dangerous is not programmes but the programmatic mind that routinely sets aside the personal in order to more efficiently achieve an impersonal cause.
these are not only dangerous but sacrilegious, for it is precisely relational particularities and personal intimacies that are at the centre of our GOD-given, SPIRIT formed identities as the beloved who are commanded to love.
Christ plays in 10000 places
Eugene Peterson
Wee liz is a talented woman.
6 weeks of art classes and has produced 2 of the following 3. One is an original.
to celebrate the return of the Belfast-Dubln line (after the railway fell into the sea) I took a day return to see Transfarmer and revelled in the ability to read and doze and sip whisky instead of directing the volvo down the long and boring road that is the M1.
I considered trying the reading, dozing and whisky while driving but decided it mightn’t end well.
Cracking meal in this place – my chorizo appetite knows no bounds.
Called in at this place to watch An Education before my train back.
Nick Hornby wrote the screen play.
Now i like Nick Hornby. Or rather i like some of his books. I loved about a boy, i live my life by what i learned from High Fidelity. I might like Nick Hornby too but i don’t know him and he lives in London and so i see no prospect of getting to know him.
An Education is somewhat of a let down. Basic take home message seems to be this:
If you’re prettier and smarter than your class mates then be sure to engage in an illicit afair with a married man in order to learn the fundamental life lesson that men are bastards and women are idiots (at least when it comes to men). This will ensure a happy and more fulfilled later life.
We have established that from every angle JESUS Christ is the key to the secret of creation
Karl Barth in Church Dogmatics
[As quoted in Christ plays in ten thousand places]
This is why i do what i do – why i live how i do. Why i live life how I do.
The fullness of life – the sheer vibrant colour of it all is often overwhelming. The spectrum from sadness to joy is intense. The experiences from despair to exultation are often overwhelming.
But this is the life we are given. Its very nature and presence is quite simply staggering. Its greatest enemy is apathy.
But yet here in Christ we find all things brought together. Our acts of love towards each other, our acts of creation in the world, our choices, our thoughts, our emotions, our reasoning. All our (in)glorious humanity the outworking of this and a movement towards it.
First patient
Recently retired professional, ended her career on a high point. Happily married. Granchild recently born. Phones an ambulance with palpitations. Arrives in ED. I pick up the chart look at the normal ECG, have a quick chat with the med student about what to look for and thankfully leave the student outside the cubicle.
After a fairly standard “you have benign sounding palpitations” type of chat I ask is there anything else worrying her. Queue floods of tears and confession of 2 years of alcohol abuse and loss of position and importance since retirement. Frustration with life and continual guilt and negative thinking fueling the cycle.
She had palpitations because she had alcohol withdrawl from recently stopping her bottle and a half of wine a day habit.
I say nice things, point out the positve aspects of her life and and family and her willingness and motivation to change and as I leave I have the impression that – yes, probably I have probably played a key and significant role in changing this woman’s life.
Second patient
Woman, early forties [incidentally both these patients are women, not because they're all weak and useless but because they have the balls (sorry) to actually deal and talk about the issuesin their lives. If they were men they'd just drink more and beat the wife...] is brought to ED following what sounds very clearly and obviously a fainting episode while attending an out-patient appointment.
Tells me she has been under a lot of stress lately. [Again, incidentally, if you go and ask all the patients in our waiting room, all of them will tell you they're been under a lot of stress lately - therefore stress causes all illness right?...] I ask why.
Queue floods of tears regarding pressure of caring for ageing mother, guilt over not being able to live with and care for mother, constant worry and anxiety over her health coupled with poor sleep and poor diet – both leading to further anxiety.
I tell her my story of responsibility (to a minor degree) for my own mother and my mother’s story of responsibility for caring for her elderly mother and how yes this is very difficult. Again I stress the importance of positive features and motivation to think better about things and change.
As she leaves the cubicle she shakes my hand and thanks me with a knowing “you’ve changed my life” look.
—
These are probably the two most useful and effective interventions I have made in the past two months. Well OK so I’ve seen a few sickies too, but even then the majority of who I see and treat will either die (if they’re that sick) or will get better anyhow and who knows if what I did actually helped.
With these two patients I’m pretty sure I made an impact.
When I came out from both these patients I was in many ways disappointed by my realisation of this.
To stress it again – I most enjoy (and think I am actually most talented) at resuscitating really, really sick people. I think I’m quite good at it. Never mind the fact that I’m not sure it makes that much of a difference. If you’re that sick that you need my skills then there’s a fair chance you’re stuffed anyhow.
I see making sick people better as my key role. Yet here I am changing lives by being a decent human being.
So perhaps I should explain how I changed their lives.
1) Very simply – I was a decent human being. I listened, I encouraged, I dispelled myths and pointed to encouraging signs. I empathised.
I learnt none of this in medical school. Well they tried to teach me this in medical school I just don’t think they did it very well. If I am a decent human being to my patients then it is not because of anything I learnt in medical school. I learned more at my parents knee and and my friends love.
2) And this is the clincher. It was because the person who was a decent human being to them was a doctor that made all the difference.
We have a mythical (and I think misplaced and usually undeserved) respect and understanding of virtually any possible problem. If an engineer and a doctor are faced with a problem regarding astrophysics or the economy then I imagine people would side with the doctor’s opinion. Not because they know but because they must be really smart – cause they’re a doctor. Because remember you don’t have to be smart to be an engineer.
It is slowly diminishing but the respect that is given to the medical profession is colossal. What we say goes.
What I say to the family of the dead motorcyclist is indelibly printed on their minds for the rest of their lives. People don’t remember what the nurse says who stays with the family after I leave. The sound byte that’s passed around about uncle billy’s health will be always be what the doctor says.
So there you go – I change lives by being a decent human being but it only works cause of the scrubs and the stethoscope.
I love my day off. In fact as I now work 4 days a week I have 3 days off a week. But I usually get one sneaky one to myself. When normal grown ups are earning a living and being responsible members of society.
My tendency of late has been baking. Call it a late twenties crisis.
I tried my first slightly misshapen potato bread today.
I made more my new favourite – the brownies
And my repeating frustration (like doing a poached egg) is my plain white bread. It just doesn’t seem to rise quite the way I’d like it to. This photo makes it look more risen than it is.
For tomorrow night I have a duck and some lamb on offer if you’re interested. If it’s defrosted that is.
On a non-food related note I also managed to make my computer into a flag waving nationalist
I was thinking I could clean up for Christmas
Published November 9, 2009 Christianity Leave a CommentI’m being drawn (kicking and screaming of course) towards this cult church in Maynooth. It may have something to do with Transfarmer but it’s mainly for tax avoidance.
Anyhow. Was there on Sunday and heard all about the advent conspiracy.
Now this really floats my boat. Imagine a theological reason to be a tight arse scrooge. You can tell I liked it.
Christmas is well known for becoming a holiday like Valentine’s day – invented by greeting card companies. Yes of course good and wonderful things are done – people get together and have a bit of a piss up and a party. My problem does not lie there, it lies with the rampant materialism.
The advent conspiracy does not say – cancel Christmas – indeed it says the opposite – come and celebrate.
Just imagine hijacking Christmas back off the greeting card companies.
[Now of course the global (though mainly western benefiting of course) economy would suffer in that no one would be buying all the stuff they don't need but hey that's kind of the plan...]
Just imagine providing clean water to the planet for 2% of an American Christmas.
[PS I have a vague plan in my head for a sister site called the matrimony conspiracy.]
Regarding his main character:
…I had given him a life not worth living, but i had also given him an iron will to live. This was a common combination on planet earth
Kurt Vonnegut
Breakfast of champions
