Archive for October, 2007

Day 5 – Country Roads

One of the nice things about road-trips is that you’ve no real plans for what to do, and if you’re me nothing really else in your diary to keep you busy. As a result you drive where you please, till you run out of ideas or get sick of your companions, or the Volvo breathes its last.

I’d phoned home to speak to Dad and find out how his first outpatient appointment had gone and I suppose that brought a lot of stuff back to me. Talk of chemo and weight and cancer remembering the past 3 months. And I suppose that was road-trip over for me. In my head anyway. I realized I’d not really thought of Dad for 4 days (which was the kind of the point of road-trip) but that 4 days was long enough and I waned to be at home again (which was kind of the point of me not being in NZ).

I’d been away for a year and now I was getting homesick after 4 days. Weird huh?

But we still had the whole day ahead of us and we decided to switch coasts and take a drive through the Wicklow mountains. If only cause the N6/M50/M1 sequence just wasn’t scenic enough.

Two major highlights:

library-5493.jpg1) Glendalough – I have vague memories of this as a kid. Why my parents were walking me through ancient graveyards at the age of 6 is beyond me, no doubt some educational/cultural value… It is kind of a cool place and it scares the willies out of you thinking about sitting out a bunch of Viking raiders up a stone tower in Medieval Ireland – even if St Patrick had already got rid of the snakes…

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2) The general scenery – Ireland does bleakness very well. The vast open expanse of the peat covered hills, topped with cloud and mist. Nice to see from a car at speed. The other bonus was autumn. If it wasn’t for the rain and cold it would probably go down as my favourite season.

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By the time we reach the south end of the M50 it’s dark and rush hour’s just starting and dual carriageway takes us all the way home (along the new bit of the A1 I’ve never been on before, making me miss my last chance for cheap fuel) in the mighty Volvo 850 which, fittingly has covered just under 850 miles in the last 5 days. Good times.

Long live the road trip.

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Day 4 – No fear of falling

To finish off last night.

There was a brief jacuzzi. Though it was just me and Sparky wearing swimming caps (one of those swimming pools) and while it was indeed bubble-tastic it had a bit of a municipal swimming pool feel to it.

We ended the night in the local chinese served by someone we came to affectionately know as smiler. It wasn’t her fault, it just took her a while to warm to us, and a few rounds of ‘hum an appropriate tune when she comes past’. Sparks led with smile like you mean it and I followed with cheer up sleepy jean.

As always it turned out she was a lovely wee lady, who by the end of the meal was asking us where we were from and what we were doing in Clifden. In an even more random set of circumstamces she also had a second job cleaning in the hotel we were staying when we met her the next morning.

We cleared out of Clifden quick smart, the weather still being half reasonable. We had a lovely drive, hugging the coast round to Galway. Made all the better for some random jazz and some early Pete Wilson stuff Jonny had sequestered about his ipod. Journeys are all the more memorable for a cohesive album than just the ipod on random.

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My lasting memory of Connemara is rocks. Lots and lost of rocks. As if the staple crop were not library-5435.jpgpotatoes but stones. Sewn in spring as pebbles and nurtured with copious amounts of wind and pissy weather until they’re ready to harvest in late autumn, fully matured into Ireland’s finest rocks. Plucked from their native dirt and transported a yard and a half to the middle of their current field to take part in a whole new wall of loosely aligned rocks to further subdivide their birth place.

The fields didn’t even have sheep in them. Sheep will eat any type of chlorophyll containing substance but simply draw the line at having to digest and metabolise rocks.

Back to Galway. We ended up in a Jury’s Inn by lunchtime. Getting a much larger room than last night for a third of the price. Most impressed. Right on the Spanish Arch too.

library-5455.jpgTo fill the afternoon we headed to the south side of the bay, through Lisdoonvarna (the home of Europe’s biggest singles/dating event – man I wish we’d got a photo outside that sign) to the cliffs of Moher.

The cliffs are an impressive set of sheer drops overlooking the barren Arran (do you like what I’ve done there…) islands. I didn’t know they even existed till about two years ago.

They charge a modest 8 euro for the parking priviledge and then you’re free to explore and let your small children run wild beside a 300 foot drop. To be fair they have put up a fairly substantial barrier and keep you well back from the edge.

Until you reach the limits of state owned land there’s nothing but a rather large sign telling you inlibrary-5474.jpg three languages (English, French, German and astoundingly not Irish) not to pass go and not to collect 200 as this here land is private land and careful now you just might die.

This advice was thankfully being dutifully ignored in at least 10 different languages (including Irish this time) as one and all hopped the fence to climb a narrow mud path skirting the cliffs to see whether the grass is indeed always greener on the other side.

The wind was fierce to say the least and there was always the awkward question of etiquette when allowing someone coming the other direction to pass. Do you keep your nerves intact by forcing them to pass on the cliff side or risk a hasty death in order to get a smile and a thank you out of the pretty girl comng towards you. After my performance today, I’m pretty sure I’ll be around for a while yet…

On the way back we had one more box to tick (such a hypocrite…). Sparks and the Office had found directions to the house used in Father Ted last year and had done a brief road trip to Galway (and ended up sleeping in the car) last year and got a great photo outside the most famous parochial house in the world.

library-5480.jpgI’d managed to find the same directions, with such helpful hints as turn right at the red phone box. To be honest if Sparks hadn’t already been there we would have turned back, the road becoming more like that corridor in Alice in wonderland that becomes narrower and smaller the further you go along it.

Yet after 5 minutes up an upmarked road (which had been suspiciously recently resurfaced) where the trees and bushes almost met in the middle, the road opened out to reveal a rock strewn ridge in the background with the famous house in the foreground. The toyota corolla parked outside didn’t really fit and the statue of our lady was missing but otherwise you were right there in Ted land.

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Round off the evening with a simply fantastic meal in an Italian restaurant just down the street (from the hotel not Ted‘s house), with lost of pasta type things I couldn’t even pronounce. I had raw beef for starters. Winner.

And so now I’ve abandoned the boys with their Potters (numbers 6 and 7) and sit in the bar on my own on my second run through In Rainbows quietly judging the punters around me. Maybe I could be back in NZ after all.

Day 3 – Harbortown

Having sorted out the brief temporal disturbance, and realizing that we’d almost missed breakfast, we sat down to a feed of sausages, bacon, black and white pudding, eggs and lashings (yes Enid Blyton is alive and well…) of tea and coffee. Our fry in seems to be lacking in potato bread and soda bread, that which makes for the famed Ulster fry. Though I’m not sure I want to make breakfast into a political statement by asking for some. I did wear my Ireland rugby top, though I admit that of all our sports tops that’s the least likely to be politically offensive, unlike the Man United top, which although politically neutral generates a whole new brand of sectarian hatred in everyone’s hearts.

