Wednesday, June 29, 2011

Top 10 Australian Albums

A little while ago my Wise Brother asked me what my top 10 Australian albums were, prompted by Triple J's recent poll.  I had to dwell on it for a while and then set myself some ground rules.  Here are the rules:

  1. No pseudo-Oz Kiwi bands.
  2. Only one album per artist.
  3. No "Greatest Hits" or "B-sides" type collations.  Which is a shame because some of my favourite CDs are in this mob but it's not really an album is it?  Feel free to assail this decision in the comments section.
  4. I must actually own the album to nominate it.  If I don't like it enough to own it, well...
So here's my list, in alphamobetical order, with as brief a review as I could summon:

Cat Empire - Two Shoes.  Joyous chaos.
The Cruel Sea - The Honeymoon is Over.  Dark swaggering.
Mia Dyson - Parking Lots.  On the shady side of the street.
The Herd - Summerland.  Opinion columns to a beat.
Lazy Susan - Long Lost.  Anecdotal.
Professor Ratbaggy - Professor Ratbaggy.  Unscientific experiment.
Powderfinger - Internationalist.  First half: rock epics.  Second half: zap gun duel
Josh Pyke - Memories and Dust.  Extroverted introversion.
The Simpletons-  Matter.  Sign of things not to come.
Something For Kate - Echolalia.  Black humoured life.

Some things jump out at me about this list.  It's surprisingly narrow, dominated by music that got played on Triple J in the late 90's, early 00's, mostly because this was when I had a job (hence could buy music) and also listened to the J's in my car to and from work.  Since then I've been either incomeless or radioless or both, so I've strayed far from the rock of mainland Oz.

Nevertheless this list would be one I would happily take on a long driving holiday.  They're all musically rich and lyrically interesting, at least to me. They're all albums that very quickly got put onto high rotation on ye olde NAD 510, and hence are intrinsically entwined in my memories of those times.

I'd be interested if a few of my Gentle Readers would post their own top ten lists as comments for perusal.

Tuesday, June 28, 2011

Socrates drank hemlock - we can only wait and hope

One of my pet peeves, if not monstrous hates, is the type of doctor who chooses to "educate" students using the lazy man's version of the Socratic method.  The Socratic method, if you're not familiar with it, consists of not directly answering questions but instead challenging the student with questions that engage them in thoughtful discussion.  This works well if you are Socrates - not so well if you're a pompous git who can't be bothered interrupting your own scribbling in the notes to even look at the student, let alone allow your cerebrum to process more than a few key words in the original question.

My boss last year was a big fan of this.  When I asked him why we weren't getting the tutorials we were supposed to, he got all Zen and said, "My job is to open the door but only you can walk through."  Deep.  Anyway, this is all prompted because I had the following exchange with one of the doctors this week:
Why is the girl in bed 12 on roxithromycin?

Well, why do we put patients on roxithromycin?

Mmmm.  A telling point.
I wonder if they do this sort of thing every time anybody asks them a question...
Do you know how fast you were going ?

Do you know how fast I was going?

Monday, June 27, 2011


Whilst idly perusing my google analytics stats I noticed that I'd gotten a few hits on my "Bookshelf" page.  Which is sad because I've been too lazy to update it for at least six months. 

From time to time I get briefly excited about a new concept, such as writing book reviews in haiku form or as limericks.  But then apathy takes over again and nothing happens.  I did briefly consider starting up another blog just for such reviews, but reasoned that the likelihood of actually keeping it going once the novelty wears off is very slim.  As you may have noticed, new concepts are very exciting to me for about a fortnight.

For those who wonder, here's a short list to update you on some the books I've read since about Christmas.  You may notice that there are quite a few 5/5 ratings here - I was lucky and hit a real purple patch around March...

Currently reading:
Titus Groan - Mervyn Peake.  The Tolstoy of baroque fantasy.

