Archive for November, 2007

Debate exposes doubt

Two things happened at the same time this afternoon.

41szyxcnlwl_aa240_.jpg1) I appear to have won a million pounds (yet again) in an online promo I never entered. These good people are all so kind in emailing me and asking me for my bank details. Who says humanity’s going downhill…

2) I have finally finished Ideas – A History from fire to Freud.

The book has been sitting there staring at me everyday, telling me to get my ass in gear and finally get it finished. Your reading habits get soft with modern novels and anatomy textbooks. I struggle a tad more with non-fiction like history and Harry Potter.

I take the occasional mad notion to “improve my mind” or some nonsense like that and try reading erudite books written by dead people (though written when they were alive, not actually written by dead people. Though that would be kind of cool). Generally I find I actually quite enjoy it. Sometimes I just enjoy the imagined kudos of reading books by dead Russians and dead alcoholic poets.

But back to the history of ideas. A book so ambitious will obviously fall foul of a temptation to see an overarching picture in the history of human thought. We love trends and progress too much, we see it everywhere. CS Lewis called this Historicism: “the historicist tries to get from historical premises conclusions which are more than historical; conclusions metaphysical or theological or atheological…”

The trend is always of course towards progress. And a very loaded sense of the word. The idea that the longer humanity keeps going, then the further forward that we make it. That every new idea is an improvement of the old. This owes a lot to Darwin and evolutionism (not evolution in the biological sense)

[Brief aside. I’m trying to avoid the whole evolution debate, as it all gets a bit infantile in online debates as people try to outwit each other and make fools of each other and it’s more about pride and and wit and arrogance and being seen to win the “argument” than it is about the issues of the debate. These things are much better discussed in a pub or cafe with actual human beings involved. One thing I can conclude from the theory of biological evolution if that if it fits then we’ve definitely stopped evolving. As soon as our brains got big enough to start protecting the weak, and indeed find “artificial” (creating fire, tools, eating meat, standing up) means to preserve the self (preserving of course, a faulty genetic lineage) then the whole natural selection process went out the window. If evolution is man kinds great salvation then the moment our brains outgrew our reproductive organs (though the female of the species says that maybe that never happened…) then we effectively committed evolutionary suicide.]

The simple premise that humanity, society, the whole shebang is getting better. That as time passes at the rate of sixty seconds a minute, so humanities change is uni-directional.

Along with it goes “chronological snobbery” (another Lewisism). The idea that anything new or modern must be better than what came before. To be introspective about ourselves as Christians – there’s an element of that when it comes to the church. How many find themselves leaving the established church for a contemporary, even “emergent” movement? And how many of these moves are strongly influenced by chronological snobbery, the fact that it’s cool and fashionable? This is not a judgment on the theology, practice or thought of modern evangelicalism – in fact that’s precisely the point, that people are more influenced by what’s new and cool than the substance of things.

In retrospect the church was a bad example. I find myself wanting to define every term, knowing that I misrepresent them all as I type. Sigh.

The other idea of historicism is the ludicrous notion that the canon of history is complete. In Christianity I’m pretty sure we believe the canon of scripture is closed – correct me if I’m a heretic, or burn me at the stake, whichever’s easier… Therefore we can now stand some 2000 years later and pass comment on the overall picture contained within.

If you do this with history then you kind of make a bit of a tit of yourself. Like writing a review of the sixth sense 10 minutes before the end. “This was a crap film, where not very much happened…” Obviously hugely different than if you stayed for the last 10 minutes. “This was a crap film, where not very much happened and it turns out your man was dead the whole time…” You get what I mean.

It also brings up what I find to be the most ludicrous notion of all. That now, that early 21st century thought has finally got it. This is the answer. Yes of course all that nonsense about the world being flat was wrong, and all that carry on with apples falling out of trees is badly misguided, and yes I know we taught you that stuff is made up of protons, electrons and neutrons but now we think there’s a few other things going on. Trust me, I’ve got it right this time.