The drive to Westport was wet and bumpy and almost resulted in a serious car accident when some Muppet pulled out in front of the office.

We kept getting stuck in queues of traffic outside chapels in small towns, as legions of the faithful piled out from mass into the narrow streets to escape the rain.

Just as we approached the doo lough pass the skies began to clear giving us a vista over the hills of Connemara, transporting us from the cloudy damp west coast or Irelandglen.jpg to somewhere just outside Glencoe. If this is somewhere in Ireland you haven’t visited then make a point of visiting it.

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The view did bring about a brief period of giddiness and some minor nudity (note – arses have been [poorly] altered to disguise identity) among the lads but this passed before it was drawn to the attention of the local Gardai (all one of them).

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From there the road followed the river out to where it entered Kilary harbour, the only fjord in Ireland (said in a Father Ted “I hear t’is the largest launduret department in Ireland…” stylee). This is another place you need to see.

At the head of the harbour are the Aasleagh falls. Again worth seeing. In fact it’s all good and I’ll leave the Bord Failte stuff to … Well.. Bord Failte I suppose.

I have this unforgettable places to see before you die book. Which is a bit of morbid and strange title but anyhow… And Kilary harbour is in there, along with the Giant’s Causeway. So I suppose that’s two done. The idea of box-ticking travelling now repels me – even though it didn’t only 2 years ago. Funny how you don’t notice things change in you.

library-5388.jpgWe stopped briefly at Kylemore abbey – a big kick ass 19th century mansion place that was taken over (though not in the military sense) by a bunch of nuns from Ypres who lost their convent (in the military sense) in France during WW2 and were given refuge in Ireland. To be fair they could have done worse, ending up in a mansion running an exclusive boarding school. Vows of poverty eh? Who needs em?

library-5301.jpgAnd so eventually we come to Clifden, a nice wee village that’s seen the benefit of some N6 Euros from Dublin, and now sports a spanking new hotel complex with a mini shopping arcade below.

We get the last room in the place. And while more pricey than a room above a pub in Newport it does give us access to a jacuzzi.

Of note this has been a bit of a soft, southern shandy drinking road trip for Nelly. Yes I do like sleeping in my car, yes I do enjoy not washing for several days in a row and eating cold noodles off a trangia. But I suppose road trip is more about the collective than the individual. And the collective isn’t up for the back of the Volvo (in any sense!!!) or cold noodles or not washing. And well to argue would just be rude wouldn’t it. Yes, rude, wouldn’t dare… Oh yes could you fluff another pillow for my back please… Ahhh…

Day 2 – Go West

Sharing a bed with a grown man is a strange experience. Especially when you’re a repressed homophobe (though I try not to be…) at heart. You always find yourself rolling over at the edge of the bed, to the point of possibly falling out of bed. All to avoid the an involuntary leg touch during the night… Sorry. Enough of that.

last-roll-177.jpgSpent the morning in Mullaghmore, feasting on fried sausages and eggs looking out at a grim and dark looking Atlantic ocean.

There was a brief break in the cloud over the beach giving us a chance to brave the wind and get a trot along the beach. The endless ocean is a leveler. Love it.

 

On our way south to Sligo we stopped at Glencar lough, keen to see last-roll-027.jpgeither a Nessy or a Timotei ad moment under the waterfall. Disappointed on both fronts, best we got was Jonny in a shower cap. And despite a quick game of ‘if we give you a tenner would you…’ we couldn’t convince him to debag and wear a shower cap under the waterfall. In 20 years time in therapy I’ll be glad he didn’t do it.

We stopped briefly down the coast to look at the waves coming in off the Atlantic. A huge swell with a lovely left to right break looked perfect for a wee surf. Though the closer i got the more it became clear I’d just get dumped upon by a swell like that.

Every other car we passed had a board or two on the roof. Made me extremely nostalgic and jealous for the old drive out to Ocean Beach at 7am with some of the murses. Made me wish I’d brought the board back with me. Maybe some day… Anyhow focus. You’re in Ireland now, remember.

last-roll-038.jpgWe were heading for Achill island. Which is almost (but not quite) a fake island, there being only a 10m gap or so separating it from the mainland. We’d read in the (never again to be trusted) Lonely Planet that there was a quality hostel with great food, a nice pub and a warm fire on the island. Our plan was an afternoon in front of the fire with a book and the papers and possibly an endless game of higher-lower with the pack of cards.

This was quickly scuppered on our arrival to Achill sound (if you have an image of Milford sound in your head then forget it) where we found the hostel had been converted to a nursing home.

We followed this with a 2 hour drive round the island looking for accommodation.

We found ourselves turned away from at least 5 places, but only when they found out who we were.last-roll-044.jpg As soon as they realized it was a group of blokes from the north then they weren’t interested and made up clear and blatant fibs that they were either fully booked (when they weren’t) or had a booking already (when they didn’t). Usually I’m not one to see the worst in people in things like this but by the fifth time it was getting ridiculous.

We divided possible reasons into the following:

1) a group of blokes traveling and wanting a room together must be poofters out to pollute the minds of their youngsters and sodomize the local livestock (don’t start me on that one please…)

2) a group of blokes traveling together will no doubt drink the place dry and throw the television out of the first floor window before spray painting the words ‘bazza wuz ere’ on all the local livestock.

3) a group of blokes from the north are here to take part in a paramilitary training exercise in a Connemara bog before using incendiary devices to blow up the local livestock.

Please don’t be three. I know we have a bit of work to do on dispelling number one but please tell me we’ve got past number three.

In the end we got a couple of rooms above a pub in Newport (where?…) where I presume they thought we’d be far enough away from the local livestock to cause no harm.

We took a (very) brief walk around the village taking in all the main sights, the bridge, the pub (voted best pub in Connemara 2006), the other pubs and even the newsagent. I love this country.

Meeting us in the Newport hotel (fighting off vicious local competition for the title) was the office, who’d pulled his usual trick of driving staggeringly long distances (4 and a half hours on his own from Portadown) to get to a place just for one night and then repeat the journey in reverse the next day. And there wasn’t even a bird involved. He amazes me. With his brilliance or stupidity I’m never entirely sure.

When he arrived we got down to some grub and a quick game of naming all the fifty states in America (damn you Vermont…) and listening to some genuine Irish fiddly-dee music in the pub.

We all went to bed, sensibly putting our clocks back an hour to prepare for the end of British summertime (though i think Connemara declared the end of British summertime shortly after the 1916 easter rising and the declaration of independence…). We all woke in the morning to find that the wonders of technology in out phones had taken time into their own hands and sliced another hour from the clock on top of what we’d already taken.