Recently read:
Never Let Me Go - Kazuo Ishiguro.  Haunting and sinister chick-lit. 5/5
Dictionary of the Napoleonic Wars - David Chandler.  Can you really "read" a dictionary? 4/5
Rifles - Six Years With Wellington's Legendary Sharpshooters - Mark Urban.  Like a Napoleonic Peter FitzSimons. 3/5
Welcome To The Monkey House - Kurt Vonnegut.  Assertively off-kilter.  3/5
Blind - Matthew Farrer.  Confusingly creative non-genre genre sci-fi.  3/5
Open - Andre Agassi.  Inside the tennis racket.  5/5
How To Make Gravy - Paul Kelly.  This is what blogs should be.  5/5
Into Thin Air - John Krakauer.  Tragic personality clashes at altitude.  5/5
Invisible Cities - Italo Calvino.  Hallucinatory travelogue.  5/5
Brighton Rock - Graham Greene.  Queen's song is better.  2/5
The Book Of Sand + Shakespeare's Memory - Jorge Luis Borges.  Betrayed by elevated expectations.  3/5
The Gospel According To Jesus Christ - José Saramago.  A cynical epiphany.  3/5
The Happiest Refugee - Anh Do.  A dull comedian from a fascinating family.  2/5
Eisenhorn Trilogy - Dan Abnett. Batman in the 40K-verse.  4/5
Titanicus - Dan Abnett.  Kill! Crush! Destroy!  3/5

Friday, June 24, 2011

Paeds case review

A 37 year old male presented to the Paediatric Ward this morning at 0830 hrs complaining of tiredness and abdominal pains.

The tiredness has been present since early December 2010 when his first child was born.  The tiredness has been relatively constant but generally is better on weekends and is relieved by additional sleep. He complains of a lack of motivation and concentration, precipitated especially by his enrollment in a medical degree.

The abdominal pains began shortly before his arrival on the ward.  Further questioning elicited that he had not had any food or drink yet today due to rising late and rushing out of the house.  He states that in similar circumstances in the past he has suffered from identical abdominal pains which persisted until he ate.

On examination he was thin although healthy, mildly dehydrated, showed no neurological abnormalities, and had a clear chest.  He was prescribed a caffeine solution and referred to the volunteers BBQ breakfast in the courtyard, where he was treated with oral toast, bacon, sausage, egg, hash brown, onion and sauce.  Shortly after treatment he was observed to be sleeping soundly in the doctors' office.

Please review in the afternoon - should be suitable for early discharge to home care.

They hate me because I am pretty

They hate me because I am pretty.  That's the only possible conclusion.

After the ward round this morning the consultant drew me aside for a private conversation where he pinged me for not using my initiative.  This soon after I volunteered to write a letter to the school of one of the patients addressing a problem and the hospital's stance on it, discussed it with the mother, wrote the letter, got the registrar to sign it, gave it to the mother and also put a copy in the notes.  All in ten minutes tops.  I thought I was a bit of a hero actually, so I was mildly taken aback to be rapped on the knuckles for not trying.

And what was the actual problem?  It seems that earlier in the round I had had the temerity to walk with the consultant to the next patient's room, rather than run off and grab the notes.  Parenthetically, the reason that I didn't scurry off and get the notes was because someone else was already doing so, so it seemed superfluous for me to make a token effort.  Little did I know that my presence alongside the consultant for those ten or fifteen seconds that it took for the notes to arrive would be so distasteful to him.

I got thrown into a bit of a funk by it, but after lunching with some of my Esteemed Colleagues, I'm back on track.  Let's face it, it's not my fault I was born so pretty.  I can't be held responsible for the fact that merely glancing upon my godlike visage unprepared can stun the viewer into a drooling stupor.

Tuesday, June 21, 2011


I was doing my special curtain dance this evening for the Hatchling.  It's the one where I pull the strings that draw the curtains surreptitiously and meanwhile make like David Copperfield, as if I'm magically enchanting the curtains to close without touching them.  The Hatchling loves it.  She also loves the curtains when they are totally stationary, so maybe it's them rather than me, but I'm keeping it fresh until she's old enough to tell me just in case.

Anyway, after putting on this great performance, my Smaller Half made some remark to the Hatchling, that she should be scared because half of her genetic material is mine.  I pointed out to my Smaller Half that since I weigh almost twice as much as her it's probably more like me:her in a 2:1 ratio.