Assumption (quick aside, can any one tell me the difference between assumption and presumption? I could look it up, but I’m a very lazy man. And no jokes about making an ass of u and me…) is a big thing. All those algebraic equations worked on the principle that “if x=4 elephants…”. Indeed scientific principle is dependent on the hypothesis – hopefully proved.

If you drop a brick off a bridge a 100 times and it falls at the same speed every time then it simply tells you that when you dropped that brick 100 times off a bridge it dropped at a certain speed. It does not tell you that it will drop at a certain speed. That takes assumption.

We now know (famous last words…) that if we drop that brick off a bridge on another planet (never mind a black hole…) that it’s gonna fall different.

We talk with such confidence that we actually know what’s going on (Christians are very guilty of this too, though we do have that old, divinely inspired word of the ultimate being and belief in the supernatural to fall back on. A kind of metaphysical joker to play) in the universe. It takes a pretty massive assumption to believe (oo err, careful now) that.

The world used to be flat, both the scientific institutions and the church denied that for quite a while (the church longer than the scientists). The history of science is full of people getting it wrong and looking like idiots. We look back at quaint and infantile scientific theorems and mock. Though we read only the classic “history as told by the victors”.

History is dependent on source. History could be defined as everything that’s ever happened ever. Then the “history” that we’re working from is nothing but a millionth of a fraction of what’s actually happened ever. We have only what was recorded (by the victors again…). And even then why do we presume that the “history” we have is what was recorded. How much has been lost, burned, or never recorded (neither Incas nor Mayans – two culturally advanced peoples – kept written records). How much of our most important archaeological data lies underneath an Iraqi marsh or a Damascus office block (even though we think cities were a pretty late development…).

Now I don’t mean to be all down and history or science, I love both, I even tentatively say I believe in both but I hope I have the sense and possibly even the humility to say that we’re not quite there yet.

As regards to something I actually have some experience in – the more I do medicine, the more it becomes clear that we haven’t a notion what’s going on in the human body. Yes, we give drugs and yes they seem to work, and we have lots of plausible theories as to why they work, but in reality we have no idea what they’re doing at a cellular or biochemical level. This is most clear when we come to the brain. We’re only at the tip of the ice berg with that one.

We used to remove the frontal lobes of people brains to make them better. We now know (we think) that that was a bad idea. We’re still electrocuting some people with severe depression or mania (and it still works sometimes).

We used to not wash our hands between delivering babies (it seems that some of us still don’t…) and couldn’t understand why they got fevers.

We used to drill holes in peoples heads after head injuries – the Egyptians did it to release demons, we do it for lack of knowing anything better to save badly battered brains. Occasionally it works. In 10 years time we may well be doing decompressive craniectomies on guys with head injuries and putting the top of their skulls in deep freezers for six months and then attaching them back on again.

Maybe we’ll just go back to the leeches?

Back to the book.

In his conclusion Peter Watson demonstrated that we seem to have made excellent progress with regards to understanding both nature and our universe and (a slightly optimistic) notion that we’ve progressed in our humanity and how we treat each other. Though I imagine it’s only white people like me who could write that. However he concludes that “man’s study of himself is the biggest intellectual failure in history”.

[He considers the idea of the soul a much more significant idea than the idea of GOD, who apparently died with the Renaissance. I must tell him that next time I’m talking to him, always enjoys a laugh so he does…]

He finishes off with an exhortation to abandon mankind’s search to understand himself through introspection and instead look “at our role and place as animals”. That leaves little room for art, music, literature, joy, pain or beauty and certainly none for the pursuit of truth. Mankind has barked up a lot of wrong trees no doubt but just because progress is kind of hard to define doesn’t mean we need to give up on it.

Ronniewatch – day hundred and something…

I suppose you’re all due a quick update for Ronniewatch. I have perhaps been neglecting him on the writing front. Though I think he probably appreciates that.