Technology is smart but also kind of dumb eh?

Day 1- Road to Nowhere

The boys have jobs and stuff and real lives so we don’t leave till after 5pm on Friday, joining the crowds of half-termers fleeing the family home for a small fiberglass box on wheels or a grim B&B on a cliff top.

The idea of weekends scares me sometimes. That you work all week and then spend two and a half days in celebration of freedom from your chosen occupation and then go straight back to it all on Monday. I have this thing against enforced, corporate happiness. That anybody can tell you how and when to be happy based on market and social demographics.

Maybe that just leaves me a grumpy old git who’s emotionally stunted and unable to relate to the majority of the population.

Maybe it just lets me think I’m better than everyone else.

Goodness such self-analysis and only three paragraphs in. Will endeavor to refrain from such.

The mighty Volvo is packed and loaded for the craic, even brought the guitar in the hope of some inspired sessions on a beach somewhere.

The boys (Jonny– who designs and engineers large green machines for separating rocks;

 

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and Sparks – who endeavors to teach young humanoids how to form words and sentences in a cohesive manner)

 

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seem intent on naming the poor car, as if it was somehow unhappy with its current moniker of car and Volvo 850. I’m all for personification of inanimate objects but I’m not sure they need a stereotypical fiddly-dee Irish name for that to happen. And I was never going to let Victor the Viagra fueled Volvo stick. Without putting up a bit of a fight anyhow.

As the west bound M1 petered out we made it through the wall of mizzle and cloud to see a glorious autumn sky and the sun setting. About as glorious as Ballygawley ever gets anyway.

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We got briefly lost in Sligo, thankfully not eaten by the natives before getting on the N15 (funny how planned and organized the roads sound when you give them a alphanumerical title, making a winding lane between farmhouses sound like a major communications artery) to Bundoran.

We’re staying in Mullaghmore, just north of Sligo in what I imagine would be some pretty spectacular scenery if it wasn’t raining and night time. Given that it nearly always rains, then the scenery is only fantastic for about 3 days a year when Bord Failte comes and takes all the photos for the ads.

By the time we got here the restaurant was near closing and we managed to throw a few steaks and a pint of the black stuff down us before a dander along the harbour and making of plans for the morrow.

Hotel is nice, better than sleeping in the Volvo at least. Though I am sharing a bed with a grown man, which always seems to be the problem of three single blokes looking accommodation together.

At least we got a sea view. Hopefully it’ll look pretty here in the morning. Prettier than Jonny will anyhow…

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On the road (again)

Nelly is off into the wilds of the west coast of Ireland, with a few muppets in the volvo for a few days. With luck we’ll find Father Ted’s house, the only Fjord (no Mondeo jokes…) in Ireland and if we’re really lucky the holy stone of Clontibbert.

It even appears we’ll be blessed with classic Irish weather. Makes me wonder why I got a car with a sun roof.

So expect the return to old form of a ‘blog a day’, Kiwi road trip, except with less surfing and lying in the sun.

Long live the road trip.

Too many sad words make for sad sad songs

Part of the problem with being unemployed, or at least partially employed, is all that awful free time you have to fill. You kind of get used to not having a second when you’re working – not that you enjoy not having a second, you just get used to it.

So recently I’ve had all this spare time to fill, I’ve been obliged to hold conversations, spend time with people, read, pray, think, even do some gardening – though I know that’s probably a step too far…

Following the Turf marathon (in fact imagine an actual Turf marathon, sponsored by Flora and all… not to self…) on Saturday I sat down all day Monday and recorded one of my own songs, one of the ones I’d battered out on the dodgy karaoke mic on the Mac Mini in NZ. The hiss and squeal on the recording was just winding me up too much, and that was just my voice.

In doing so, I think I’ve found the perfect way to procrastinate and whittle away a perfectly useful day. Possibly even better than Halo 3 or Harry Potter.

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Yours sincerely, with headphones on like the next Nigel Godrich.

Nelly

PS Bonus points if you spot the Kylie quote

I Left You Behind

Welcome to Dundalk

[With apologies for the rapid and disorientating change in tone from previous blog… so it goes...]

In my role as part-time music producer to the stars I’ve come in contact with some big names, Chris De Burgh, Sade, The Wurzels… all the quality acts that have been making such good quality music over the past few years.

But of all my associations, the one of which I’m most proud is that with the now legendary Turf Brothers. Few names command such respect, and indeed 6 figure sums as the Turf Brothers do in the 21st century. Their recent reunion and subsequent world tour has been selling out some of the biggest and most prestigious venues in the world from Djibouti to Vanuatu.

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Most recently described by a respectable music journalist as sounding like “a mouse farting through a tuba”, the Turf Brothers have consistently been “pushing the envelope” of the musical, creative and indeed metaphysical boundaries of the 21st century.

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Having spent some of their earlier years in relative obscurity they graduated to the mainstream of rock super stardom with their 1971 release, “Where’s the Milk?“, which combined a tribute to the Dali Lama’s struggle for a free Tibet, with a whimsical look at modern dairy practices.

They experienced some low points, ranging from Daniel O’s brief and disastrous marriage to former wonder woman star – Lynda Carter, and Dilbert Turf’s long running battle with his Benilyn addiction.

Many believe their greatest moment was winning all of the Nobel Peace Prizes in the same year, others believe it was their simple and elementary proof that the moon is indeed made of cheese.

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In any case, most believe that these will be eclipsed by their most recent work, recorded behind very tightly closed doors in a bog in Dundalk.

And so without further procrastination and confabulation, it gives me great pleasure to present to you the long awaited Welcome to Dundalk.

Last night I nearly died

Below is what I’d been writing about Dad being sick, since all this started back in August:

He’d been itchy for a week. And I’d not really been paying attention. I’m not a good quality of life doctor. All the minor things, that cause disruption to people’s everyday life I’m probably not that good with. If you’ve had a sore toe for 7 years, and you’ve no idea why, then not only do I not care, I won’t have a clue what’s causing it either. If you’re dying, if you’re blood pressure’s disappearing, if you’re heading towards that bright light, then I’m probably your man. (on reflection that sounds like the intro monologue to the A-team, that was not my intention).

So he was itchy, and I didn’t know why, and frankly I didn’t much care.

And then his eyes turned yellow, and he was itchy. And all of a sudden everything changed. When it’s your own father, everything’s different.

Painless jaundice is not a good diagnosis. For a start it’s not even a diagnosis at all. It’s more a sign of something else. But painless jaundice is also not a good sign, because the majority of people with painless jaundice will be dead in a year.