It's kind of strange the way people usually talk about being half Scottish or a quarter Aboriginal or one-eighth Indian, but you seldom hear people say that they are one-third this or two-fifths that.  Yet a set of scales and some simple arithmetic is all that it would require to calculate much more accurate genetic histories for the purposes of determining risk.  Tip for all you first-year med students out there: in your upcoming genetics exams you'll get top marks if you include these types of weight-based calculations in your answers.

Monday, June 20, 2011

Knife edge

Fresh start today.  I'll be doing six weeks with the little people, by which I mean paediatrics.  I've been really looking forward to it, from both a personal and an professional point of view.  I got to see very few kids last year so this will be a good learning experience.  Plus, I like kids.

A few times I've heard people say to me, "I couldn't do paediatrics, I hate seeing kids in pain".  Which kind of confused me.  I always felt like replying, "But you like seeing adults in pain do you?"  I didn't actually say that since obviously that would be a pretty jerkish response.  But I guess I couldn't really connect to what they were saying.

But last week I was reading a book on death and dying and I opened it up to a chapter on the death of children.  The sentence that fell under my eye was: "Parents who have a child that dies will often experience grief, guilt and anger so severe that they feel that they are losing their minds". 

As I read that sentence I involuntarily contemplated how I would feel in that situation.  And it was like a panic attack.  For about twenty seconds, my chest was tight, I couldn't breath, my whole body seemed to tense up and freeze.  And that was just from reading one sentence in a book.  I can't imagine the horror of having to cope with it in reality, day after day, forever.

So now I'm feeling quite apprehensive about the next six weeks of paediatrics.  Hopefully I'm not going to be a walking mess of raw nerves.  On the round this morning I didn't see any kids who were really life-threateningly sick.  Which was nice.  But it meant that I spent the morning wanting to grab them all and play with them and then feeling increasingly homesick and missing my little Hatchling.

This is going to be tiring...

Saturday, June 18, 2011

And on and on

One of my Esteemed Colleagues was lamenting to me that the Moronic Nursing Student has now appeared in this blog more often than him.  I say to him, "Good sir, thank your lucky stars.  For the Moronic Nursing Student is my arch-nemesis, and were your deeds to match his in infamy your brain would be in a most parlous state, unfit for the practice of medicine."


Moronic Nursing Student
People are so stupid.  The number of people who say to me that they don't like to take medication because they don't like chemicals is incredible.  Don't they realize that everything is made out of chemicals?

I suppose not.

Moronic Nursing Student
And people who want to take herbal remedies because they're natural and organic but won't take medical drugs.  Don't they realize that the definition of organic is that it contains carbon?  So all drugs are actually organic?

What about lithium or gold?

Moronic Nursing Student
(puzzled) They're natural.

But they don't contain carbon.

Moronic Nursing Student
No, but they're natural.  God people can be so stupid.

Friday, June 17, 2011


O rapture, O sweet sweet manna from heaven, O light of my senses, O dream of summer days!  I just witnessed a thing of marvel and wonder.  The nurse who has been very rude to me for the last six weeks just slammed the Moronic Nursing Student.  I experience the whole thing in slow-mo, it seemed to last for hours.

Nursing Student
I just wanted to say thanks very much to you guys, I really learned heaps from being here compared to when I started.

Ha!  Compared to when you started I'm not surprised!

Trained monkey

So today is the last day of having to put up with my friend the Moronic Nursing Student.  I turned up this morning and had to grit my teeth so hard that they crumbled like chalk.  Here's a rough transcription of the first 30 seconds, prompted by me throwing a piece of paper at a bin and having it land right on the rim:

You've obviously never played basketball.  I used to play basketball with my mates, half of them were in the state team, they were just psycho.  How'd your plumbing problems go yesterday?  I reckon a trained monkey could be a plumber.  It's not hard.  I don't know why they get paid so much.  It's like electricians.  I reckon a trained monkey could be an electrician.  I don't know why they get paid so much.  So tell me, why do you reckon that person was there in the hall?
The special sitting on the chair? Presumably the patient is bonkers or violent or a wanderer.

See, the thing is, with age-related cognitive decline, people forget they can't walk, so they're a falls risk.  Some people fall over really easily, they get up and boom, they fall down.  We had one guy who fell down more than six thousand times in one month, he was full on.  So you've got to have someone sitting there watching them to make sure they don't try to walk.