He’s been home for about a month now and seems to have managed to stop losing weight, if not put any on quite yet. He reminds me less of a concentration camp escapee now that he’s recovering from his Nelly inflicted hair do.

Food is such an issue he’s taken up cooking, sparking a series of Ronnie’s kitchen nightmares jokes and generating yet more dishes for wee Liz to clean up. It has meant a hugely increased amount of fried-chinese style food is being consumed by yours truly – it wouldn’t do to see the left overs go to waste now would it?

He now has a clot in his leg. Or more accurately he’s probably had it for a month or two, but it’s only becoming apparent now. Note the photo below shows a DVT. Not twins.
dvt.jpg On a medical note, it’s one of those things that we’re probably discovering more often cause we scan more often for them now. Which brings up the whole question of is it or is it not worth treating? Large parts of medicine are made up of what is know as plausible theory. For example if someone is a bit short on oxygen then giving them oxygen must be good for them. Right? [Hint: if anyone ever asks you such a question then the answer is “not necessarily”, though if you’re in Sunday school at the time then it’s probably GOD, JESUS or Moses…]

To complicate the example (and I will try to keep it simple), if someone dies from Pneumonia (pronounced of course “p-new-monia”, all that silent “p” stuff is just what we use to make lay-people look stupid. Next time a doctor uses the silent “p” be sure to correct him. What, do you think I’m trying to make you look stoopid or something…?), then generally what’s done it will be the lack of oxygen to the tissues (particularly heart, brain, kidneys etc…) of the body.

The plausible theory would be that providing supplementary oxygen should help prevent them dying. Surely we have lots of evidence to confirm this? [See “Hint” above]

There’s a guy (admittedly I paraphrase to the point of invention. This is the type of thing I picked up on the morning ward round in NZ, along with how you can use coconuts as IV fluids if you need to, so I’m dubious if it actually happened) in South Africa trying to conduct a study comparing the treatment of kids with pneumonia, where the only difference in treatment is the availability of supplementary oxygen (in many parts of SA this is common). In the less well-equipped areas, where no oxygen is available the kids who run low on oxygen either get better or die.

The interesting question is that whether giving oxygen actually makes any difference to survival. Does giving oxygen simply make the numbers on the monitor look better? In other words if your pneumonia is bad enough for you to need oxygen then giving you oxygen isn’t gonna make a difference.

I feel I may have lost even some of the early readers with that little foray, even the enthusiastic ones who started off with appropriate footwear and a flask of warm lemon drink.


The problems with clots in the leg is that they fire off and travel round the body and get stuck in the lungs and stop the blood flow from the heart – which is unsurprisingly kind of bad. Sort of like sticking your finger in the end of a running hose.

The treatment to stop that happening is good old fashioned rat poison (minus the crushed glass of course). Of all the nasty drugs patients come in on, I hate that more that all the others.

Incidentally I’m doing well on my list of things I never wanted to see happen to my family:

“The biopsy tells us it’s cancer” – Check

The “sit down in the relatives room and wait for the surgeon” chat – Check

Relative on a ventilator – Check

Relative on warfarin – Check

But I suppose it does work despite all the complications so maybe I shouldn’t diss it quite so much…

Consider it added to Dad’s ever growing list of “every complication possible” (though no matter what he says, he’s got all kinds of options left to explore!).

It does give him a busy week, 4 hospital appointments in 5 days, 3 sets of blood tests. I tend to underestimate the effect of all these diagnoses on people. To me a clot in the leg is “not a big deal”, just cause it won’t kill him. Again confirming that I have a lot to learn about quality of life.

We were also back for an appointment in the Belfast hospital where Dad had the surgery. Walking along the corridors was not a pleasant experience. I went down the wee spiral stairs in the atrium to get a cup of coffee and it all hit me again, the waiting, the phone calls, the fear.