I got him to lie down on the sofa and I examined him, noticing his liver was bigger than it should have been. Noticing that no matter how hard I pushed on his gallbladder he wasn’t sore.

I’d agreed to do a few shifts in Craigavon A&E while I was back in the country. Mostly for social reasons, as working there was a good way to catch up with everyone. But also cause I just missed the place. I noticed dad was yellow at 7pm. I had him in A&E at 9pm. My shift began at 10pm. One of the other docs saw dad, for which I am eternally grateful. I took his blood and ordered the tests, but having someone else ‘in charge’ of your dad’s care makes all the difference even if it was only on paper.

I got offered the night off. I refused. I knew if I went home I would just worry. I was already trying not to worry Dad too much. I stayed and did my night shift, and worked myself into the ground, working as hard and as fast as I possibly could to avoid the thought that kept relentlessly forcing itself upon me. That my Dad probably had some form of horrible widespread cancer and that he’d be dead in six months.

I worked, and worked. I did not stop. I did my best with the lonely, and the suicidal, with the alcoholics, even with the girl who’d waited 3 and a half hours with a sore ear (which I confess I gave antibiotics for, even though she didn’t need them, just cause I felt sorry for her…) and the poor guy who waited 4 hours for me to put one stitch in his chin at 3.30am.

And at 6.30 there was no one left. And I went and sat down in the tea room. And I cried. I got up and went outside. I cried some more. My hands shook. I told the Sister about my Dad. She said did I mean the young, well-looking man she’d seen me with earlier and told me he looked far too well to be dead in 6 months. And for that I am eternally grateful.

I went back and drank tea and stared at the wall till 7.30am when a mum walked in with her ‘packed and ready to depart this world’ 9 month old baby, with patches of the meningitis rash all over it. Baby was awake but crying feebly. Funny how quickly you slip into the ‘calm and in control doctor’ mode. I find this works whether or not I am either calm or in control.

Within 2 minutes of arriving he had a drip and a dose of antibiotics and half a bag of fluid. In 30 minutes he was covered in the rash. By this stage he had 6 doctors huddled round his tiny frame. Within an hour he was on a breathing machine with ever increasing amounts of drugs to keep his blood pressure up. In two hours he was on his way to ICU in Belfast.

I realise I have learnt a few things in the past year. If nothing else how much I love this stuff.

From here it snowballs. Dad gets three different scans in five days – the queen doesn’t get this kind of treatment said the radiologist – and he wasn’t far wrong. For the first three days I cannot get the image of my Dad – my Dad dying – out of my head. I don’t sleep or eat. My stomach feels sick the whole time.

I wrote in my journal – how big is my god? Big enough  for me to realise that no one but him is in charge? To understand that he has not fallen asleep on the job? To come to terms with what it means to follow JESUS CHRIST? Is my god sufficient? Can I love a god this big? On whose terms do I trust GOD?

After three days he gets a CT scan done. And I breathe out a long held breath. That he does not have metastatic cancer. We still don’t know what is causing the obstruction to his liver. For that we must wait another week.

And in the meantime there is my daddy. My poor, itchy, yellow daddy. Who cannot sleep because of the itch, who would take his skin off with a potato peeler given the chance. Who paces the house at night and rubs the tops of his feet off the rims of the carpeted stairs for relief. Whose stomach is sick, because none of the bile can get out of his liver to break down his food.

Me and Dad come back from the CT scan and I tell Mum that it’s not the worst case scenario, that we still don’t know what it is, but that it’s not horrible. And she breaks down, and I suppose we all do. And it’s the first real family release of emotion. We huddle and pray and cry. We can do no other.

Two weeks after I notice he’s yellow, he has a camera test to look at his bile duct and there’s a tumour there. A small one no doubt but it’s there. And now we know. Now we know it’s not good (though could be worse), that I’m going to have to start using the ‘C word’, the word that every patient over the age of 60, admitted to hospital worries about.

I’ve told a few people they have cancer. A universally difficult thing to do. And every time, I know I have to say it. I have to say ‘the biopsy shows that it’s cancer’. I can’t use any nonsense about masses or tumours or growths. Unless I say cancer then no one gets it. It sticks in my throat like a dirty word. Like something in a foreign language that shouldn’t be coming out of my mouth.

I find it hard not to see horrible things round every corner. This is the kind of medicine I practice – and I do mean practice. I am paid to look for the worst diagnoses and test for those and if it’s nothing serious then to be frank – I don’t really care.

And so we leave Dad in hospital and me and Mum go home and watch Hot Fuzz, anything to keep our minds off things. But I can do nothing but picture a lonely future for Mum, watching DVDs of an evening, knowing Dad’s no longer there. Few things upset me more than to see loneliness in people’s lives.

So now we know it’s cancer, a word I find difficult even to type. Now I know he needs an operation, a fairly major one. Where he’ll lose half his pancreas, half his stomach, his gall bladder and a bit of bowel. This is major re-plumbing. This is a big deal. It is not easy to picture your own Dad on an operating table. To picture your own Dad in an ICU, with a line like a zipper across his belly. Through all this I have fluctuated between being glad that I know as much as I do and hating that I know too much.

The Chinese whispers of inter-hospital transfers (Dad needs to go to Belfast for the op), leaves us with possibility he might have the surgery done on Friday, two days after we’ve found out it’s cancer. Everything seems too quick. They talk about stages in acceptance of bad news. And I see now it takes time. The enormity of what is happening to our small family unit is slowly dawning. That from now on everything will be different.

When we leave for Belfast on Thursday I look at my Dad – who apart from looking like Homer with a bad case of fleas – is the picture of health. He is not sick. Now of course I know he’s sick, but he’s not sick in the way I think of sick. And on Thursday I think – is this the last time I’m gonna see my Dad healthy? Thursday is a big deal and there are a lot of tears.

When we get there we realise the operation won’t be until the Monday. A last minute reprieve – in our minds anyhow. Dad rings a guy from church to let him know and gets a ‘oh it’s a voice from beyond the grave’ response.

Of note, we could not get through this without being able to take the piss along the way. Our family exists on banter and sarcasm and taking the hand out of each other. If we could not laugh then it would be a thousand times more difficult.

So we all go home for the weekend. Two days reprieve, two days for the slow dawning of what might lie ahead. I’m so glad he came home. That he didn’t spend a pointless weekend in a Belfast hospital, alone. With half crazy men in the beds beside him and nurses who don’t acknowledge his even existence never mind his pain.

