Archive for November 9th, 2009

A well respected man

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.

Like eating glass

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

Screen shot 2009-11-09 at 22.06

I was thinking I could clean up for Christmas

I’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.]


November 2009