A Pure Pleasure

I went to church yesterday. The sermon  was  about forgiveness . I do realise that my voluntary presence there should mean that I am an adherent of what is, let's face it, a pretty basic tenet of the Christian faith. 

Yet I can't help but feel a little resentful about losing one of the few pleasures left to me. I am middle-aged, overweight and ridden with cholesterol (therefore low everything diet) asthmatic (no smoking) and arthritic (which means not just less joie de vivre but more paracetamol and more need to watch the other liver toxins).

Hating is pretty much calorie-free,  low cholesterol, non-toxic to the liver and it can even give you a good cardio workout now and then.So I indulge freely.

I hate cyclists amongst other things. For the pedant I would point out that this is a grammatically correct statement. I don't just hate cyclists; I hate the way they insert themselves into the spaces that normal folk (pedestrians, motorists,rampaging gila monsters etc) leave between each other.

By cyclists I mean those lycra suited bums-in -the-air, nose-on -the-handlebar types that infest our roads in geometrical formations of lime green and lemon and tropical mandarin. Their heads are covered with sculptured helmets resembling frozen wave formations and their numbed nuts and torsos decorated with industrial logos (does anyone actually sponsor these people or is this their substitute for having friends?) (I do exempt school children and bicycle-clipped pensioners from my wrath.)

Cyclists are not required to carry third party insurance nor do they display any identification.This apparently means that they are exempted from speeding or traffic light violations where cameras would otherwise be used and if in (for example) running a red light they are collected by a car , the car's driver bears the brunt of the costs.

My attitude to cyclists is not a common one in my profession or in my specialty; most doctors feel they should pay lip service to the claimed health advantages and carbon saving superiority of the pernicious peddlers. 

 Anaesthetists in particular are prey to the lure of the lycra.In fact at any anaesthetic conference in this country the free afternoon includes a group bicycle ride wherein the natives of whatever unfortunate state is hosting the said knees -up are forced to watch the arses of several dozen whippet thin non smoking vegetarian middleaged gasmen disappearing over the horizon of their capital city.

I once played the part of a patient in a mock exam. I got to choose the scenario as long as the patient had an acceptable story for a chronic pain patient and the real patient volunteers were mixed in with the actors.I chose to be a middle-aged histrionic who had been run over by a bicycle and was left with an ulnar nerve injury and a pathological hatred of cyclists .I worked myself into a foaming rage with such verisimilitude that the first candidate hit the stress-call button .Luckily Security didn't come.

I also hate my cat.It was foisted on me 16 years ago and has cost a fortune in food, boarding fees and vetinary care.

I thought we had an escape some five years ago when it was bitten by a snake.We came home to find it lying on the porch .It looked quite normal we thought -until the Urban Terrorist poked at it and it slid stiffly off the verandah and into the bushes with all the grace of the Queen Mary. Only daughter-of-mine's fondness for the beast saved it then - the anti-venom ,steroids and "intensive care" (an oxygen tent and a methadone drip and no actual supervision overnight) all racked up over a thousand dollars.  It was worth it , I thought, to see the affection between my darling child and her pet.

 The other day I was driving into the house when the cat leaped out screeched across a parked car with open claws and bounded into a nearby tree.  I cursed "When will that bloody animal die?" D.O.M beside me said softly " about five minutes if you tell me where you keep the shovel".

Knit Your Own Expert

                  I spend a lot of time railing against the proliferation of so-called "expert advice". Why, in a centre of excellence not a million miles from where I work there stands a building which houses the Mary Poppins Institute of the Blindingly Obvious.In this evidence based hall of wonders countless (?taxpayer funded ) nursing academics toil with such fundamental problems of existence as "which intravenous cannula is safest to use?) (note they don't ask "which intravenous cannula is easiest or most efficient or less painful" and their ceaseless sifting of evidence does not actually include asking the grunts) but lo! they speak and now it is that I am given blunt thingummies that retract on insertion to place in the non-existent veins of needle-phobic CRPS sufferers.