Brief note, we have had almost without exception, fantastic care, from truly dedicated people, just the odd bad apple…

I left mum and dad alone for the weekend and went to Donegal for a weekend with almost 20 of my best mates. To sit in a cottage and play silly games on the beach and sit up till the wee small hours of the morning putting the world to rights. I needed that. I needed their ‘tears and sweet amens‘, I needed to know they were with me.

Me, Mum and Si went up on Monday morning to see Da before the operation. That was not easy. We left before the porter arrived to take him down. There would be no painful family processions behind the bed. As if there was something to be mourned.

When someone has surgery, the relatives are always most concerned and worried while the patient is ‘under the knife‘ so to speak (when in fact the ‘knife‘ is only really used for skin incisions and all the ‘real’ surgery is done with fingers and ‘blunt dissection’). Their biggest concern is that they might die ‘on the table‘. (which is more of a bed anyhow…)

This is another fallacy. People do not die during surgery, well of course some do, people who bleed out for example, but percentage wise it’s tiny. Medically I know this. I know that the worrying time is the time after surgery, not the surgery itself.

I know this. It matters not a jot. I worry I might never see my dad again. I worry that he won’t make it. I can think of nothing else.

We go home (it’s a five hour operation) and try to watch the Two Towers to take our minds off things. Anything except to brood. Where the disaster that is only ‘vaguely possible’, moves to the ‘just might happen’ into the ‘more than likely’ before becoming the ‘almost certain’.

It doesn’t really work but it’s a valiant effort. Dad sleeps through all of this. Some people…

That night we drive up and see him in the intensive care unit. Still regaled in his blue paper gown and with pin point pupils from the morphine, he just keeps telling us again and again how much he loves us and how lucky he’s been to have the life he’s had. And I wish he wouldn’t cause it just makes me cry all the more.

Three days later and he’s in trouble. Cause what was left of his pancreas has rotted and gone gangrenous and then he bled into it. No one expected this. Not even the surgeon who’s been doing these for 15 years. He goes for another major operation.

For the first time I really panic. I really go to pieces. I had this all thought out – I suppose. I’d been through it all with dad and mum, of what might happen of what could go wrong. And I was prepared for that. But not this.

Now watching my dad, now on a ventilator (the fictitiously named ‘life support machine‘ – there being no such thing) with tubes and wires everywhere, with bags of blood and plasma dripping in. With no response from him but a drunken looking grimace on occasion.

People on ventilators generally look like they’re dying. Whether they are or not. I have been working in an intensive care unit for 15 months in a row. I can think of few things worse than seeing my dad on a ventilator with a dropping blood pressure (again why ‘What Sarah said‘ is such a good song) and fighting to believe what I know. That he can get through this. That yes this is a big deal, but he can get through this.

This was all the nightmares I’d had about being on ‘the other side’. The nurses bringing you into the ‘relatives room’ with comforting lighting and the nice sofa. Being the one receiving the bad news.

Not being the doctor that opens the door of the relatives room, introducing himself delicately, politely and gravely. With a family’s collective gaze fixed on every gesture, expression and word that you make. Not being the one that says ‘I can’t begin to imagine how hard this is for you‘, not being the one that says ‘we have to take one day at a time‘. Not being the one that gets to say all the kind, compassionate words of encouragement – sleeping at night only because I get to say them and not receive them.

So this is what it’s like then.

We leave the ICU eventually. When it seems clear he’s ‘stable’. I have seen too many 24hr bedside vigils. With relatives wearing themselves to pieces just to ‘be there‘. Part of me doesn’t want to leave. Part of me has more sense. Another part of me screams ‘give him some norad you fools… can’t you see he needs more fluid… if you lose his kidneys he’s stuffed, can’t you see this…’ but I stifle the screams. This is not my ICU, this is not my job, this is not my patient.
I ring up the next morning at 6am. Dad has been very ‘naughty’ according to his nurse. Having ‘surfaced’ from his sedation at 4am and not liking the breathing tube in his throat, he pulled it out. This is quite impressive. His first words, as they prepare to put him to sleep to put it back in, are ‘it’s good to be back’. In the end they leave him be.

At 6am on the phone I get to speak to him. To hear a weak, slightly horse voice tell me he loves me. Maybe the ‘voice beyond the grave‘ wasn’t such a facile comment after all…

Everything changes. We all smile. We laugh. We make jokes. Clinically, medically, not much has changed. In our lives everything has changed. ‘rollercoaster’ is too twee a word to describe it but it’s the best I have.

Four days later we get the pathology back. This is the results of some tests on what they cut out. Where they make slides of the cancer ’tissue’ and look at them under microscopes, and put funny dye on them to work out which cells are which. I’m glad someone does this job. I’m glad it’s not me.

To know exactly what type of cancer it is is important. People can be cured with certain types of cancer and not with others. They talk of 5 year survival rates. That if you’re still alive five years later then it’s probably not gonna come back and you’re probably ‘cured‘.

Brief note on ‘cured‘. No one is ever cured. Mortality rates among human beings remain rather high at just under 100%, taking into account some rather exceptional circumstances over 2000 years ago. Indeed the ‘human condition’ itself is to die. ‘Please don’t cry, we’re designed to die‘ sings Jeff Tweedy. My boss in NZ describes oxygen as a toxic substance that causes pain, misery, suffering and occasional euphoria, that eventually brings about decay, decline and death over a period of roughly 70 years.

We knew dad had one of two types of cancer: pancreatic or ampullary (an area of the bile duct). The difference was (roughly) 10% versus 70% 5 year survival. So now you see why it matters. The poor wee first year doctor who they dragged down to tell me was smiling (and no this is not darling lorraine) when she came in. I prayed this meant it was good news and not naievity on her part.

When she told me it was ampullary and that there was no spread to the lymph nodes, I could have hugged her, even though I didn’t know her from eve. I told her this, though in the end I still just shook her hand.

I never thought being told your dad had cancer could be such good news. I went back to the bed smiling and told dad it was the cancer we were hoping for. And he prayed and thanked GOD. And we cried. Tears need not always be bitter.

We needed that. Needed to know that the fight was worth winning. When you’ve been through two major operations in a week, lost half your blood volume, lost an organ or two and had your insides replumbed, then you need the prospect of light at the end of the tunnel. When you haven’t slept for weeks thinking that maybe all this is a bit pointless, maybe I’m going through all these horrible things for no good reason. You need a bit of good news.

After two weeks in ICU he got moved to the ward. And the change in him was noticeable. The freedom and independence he now had in being able to get up and walk around himself, the fact that he could finally sleep changed everything. He was weak and tired, but there was joy and hope in his face. That yes we’re going to get through this. He’s gonna come home soon.