My goodness, I never suspected.

It's pretty boring having to watch them, I reckon a trained monkey could do it.

He has also lectured me extensively on painkillers, napalm, styrofoam, back pain, how to put in cannulas, his last bout of diarhoea, his mobile phone plan, the legality of restraining patients, what the effective dose of anti-epileptic medication is, and so on and so on and so on. And so on.

I got some small measure of retribution just now when he slipped up and admitted to never having heard of conversion disorder.  So I expressed great astonishment that such information was not in the nursing curriculum and wondered why he had never come across this in his background reading, then brutally patronized him him for a few minutes whilst desperately trying to remember the few scanty shreds of knowledge that I could dredge up from second year.

Revenge is a dish best served hot!

Sunday, June 12, 2011

Lower back pain explained

In the last five weeks I've seen a lot of patients with chronic lower back pain.  Depending on the cause, they can also present with other symptoms which can be quite mystifying unless you have a detailed knowledge of the lumbosacral plexus - the network of nerves which leave the spine in the lower back and control the motor and sensory function of the lower body.

The problem is, the lumbosacral plexus is rather complicated.  That is, it has always been considered complicated until just this week when I realized that it can be easily understood in terms of the battle of Waterloo.  A little bit of work and voila!  This aide memoire inventee a moi pour la purpose de la education medique, as they say in France.

To use it, simply note that the French commanders are in blue, the Allied commanders are in red (British), grey (Prussian), and black (Brunswick), and the local villages and farm buildings are in brown.  (The Dutch are not included in this diagram since they correspond better to the visceral innervation.)

For example, if a patient came in complaining of lower back pain and sudden onset ineffectual cavalry charges in the genital area, the diagram clearly shows that this is the fault of Marshal Ney, and that the underlying lesion lies somewhere in the vicinity of the sleepy hamlets of Rossomme and Papelotte.  Or if the patient instead complained of lower back pain and surprise arrival on their flanks of a brigade of horse artillery, the diagram indicates that this is related to the activity of General Bulow of Prussia.

Every patient is different, of course, so please use these suggestions with caution and don't leap to conclusions.  But it's definitely worth asking, when your next patient comes in with long-standing back pain unresponsive to conventional treatment, whether or not a whiff of black powder or a snifter of grape-shot might help!

Thursday, June 9, 2011

Insidious mind-control

As you know, life is unfulfilling unless I have something to rail against.  At the moment, things are going fantastically because I am on a righteous crusade against non-canonical nursery rhymes.  It may seem harmless when people tweak these little rhymes and songs a bit but stop for a moment and think about what these shadowy powers-that-be hope to achieve with their historical revision?  I put it to you that the culture wars are being fought (and lost!) right under our noses.  Soon our children will be placing calls to the Stasi in the dead of night to report on our activities.  Think I'm exaggerating? Read on.

It all started when we were given some type of poster-thing by a community midwife to encourage us to sing and read to the Hatchling.  All well and good.  But these are the lyrics to Twinkle Twinkle Little Star that were printed on the poster: (the emphasis is mine)

Twinkle twinkle little star
How I wonder what you are
Up above the world so high
Like a diamond in the sky
Twinkle twinkle little star
I'm so glad that you came by

How about that last line eh?  Stupid or what?  Stars don't "come by" to visit like they are your friends.  And it completely stuffs up the rhyming scheme of the song.  I can't say for certain why some faceless bureaucrat in the Department of Nursery Rhymes saw fit to change it.  But I'm pretty sure it's part of some leftist conspiracy to indoctrinate our children into thinking that it's nice to have people just dropping in out of the blue, so as to weaken our resolve in the Great War On Immigrants and erode the sanctity of property ownership.