              (I must ask Daughter -of-Mine for an appropriate icon to follow the words "Evidence -Based"..it should look both portentous and profound...it should call to mind the faint echo of a gregorian chant mixed with a whiff of incense ...whilst breathing a gently cold chill down one's back . I'm sure she will know how.)

             In fact I don't need the Institute any more. I have something so much better. I have a 17 year old daughter. A conversation with her is like watching a sex education film circa 1970-- the ones where the frame is frozen and an authoritative  figure in a white coat  and horn-rimmed glasses indicates the unpleasant bits with a pointer whilst turning intermittently and hectoring the audience.

           We were having a Sunday roast lunch the other day and my efforts to engage the Urban Terrorist in a conversation on Global Warming (O.K. 2/3 rds of the way to a bad outcome already and possibly more after he revealed his plan to save mankind by constructing a giant fart collector and shooting the accumulated methane into outer space) were somewhat hampered by D.O.M.'s running commentary on how one should hold a conversation with a 9 year old.

           I finally said in exasperation "Look, it's difficult enough trying to mother this child without you sitting on my shoulder like some malevolent Jimminy Cricket." "You're the second person who's called me that this week." she answered. I repeated "I'm the second person who's called you a malevolent Jimminy Cricket in a week?""Yes"she replied,apparently unperturbed"At least Samuel-at-school said it was like being followed around by Jimminy Cricket's bitch of a sister so I suppose that's the same thing".

           It is amazing that she combines insight of her actions ( or at least acknowledgment of their effect on others) with such a total lack of caring about either.

          I had a haircut this week. I loathe having my neck touched so as usual I asked that it be cut extra short to prolong the interval between cuts. (I used to go to my sister-in law's house and down a half bottle of merlot preparatory to the ordeal but I eventually noticed that she was downing the other half which made me even more nervous- now I go to her salon.) After the haircut I tend to use more make-up (or rather I DO use make-up) in an semi-conscious effort to look less butch. "Mmmmm"said D.O.M. "Only now of course you look like a bloke in drag."

.

         

Is this Sex Ed?

  On Thursdays I pick up the Urban Terrorist(9 y.o.) from after school care early for his football practice. I send him off to the middle school toilets to change into his gear first which means that I can then drive to the footy club and shove him out the car more or less without stopping.(quality time is so important n'est pas?)

   A few weeks ago he came running out of the toilets waving a condom he had found.My (obvious I thought ) question was -had it been used?This generated a discussion which made the playground supervisor purse her lips a little i.e. how much chance would you have of contracting HIV or Hep C from cutaneous contact with the contents of a condom?We were exploring the effects of time and drying when the supervisor took me aside.This had happened before, she told me (thinks-how active exactly are the middle school population around here?) The problem was, she said, not that he had brought it out of the toilets but that he had proceeded to explain to the other children just what it was used for.

  It reminded me of the time when Daughter-of -Mine came to a sex education lecture with us.It was that precious Life Education Group who travel from school to school and offer lectures for parents and children.D.O.M. was 8 at the time.We sat in a darkened lecture theatre while a jolly-hockey -sticks type ran through the introductory patter which went something like "first the mummy and daddy who love each other very much go into their bedroom and kiss and hug and touch each other in a very special way and..."..at which point a bored DOM said in a penetrating voice "why doesn't he just stick it in and get it over with?"The bloke behind leant over and said "now there's a quote to save for the wedding speeches"

Nanny Says

  I was in a particularly foul mood as I went round the hospital the other day. Stern reminders and self righteous exhortations stared up at me from every available flat surface.

  In the toilet I was reminded to wash my hands, invited to dispose of my sharps safely and intimately asked if I had had a smear lately.

  Over the wash basin in the ward I was not just asked to wash my hands- I was shown in a step by step diagram and cheerily threatened with the "glitter squad"(I asked- they use some sort of dye in the soap that shows up on your skin in U.V. light and shames you by showing where you haven't washed).

  Signs everywhere informed me that the staff were entitled to be treated with courtesy,that I must not use a mobile phone because of sensitive equipment (see last post) and that I should not be visiting if I was showing the early stages of everything from SARS to Ebola.