Each day seemed busier than the last. With seemingly queues of staff waiting to speak to him each morning. Between surgeons, doctors, nurses, physios, dieticians. A lot of information to take in. And then there was (is) the diabetes to get used to. With no pancreas, Dad has no insulin and therefore has very high sugar levels in his blood. So now he has to poke and inject himself with various needles to keep the sugars under control. He took to it like a duck to water.

On Monday we think we might be getting him home by Friday. On Thursday it turns out it won’t be till Monday. On Friday it turns out it might be six weeks. On Friday it might be not at all.

On Friday he had a scan (an ultrtasound of his heart) to look for an infection and on it they see what is described technically as a ‘vegetation’. A little clump of bacteria and platelets attached to his aortic valve in his heart. This is again, kind of a big deal.

This is like having a knife plunged into your stomach. The rug pulled out from under you. 2 steps forward and 8 back. In my head I know that this is it. That this is not going to end well. All I can picture is poor sweet Herbie, the Maori with the Bono glasses and the exquistie giggle, like he was being tickled, who became our most frequent flyer in ICU till his dialysis line got infected (he’d been through five lines, two of which were mine…) and his heart valves got infected and quickly rotted away. And that was all she wrote. I know too much sometimes.

This feels worse than realising he had cancer. Whether or not it is worse is another question.
I think I’d just got used to the idea of my Dad living through all this. I’d just got used to the idea of him being alive. And then I was thrust back into the awful visions of my Dad lying there, colour fading from his cheeks, his chest no longer rising and falling, the pulse in his neck no longer throbbing. The painful, miserable finality of it all.

Left thinking of funerals and kind words and of the pain and anger I would carry with me and nurture and water until my self-pity is fully grown into bitterness. Till GOD eventually gets fed up with me and takes me home.

Why the up and down? Why bring him this far, why make it so hard, why make it so $%^&*() hard?

I’m just left angry. At what I don’t know, my thoughts aren’t organised to find an appropriate target. Truth will not let me stick it on GOD.

It was a horrible weekend. Waiting for another test on Monday that we all believed was merely to confirm what we already knew. He spiked high temperatures, he felt woeful, his blood pressure dropped. I found it hard to watch my Dad get sicker. To watch and not to do something about it.

Sunday evening I had a quick word with one of the junior docs, desperately not trying to seem to be telling them their job but needing to know that they knew he was getting sick again. It is an awkward position to be in. Doctor’s relatives are often the hardest to treat, I have no desire to be a difficult relative, but when it’s your own Dad then the great Kiwi maxim ‘She’ll be right’ is simply not good enough.

I graduated from baby doctor to grown up doctor (well maybe pre-school doctor…) by getting things wrong, by making bad decisions, by screwing up. Rarely resulting in any significant consequence. Perhaps sailing a little close to the wind is more appropriate. This is how you become a better doctor. By making lots of silly mistakes. It was fine for me but when it’s your own Dad then I’m having none of it. This makes me no more self-centred than the next person, merely someone in a position to do something about it.

At some point in the weekend I let go. Let go of diagnoses and drugs and numbers and survival rates and just repeat ‘Thy will be done’ over and over to myself. I realise that Dad not making it would still be grace – he gets away from sickness and into eternal joy he does not deserve. That the pain we would go through would still be grace – each of us desperate sinners, deserving of punishment for our neglect and rejection of GOD as the whole point of the universe.

As a brief aside I find myself unable to reconcile these two aspects of prayer: 1) thy will be done, and 2) if you have faith as small as a mustard seed… I don’t know which to pray and find myself unable to pray both. Never have I once doubted that GOD could simply and quickly heal him. I have doubted every day whether or not he will. When I first noticed Dad was jaundiced, I knew what that meant. My first thought was not ‘GOD heal him’, but ‘Thy will be done’. I instantly gravitate to 1). Perhaps this makes me fatalistic. I’m not sure that’s a good or a bad thing. When I say ‘thy will be done’ it is with gritted teeth, with a clenched fist.

On Monday, about lunch time, Dad rings. Telling us he’s had the test. Telling us that the doctor told him that they could find no infection on his heart valves and that the ‘vegetation’ on the first test was something called ‘artefact’ (an image on the screen to do with funny reflections of ultrasonic signals). All of a sudden the sun comes out, the room warms up and everything changes. Again.

What this means is the infection is not in his heart but coming from an abscess in his belly. This is wonderful news. In the way that finding out what type of cancer Dad had was good news. Everything is relative.

I sat at my desk and cried, no wept. For a good 15 minutes. Something I haven’t done since all this started.

Thinking about it I’m really not that sure how much more bad news I can take. The thumping of the adrenaline as the phone rings when it’s not meant to, or a blood test or a scan result. Each one like losing him all over again. I’m not sure how much we can take of all this.

And so began the slow windy, hilly road to ‘recovery’, whatever that means. It means eating, and blood sugars, and insulin, and wounds healing, and 5 laps a day round the ward.

It means starting to get on with all the other things in our lives, thinking about jobs and cars and other people. All the people I neglected and turned away from to be with Dad. So it goes. I have no regrets on that.

It means, not worrying about him, not sleeping with the phone beside me so that if it rings with bad news at 3am then mum won’t have to hear it first.

At one point shortly after the operation, the phone kept ringing, good, kind-hearted people ringing to give support and prayers and find out things were going. And I was frequently terse and brief in my replies because I had neither the energy or (to my shame) the inclination to talk to that many people. At the time I came up with the idea of Ronniewatch, a nightly five minute TV program, perhaps just before the ten o-clock news, possibly presented by Huw Edwards or the lovely Sarah Travers. They could have the guy from Big Brother say “Day 7 in the ICU, Ronnie takes his first steps…” and that kind of thing. Just so that everyone would know he was getting better.

And he is getting better, and I know he will. Though I debate in my head whether this is faith in GOD, or faith in modern medicine, or (much more likely) faith in the fact that there comes a point when human beings will just get better, no matter what you do or how you feel about it.

But oh what it would mean to get him home. Days become weeks and all of a sudden 2 months have passed. The word home comes out of my mouth with a tremble and a sigh, my lungs emptied so I need to breathe before I can make another sentence. Like it does when Luke Skywalker says, “but that will lead them straight… home” in the first Star Wars, just after they find the slaughtered Jawas in the desert. Home in the way Sam means when he says, “well, I’m back” at the end of the Lord of the Rings. Home in the way Paul Simon meant when he sang, “I’m sittin in a railway station, got a ticket for a destination… I wish I was homeward bound…

Asleep in the back

Since I’ve got back I’ve been driving Dad’s Saab 9-5 estate. Beautiful car, absolute flying machine, all shiny and nice and clean. Lovely to drive but a bit nice for me, I always worried about bumping it or scratching it. Especially when i bumped it and scratched it. And that one time I parked a bit close to the wall… enough confession.