On a positive note we did get to meet some of the staff who’d looked after him, and that was cool. For them and us I think.

To end on a positive note, he got behind the wheel of a car again (the mighty volvo of course) and we drove down to the shop for some milk. Winner.

Hidden in the back of my mind, somewhere under all the blogs and the books and the new Broken Social Scene album is the likelihood of the odd bad day ahead.

Not that I expect them, not that I’m being negative. Just that the road to recovery has lots of chances for wrong turns along the way.

[Note: I admit that last one is a tad clicheed, hope it doesn’t leave you sick as a parrot… Just take me away from the keyboard before I hurt myself…]

Everything in its right place

I find technology deeply satisfying. Disturbingly so. That these fascinating little pieces of silicon can bring such order and peace to our otherwise chaotic existence.

This is of course nonsense. Technology is more like an alcoholic – they promise you the world and live up to none of it. I don’t really blame them, they’re just computers, it’s not really fair to force moral standards upon them.

iPods and computers and phones and address books and usernames and logins promise to bring final closure and nirvana to our lives. That dashboards and time machines hold the key to life.

Like Rob’s great re-organization in Hi-Fidelity, it seems deeply comforting. That if we can only get our shit in order then somehow we’ll not have to it all reorganize again later.


I have so far spent the past 3 hours installing Apple’s new OS on my computer. Mostly very simple, and point and click and idiot-proof for muppets like me. It needs to be.

It’s telling me it has roughly 2 hours remaining in indexing the contents of my computer. It’s making a history of everything I have in this box, so if I give it one word it’ll go and retrieve and file containing or associated with that search term.

To some of us that gives a warm fuzzy glow inside.

I used to think there were more important things in life. I suppose I still now, just not right now…

It’s the type of mood that makes me want to buy an iPhone and live in a Starbucks.

Don’t worry it’ll pass.

Packt Like Sardines in a Crushd Tin Box


Such was the view I woke up to this morning. Well that was the view on my left side. On my right was Gaz:


He must have got out of the wrong side that morning…

And no I have not flipped out and fled the country back to NZ. Such scenes do exist in NI. I tended to block stuff like this out when I was in NZ, how beautiful a country we actually live in. Autumn rules. Though it is a tad on the chilly side. All I have to do is compare the strand in Newcastle:


with Napier:



Though perhaps I’m being unfair.

No, in fact I’m only in sunny Castlewellan castle with a crowd of 170 miscreants from CE. This is fast becoming an annual tradition of dragging a crowd of folk up to the castle and abandoning them in the basement with bunk beds to see if they can find all the hidden passages. There is of course the obligatory trip to Newcastle on the Saturday afternoon to see how slow the dodgems really are and but tubs of ice cream in Mauds and keep up the good Norn Irish tradition of eating ice cream while dressed in 4 layers and walking along a windswept beach.

There was a lot of bant, the craic was good, there was a deficiency of sleep. There was a lot of good teaching, there was a lot of singing, a lot of prayer and many a long, meandering chat on the state of our souls. Good times.

There was a lot of me feeling almost intimidated by large groups of people, most of whom I don’t know. I regret my rather backward social skills, my fear of small talk and my inflated sense of self-importance. I spent a lot of time listening to Gilly tell me their stories and finding myself in rather illustrious company. Somehow it still surprises me that GOD does such work in other people’s lives. I still live in a rather Nelly-centric universe.

library-5382.jpgMore importantly there were 22 people in the Volvo (incidentally you can see in the photo that someone stood on the wiper controls). Though this was underplanned and suffered due to a lack of commitment from the participants – I mean what was all that moaning about needing to breathe all about? I despair for the youth of today…

I think the only way is to get them all lying flat in rows in the back, and possibly consider the removal of a limb or two. I mean two hands is just indulgent…

I think we could make 30.