  It was nearly the last straw when, in the tearoom I noticed that the filter pot was standing on a mat giving the accurate standard drinks count in various bottles and glasses."You're a COFFEE MACHINE" I shouted at it "What do you care?"

 But it WAS absolutely the last straw when I walked through the long corridor connecting the clinics to one of the ward blocks .The offices of one of the surgical research units take up one side of the corridor and posted at intervals along the wall (for some reason at knee height)were photocopied A4 pages which read "These walls are paper thin and we can hear every word. We are working very hard so please don't make so much noise."

  Now every time I go down that corridor I aim a kick at each and every notice They are very conveniently placed for this, it gives me good excercise (or did I not mention the signs in every stairwell that exhort me to do this ?) and it makes me feel more cheerful.

No Hat No Play No nsense

I picked up the Urban Terrorist from after school care the other day.It was half past five on a cloudy winter's day- barely a glimmer of light in the sky. U.T. was playing hand ball outside with three other children- all wearing hats .

 

The after school care  has a blanket"guideline"of No Hat No Play

No-one seems to know the difference between a guideline and a rule or policy.

When asked why they blame the National Childcare Accreditation people and the Anti-Cancer Council. This only works until some-one e-mails those and confirms that No Hat No Play is essentially crap .

Attempting to discuss sunlight hours needed for good or ill depending on time of year ,weather patterns ,skin type etc or discussion of vitamin D levels or requirements is useless- "the guidelines say so".

Pointing out  all of the above to the people who look after your obnoxious offspring with patience and good humour day after day is probably not wise.

So why do it?

Because every now and then I make a pathetic attempt to fight the dumbing down of evidence based practice .

Because I hate that guidelines-a summary of the evidence and  advice for best practice - are corrupted into inviolable laws in an obscene game of managerial chinese whispers.

Because I want to see people who are good at their jobs allowed to use their judgement and I want to see people who don't have that judgement exposed.

Because I am a miserable mad old bat who likes ranting.

So why do it?

Resignation Dominoes-the new game from SAHC

On Friday half the salaried Emergency Physicians quit.On Monday  a third of the anaesthetists.Today another group - generating a  great headline in the local paper "Colorectal surgeon says "We've had a gutful".

CME aka my 360 degree self reflecting split personality

I went to the College of Anaesthetists Annual Scientific Meeting last month.They have recently changed MOPS (Maintenance of Professional Standards) program to CME (continuous medical education).O.K. I can live with that. Except that the wankers have really been to town on this one.I used to have to submit evidence that I'd read journals, been to scientific meetings, taught undergraduates and post graduates and been involved in exams, audits, meetings etc. Fair enough although you might wonder how I could avoid all of that with a full time post at a public teaching hospital (now part-time but that's another story).

My problem began with the almost 16 downloads required to explain the new program. Apparently I'm not just an anaesthetist any more. I'm The-Anaesthetist -as -teacher and The-Anaesthetist -as- Scholar and The -Anaesthetist-as -Manager (or something like that -I may have blanked out a bit)--and I must maintain a "reflective diary" in which I perform "360 degree viewing " (which conjures up a frightful picture) in all these areas.

What the hell am I paying these people thousands of dollars a year for?

And YET- my registrars can't find a helpful person on the phone when they have problems with their exams.

 

I Spawned a Fogan

Number 1 Son called me the other day. He's just moved in with his girlfriend (sorry, (shudder) the missus). Having refused his grandfather's offer of free second hand furniture he embarked on a 6 week spending spree . Luckily they are limited by having to cram it all into a space slightly bigger than my loungeroom (known to the estate agents as a studio apartment).

               I interrupted his enthusiastic description of (I think) matching bookshelves and coffee tables with an unfortunate yawn. He then said condescendingly - "you know Mum, people these days like nice things. They don't just live in houses full of random furniture like you do."

               He's 19. He couldn't wait to leave school, get a job, settle down with his girlfriend and devote his evenings to the scintillating joys of DVDs on their mega plasma screen and steak meals at the local pub.

              What's a good term for some-one half way between a bogan and a young fogey?- How about a young Bogey? Or a Young Fogan?