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I’ve been looking for a car to live up to the RVR – my Kiwi wagon. Well it was actually a Japenese import but you know what I mean. I tended to live (quite literally) out of the car during my solo road-trips round NZ, with surf board on the roof, bike on the back, a gas stove and a lot of books. It provided a reasonably comfortable night’s sleep when you put all the seat’s back. As long as you weren’t in any rush to stand up straight come morning. See here for an example.

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I like the idea of living out of my car. I liked the practicality of the RVR, liked the sheer functionality of it. I even liked the weird way it only had a back door one one side and only the driver side electric window worked. I get attached to old broken things.

So when I got home I started looking for something similar and there was really only one choice.

A volvo estate.

If you could buy wood panel station wagons in the UK I’d have one. A nice big car for the kids and the dog I don’t have.

As soon as Dad got home from hospital he set upon the Autotrader website with vigour and 3 days after discharge we were down the M1 looking at an 11 year 850 in Lisburn. Dad knows about cars. Like what makes them good and stuff. I need his approval to get a car. The guy who owned it clearly took care of it, possibly to the point of neurosis – he had receipts for oil filters he’d bought in 1997. When we asked him had the car been in any accidents he became a bit sheepish and admitted that yes, he had put a scratch in the bumper a few years ago.

So yes, I bought it. The Volvo 850 estate. The car that redefined the right angle. In all her glory.

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Be sure to find Nelly asleep in a car park near you soon.

Tea in the Sahara

One of the cool things about being back in the country is my re-acquaintance with African tea. It’s not so much the tea (which I’ll come to) but the whole experience that I’ve missed.

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I was introduced to the concept by my good friend Rab who grew up as a missionary kid on a group of islands off the coast of Guinea Bissau. I’ll pause while you consult an atlas.

Tea is a good 4-6 hour experience if it’s done right. All you need is a tiny charcoal stove, a tiny ceramic pot, some water, some tea leaves, a whole lot of sugar and time to appreciate the whole thing. The tea arrives in rounds taking maybe 15 minutes each to boil. From the tiny tea pot you’re served a shot-sized glass of black liquid, occasionally with grass, sand or leaf in it depending where placed the stove.

Round one is hard work. Even to a fan of the beverage it’s hard work. It tastes like the tea you find in the ginormous tea pots in church several weeks after a funeral. only re-heated and with sugar added. But don’t let me put you off. At it’s finest (the fourth round) it tastes like a mixture of coke, tea and cigarettes all mixed together with sugar added. I mean that in a good way though I suspect it’ll not come across that way.
Basically we just sit outside Rab’s garage in the driveway watching the tea boil and chatting. This sounds perhaps a tad simple. But you see it cuts away a lot of the nonsense that we seem to have filled our lives with. We are cursed with TVs in every room, and though I hate to admit it, we are scared of silence, of being together without music. That the very noise of our existence together might frighten each other away if it’s not drowned out with Top 40 hits and inane DJ chatter.

When we meet together, it’s often to watch a DVD, or go to the cinema, experiences where for the most part we sit in silence. Depending on whether or not you’ve got friends that talk all the way through the film or not. Everything we do has so much to distract us from each other that we lose each other in between.

Now I know this is not always a bad thing, we need time to be alone together, to be distracted together. I just miss the variety. So I think all that the tea does is take people away from what has become the normal social context and sit them down and simply bore them into enjoying each others company.

Before you know it you’ve passed three hours talking to someone, maybe taking the piss out of them, maybe just slagging, but occasionally you’ll rediscover the long lost art of conversation. Instead of the 21st century equivalent which is mostly conversation reacting and stemming from whatever’s on TV.

Mankind (an interesting word when you split it up, kind of ridiculous when you think about it. Man? Kind? You must be joking…) has been doing this for years, sitting round camp fires telling stories, eating missionaries, invading Poland. The tea was just an excuse to get people together. This is what we’ve been doing for donkeys ages. We just forgot how when we got to Ireland and realised it did nothing but piss all the time and we had to move indoors and invent Strictly Come Dancing.

Come home Billy Bird

Yes, he’s back.

Bang on the two month mark since he first went into the Mater, Da has finally made it home. Slightly the worse for wear but he’ll get over all that I know.

The joy of getting him home, of having him back, of having the five of us sitting in the living room taking the piss out of each other. It was just class. There’s a lot to be thankful for I know.

I promised we’d have him home for the quarter finals, though I broke that promise clearly. And Ireland didn’t even make it that far, so he wasn’t missing much. At least now we’ll be able to lie on the sofa in the house and watch England get trounced – presuming France have read the script OK.

And to celebrate this Simon and Morsies have finally got round to geting a puppy. A hyper, whimpering, piddling, poopng puppy. Gorgeous wee thing, whatever they call her. My suggestion of Dog – Mk1 wasn’t popular.

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So now it feels like I dreamed it might be again. Like the tail end of an episode of the Waltons.

Night John-boy.

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Once upon a time there was an ocean

Of the many, and increasingly sizeable, list of things I miss about NZ is living by the sea. Of being able to dander out the front door and round the marina to westshore and sit on the big concrete blocks above the gravel beach in the dark and think about the quickest way home.

And so armed with the excuse of needing to get a part fitted to Dad’s car (that he’ll not be driving for a few months yet) I’m now back on the north coast. Having dropped off the car and got a wonderful old Saab automatic as a courtesy car.

My first stop was unsurprisingly Portstewart strand. Scene of many a dark and windy walk, either on my own or with mates. I love beaches, not so much for sun and surf but for the time just before it gets dark (indeed I think they actually call it dusk these days, they’ve a word for everything…) when the sun is so low that it starts casting cool shadows on the undersurface of the clouds. When the temperature has just dropped and you can wear a hat and feel fully justified with it on a practical as opposed to fashion grounds.

Even the mini waves of sand cast up by the wind into my eyes do not deter me. Nor the softness of the sand left by the departing tide that stretches your calves with each step.

I like the barrenness and the isolation. It is here I can think straight. I can rejoice in the innumerable joys of simply being alive and begin to reconcile that to all the horrible things that happen to people I love. Mostly by humming old hymns to myself, with the odd Bright Eyes tune thrown in for good measure.

My mind races with all my longing but can’t keep up with what I’ve got…


I was here at the weekend with a mate who asked the intriguingly insightful question ‘what type of a boyfriend do you think you’d make at the age of 26?’

My immediate thought was ‘a pretty shitty one’. My second thought was simply, ‘kind of hard work’. Then I thought that through and thought that the first one probably covered both.