Heavy metal drummer

muppet_animal.jpgI’ve been sitting with the drum kit from church sitting in my room all week. Occasionally I try to play it. On a scale of 1-5 of drumming ability I come in a tenuous 2. I know what I want to play, I can even slap out said beat most comfortably on my thighs (without spoons…), but I lack somewhat the nuance, rhythm and co-ordination to make the beat boxes sound the way they do in my head.

Mostly I sit there with my headphones on drumming along to old Radiohead tunes and making bizarre facial movements with the extent of the concentration. I used to do this playing the guitar, until I was able to play the guitar, and then that stopped. Maybe that’s how I’ll know I’ve conquered the drums, when my face looks less like I’m sucking a lemon.

I played in church on Sunday night, only the second time I’ve done so. I was nervous when it came to it. I haven’t been nervous playing music since the infamous gig in NZ. Not a pleasant experience – the nerves not the gig, though again that depends on your point of view…

The one benefit of playing drums is that at least you can’t start in the wrong key. Though switching from a 6/8 to a 4/4 mid-song is probably beyond me. I’d probably need to know the difference between the two first.

Never leave a job half done

I applied for a job yesterday. One I’m feeling rather less confident than usual that I’ll get, and one that I’m not entirely sure I want. I feel confident the interview panel will not be reading of my doubts regarding the position.

My job is largely delaying the inevitable – keeping the old ticker ticking along, maintaining the vitality of the vital signs and endeavouring to maintain oxidative metabolism at the cellular level. Eventually this all stops, this is pretty much universal. And personally I know I’ll look back and see it as no bad thing. I’m keenly awaiting Human Mk II – to see if they get round to fixing the current bugs (total system failure, usually occurring between year 0 and 100) and possibly reconsidering the idea of putting the reproductive and waste disposal systems so close together.

No doubt they’ll just make the bum a bit curvier, add a spoiler and double the price…

Occasionally I am lucky enough to be involved in actually improving someone’s quality of life or return them after their brief tango with the grim reaper to a relatively normal (and more importantly dignified, satisfied and even enjoyable) level of function. An awful lot of us do seem to enjoy being alive, no matter how much we complain about the weather or X-Factor.

Since qualifying I’ve largely been soothing my ego running around resuscitation rooms wearing scrubs and shouting STAT and such. Well not really but I do tend to slip into the adrenaline junkie type of doctor (you could actually try being a literal adrenaline junkie and see how long you last – heroin is much more of a long term career move…) Medicine is both good and bad for me. It does indeed feed my ego. It also gives me opportunities to practise (definitely practise!) such good old fashioned concepts as humanity, compassion and a job done well for the sake of it being well done. I have a complex relationship with my work, it’s not the work’s fault, I manage to form complex relationships with everything.

Since Da got sick I’ve not been working and have filled my time with writing meandering self-deprecating blogs and and even the odd depressing fairy tale. Throw in a very occasional shift as a locum in A&E and a couple of hours cutting up dead bodies and it seems my week is filled.

I’m fairly under confident about the job, seeing as it specifies experience in a speciality I have no experience in. It also states that the successful applicant will have (I’ve never understood the use of the future tense in job applications) a firm commitment to a career in such and such a speciality. Which I also don’t have.

In my favour, I am the only doctor I know personally who is currently unemployed (I’m sure there are others floating about somewhere given last years fiasco) and as a result am immediately available whereas everyone else will have to wait another 2 months to get out of their contracts.

What worries me is not so much not getting the job but what if I do actually get it? It’ll mean getting up every morning (though to be fair I’m up at 0730 most days), only getting 3 cups of coffee in a day, having to stop cutting up dead bodies and start piecing together live ones, having to wear a shirt and tie to work (possibly one of the most daunting prospects), not having time for people and receding into my little self protective shell which I seem to have been coming out of of late, because of boredom if nothing else.

If nothing else it might save you from quite so much poetic disintegrated psychobablehicoughup that makes fascinating reading as my former boss described what I write.


November 2007