It's amazing how many leftist conspiracies you can find in children's literature once you become sufficiently deranged and paranoid.  For example, one of the Hatchling's favourite books is one called Where is the Green Sheep?  This simple book shows us all sorts of other sheep in our lengthy search for the Green Sheep.  Entertaining stuff, to be sure, but the author and illustrator don't miss a single opportunity to brainwash us into their pinko views.  Here's a short list of some of the sheep in the book and their barely subliminal messages:
  • The red sheep and the blue sheep - clearly intended to make us think that it's okay to look funny or to be born ethnic.
  • The train sheep and the car sheep - the train sheep reclines in unnatural comfort amidst a seething menagerie of unhygienic foreign animals while the car sheep struggles to repair his broken vehicle.  How much multiculturalism, environmentalism, communism and other isms can be crammed into just one page?
  • The thin sheep and the wide sheep - because sheep can't be called fat anymore because it might hurt their feelings.  Still, they can't stop me from the enjoying the juicy strip of wide down the edge of my lamb chops!
  • The wind sheep and the wave sheep - more environmentalism, more lazy layabouts.  I see there's no brown coal sheep, no uranium sheep, not even a natural gas sheep.  Sheep don't need real jobs, being happy to fly kites and go surfing.  Hence no need for a construction worker sheep or a chartered accountant sheep or a soldier sheep or any other form of gainful employment sheep.  I'm surprised the illustrator didn't just draw the surfing sheep with a disability support pension sticking out of his back pocket while it laughs all the way to the bank!
 I'll bet you're not laughing now.  The next time you are reading a book to your child or singing a song to your baby, give some thought to what they might really be hearing.  Remember, if you don't vote Right, don't vote at all.

Wednesday, June 8, 2011

In a nutshell

So, what did you think of that patient?

Well his relationship with his wife seemed very strange.  She's very passive and seems to out-source her aggression to him.  And she's very dependent on him but he just shuts her down when she vocalises her guilt.  He seems like someone with a lot of frustration in his life but the only way he is able to express that frustration is through anger.
There's a simpler way of putting it - he's an arsehole.

Monday, June 6, 2011

My five favourite soups

My five favourite soups are:
  1. Pho
  2. Potato and leek
  3. Pea and ham
  4. French onion
  5. Minestrone

Sunday, June 5, 2011

Thank you for your help

Before I start... bugger.  Now that I've started, I want to make it clear that I do not have a seething contempt for nurses.  Oh sure, some nurses.  Like the bizarre passive-aggressive nurse I currently work* with.  He somehow manages to undercut me at me every opportunity.  Like the time I called in sick and he answered the phone.  When I told him I wouldn't be in, he said "Oh.  Well, I don't suppose it really matters anyway."  He's either a comic genius or a brutal misanthrope.  Or both.  Or neither.  Yep, that about covers it.

Anyway, I was telling you that I don't hate nurses.  I have no stories to tell you about likeable nurses to prove this because stories in which everyone acts in a reasonable and pleasant way aren't very memorable or interesting.  But just keep in mind that most nurses are great because I'm about to unload on one chump who happens to be a nursing student.

The problem is this - he seems to be very competitive with me and is always trying to show me up.  For example, on his first day I had a syringe driver that I was about to hook up to a patient.  The guy stops me and points to a series of tiny bubbles in the tubing and insisted that I flush them out of the line.  When I said I hadn't noticed them, he said "That's what nurses are for!  Lucky I was here."  For the record, to give someone an air embolus you need to get about 200 mL into their veins,  The bubbles in the tube would have been a fraction of a drop.  Still, nice catch there, Inspector.  He spent the next 10 minutes flicking the syringe to try to remove some errant molecules of nitrogen clinging to the side of it.

This week he managed to creep up behind me while I was discussing a patient's medication with her, and chip in with unhelpful comments just at the worst moment:
So you've gotten good pain relief from fentanyl.  This means we'll be able to think about a range of medications to find one that's right for you.

Annoying Nursing Student
It's a class of drugs called opioids.  Things like morphine.

Worried Patient
Morphine?  I don't want to take morphine! Isn't that for people who are dying?

A lot of people are worried about that.  But there are lots of people who use morphine or similar medications for pain control.  The reason that these drugs have this reputation for being for dying people is that they are effective.  So they do get used in extreme situations.  But they are also useful for people like you who only need much smaller doses.

Annoying Nursing Student
Watch out though, because if you take too much you'll stop breathing and die.


*"work" being defined in this case as performing pointless tasks for no remuneration.

Friday, June 3, 2011

The truth shall set you free

Baffled Consultant
I've never known students to be placed in that unit before.  Did you choose it?

Well, it was my 5th preference so, in a sense, yes.