I live in a fantasy world when it comes to relationships where we (there is no we, just an imaginary we) only speak to each other in song lyrics and say nothing but profound meaningful things to each other all the time. This is all bollocks I know but it is what it is.

Managing to get from mere acquaintance and indeed friendship towards what I think love is (don’t get me started…) is a complete mystery to me. I just want to wake up some day in my own marital bliss (ha!), or even just begin where Fight Club ends and not have to deal with all the craziness that gets you there.

My body is a cage

Songs for train journeys on sunny mornings:

Eels – numbered days

Gemma Hayes – stop chasing everything

Duke special – Brixton leaves me alone.

Postal Service – Clark Gable.

And so passed my most recent acquaintance with public transport in Norn Iron. The last time was 15 months ago on a trip to dublin for a course. In fact in my whole time in nz I managed not to even come close to public transport.

Anyhow, today I’m on the 0750 (yes there’s a 0750 these days, who’d have thought it!) to City Hospital for my second job. Funny how when you say it like that it makes it sound like I’m overworked. Ha.

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I managed to get a part time job as an anatomy demonstrator at Queens. This involves taking a group of medical students through a guided dissection of an elderly, rather saggy looking corpse. And not nude modelling for groups of students to draw charcoal etchings of me sitting on a stool looking pensive, as my brother thought.

I’m both scared and quite sure that they’re gonna know all the anatomy  better than I do. Though we are starting with the pancreas, gallbladder and spleen – all the organs my Dad no longer has, which is convenient (though not for Dad). I suppose it’ll give me an anecdote or two.

Anyhow getting to see Norn Iron in all it’s crispy clear beauty is just the best. To not have to worry about pressing the acclerator or not driving into the car in front is just wonderful. We’ve driven quarter of the way to NZ (about 4500 miles) just in visitng dad in the past 7 weeks.

And so I find myself back in the dissecting room. I love the smell of fomaldehyde in the morning.

The first group of the day are already huddled round their corpse, the plastic sheet still covering it. On a friday morning many a tall tale is told over (my dead body?) the plastic sheets about how drunk so and so was the night before.

They all look so young. Almost a definiton of getting older, that all the new doctors look incredibly young. I doubt most of the other demonstrators believe I’m actually a doctor, looking no older than the students, even with my 3 day old facial fluff. Coupled with the fact that I’m the only one not wearing ‘proper clothes’ ie shirt and tie. I mean who are they dressing proper for – the cadavers?

I start off with little simple questions about our poor recently departed stiff. For example, ‘my Dad no longer has this organ (Nelly points out recently departed’s pancreas) what does that mean for him?’

I’m surprised that what we’re teaching is so… Well… Basic I suppose. I forget easily that I knew none of this at their stage, and indeed only learnt a lot of it in the past few years. At least my fears of students pointing to obscure organs and blood vessels and asking complicated questions were unfounded.

I must admit it became something like anatomy according to my da. It makes for an excellent clinical scenario to give the students. Even other demonstartors used dad as an example. I’m not sure he’d like the (in) fame.

The second group reminds of that time I tried to get blood out of a stone, and even more of what it’s like to lead groups of young Christians to think about anything.

I run out of Dad related anecdotes with them and settle on getting them to learn the ‘hip bones connected to the … Other bone’ rhyme and send them on their way to make the lame see and the blind walk.

Our future is safe in their hands. As long as they can remember which bone the hand bone is connected to…

Time is running out

“The patient in cubicle 4 is about to breach…”

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So greeted my illustrious return to the NHS and the world of emergency medicine. Sounds like a whale giving birth doesn’t it?

What the poor patient in cubicle 4 had breached was the 4 hour transit time target that all A&E patients are meant to meet. Not that the poor patient knew any of this, nor was meeting this target their responsibility anyhow. Why are we talking about the patient anyway? They’re hardly important.

The idea is that all patients should spend less than 4 hours in an A&E department. From turning up at the front desk till either transfer to a ward or discharge home. The 4 hour targets are Department of Health dictated policies, who unfortunately are in charge of handing out the money for the whole ‘Health Service’ carry on, including the greenbacks I take home at the end of the day.

Now the idea of spending less than 4 hours in an A&E department does indeed seem like a fine and noble idea, if I have a broken ankle, I want seen, investigated, and home in a plaster cast before 4 hours is up. I think 4 hours is not too much to ask.

However if I’ve just flipped the car on the M1 and mashed my good self to a set of malfunctioning organ systems held together by drips, ventilators and sticky tape then I don’t want neglected so that the staff have to leave me to sort out that broken ankle just cause it’s about to breach.

Even then I don’t think I should have to wait 4 hours to get my ankle sorted. The sensible thing to do seems to be to provide more staff so that they can do both at the same time. Or maybe that’s a bit of a crazy idea…

Or say, for example, my 50 year old, overweight, smoking, diabetic self gets brought in with chest pain. I get seen promptly and some medication and the pain settles a bit and they do some blood tests and an x-ray and they’re still not entirely sure what’s wrong with me. But look, it’s been 3 and a half hours already and I’m about to breach and all of a sudden I’m dumped/bounced/thrown/admitted to a medical ward with a label of ‘chest pain, query cause’ where I languish for a further 6 hours till the ward doctors get a chance to see me (cause they’ve been seeing a long list similar patients with labels like ‘sick, query cause’, ‘unwell, query cause’, and ‘turned up in A&E, and wouldn’t go home, query cause’.)

And so roughly 10 hours after admission I get bored waiting and decide finally to rupture the aortic aneurysm in my chest that was causing the pain in the first place, the aneurysm that would have been seen on the CT scan I probably should have had done in A&E at the 3 and a half hour mark. And so as the cardiac arrest call goes off and I head towards the bright white light, I think that it’s crazy the lengths you have to go to get some attention round here…

You see I’m not sure that staying less than 4 hours in an A&E department is necessarily good for you, or what we would call ‘in the patient’s best interest’. I’m not sure who came up with idea that 4 hours is better than 6 or 8 or 10, I’m pretty sure they’ve no idea how the concept of emergency medicine and diagnosis is meant to work. Though I’m sure they have an acute awareness that if you measure the numbers meeting 4 hour targets at the beginning and then measure them a year later (after shouting and screaming that at people that you must make numbers better – adopt Kim Jong-Il type rant if needed) then you can probably say that you’ve made the numbers better and well, OK, we’ll stay in government for a while longer then…

And so your beloved trained scrub-monkey is gutted and disillusioned that we’ve sold our souls so cheaply to a system that resembles a man flogging a dying horse instead of getting it a nice new set of heels and a nose bag full of barley and perhaps even a fellow work house or seven to share the load.


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October 2007
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