Saturday, 29 December 2007

New Years Resolutions

I'm not usually one to make resolutions, mainly because the probability of me keeping them is equal to that of winning the lottery without buying a ticket.

This year though, for various reasons I'm determined. I'm going to make some resolutions and am determined to keep them (well, at least some of them)

1) No sweets, chocolate, crisps or biscuits (for at least a month). Now before you all fall off your chair screaming "for the love of god....WHY?!?!" Perhaps I should explain. I'm addicted to sweets and chocolate and by addicted I mean in a Heroin sort of way. Before Christmas I was eating 5 or so KitKats before lunchtime. I've tried to cut down in the past but once I've had one I've got to have more, and then more after that, and another for the drive home and maybe another couple from the petrol station, you get the idea. I've done this in the past for lent, but in the last couple of years even that has failed miserably. I'm doing this for a number of reasons a) I don't want to get diabetes, b) I'll save a fairly substantial amount of money, c) because addictions are bad, d) because I need to prove that I can do it, e) my metabolism seems to be slowing down and my trousers are becoming uncomfortably tight (they're still only 32s though), and f) because it links to another couple of my resolutions.

2) Exercise. I can't remember the last time I did any substantial exercise, and by substantial in fact I mean any at all. My resting heart rate is ridiculously high for someone my age, one of my aims for 2008 is to reduce this to less than 75. I am determined to develop at least some element of fitness. How I'm going to go about this I've not yet decided but watch this space.

3) Work. Perhaps the most important resolution for this year considering finals are rapidly approaching. I've never been a particularly motivated person work wise but I'm going to have to work hard to make sure I get through the week of hell successfully. I intend to plan out some sort of revision timetable and stick to it. Bribery is my best motivation and I've already convinced myself of the following equation.

work = passing exams = Dr Little Medic AND games console (yeah baby) , etc etc.

I'm determined not to waste quite as much time as I do at the moment and I will try my hardest to do some relevant work/revision most days. Missbliss has already been very good about helping and motivating me, now if only I could persuade her to bake me more cakes when i've met my targets (cake of course being exempt from resolution number 1, come on, you gotta give me something)fr

4) Keep my car clean and tidy. "pfft, that's an easy one" I hear you cry. Well you'd think so but usually my car is a tip. Missbliss bought me new mats for Christmas and also offered to clean the inside (which was well overdue....., by a couple of years or so) Missbliss is ideal for this sort of thing, in the same way that in Schindler's List, Schindler saves the children for their small fingers to clean the inside of shells, missbliss is small enough to poke around with a Dyson in a fiesta. Before she began I removed several thousand tonnes of old sweet wrappers. (another reason to give up sweets).

5) Enjoy PBL - those of you that read my predictions for 2008, in particular number 1 will realise why this is here. There is absolutely no way on earth I could keep this one, not even for all the cakes in a French Patisserie. I suspeect this will be broken by 3pm on the 3rd Jan. Hey, nobody is perfect, 4 out of 5 wouldn't be bad.

In effect, these resolutions equate to a normal healthy lifestyle. Hopefully they will. I'm confident they will, no, really they will. Honestly. I think. Maybe. Oh shitters.

Thursday, 27 December 2007

Predictions for 2008

I hope you all had a very merry Christmas. 2007 is almost over, and as ever, it has gone remarkably quickly. 2007 was a pretty exciting year for me and missbliss, lets hope 2008 is better than ever. I'm now going to make a few predictions for the months ahead. Maybe in a years time, if I'm still blogging I'll look back and see how I did.

1) I will keep all but one of my new years resolutions. (Coming to a blogpost near you later this week)

2) Facebook will see a significant downturn in use as people get bored of it. I think this has started to happen already, it certainly has for me. Facebook won't just vanish off the face of the web but its growth and use will slow. It may well be bought by Google or Microsoft towards the end of 2008

3) The Americans will bottle the opportunity to elect a female or black President, instead opting for the 'safe' option of a white male.

4) 16GB USB memory sticks will be available under £20 by Christmas (currently you can get 4GB memory sticks for under £20). There will be at least one government scandal involving the loss of said USB memory sticks with personal data on.

5) Despite widespread predictions of a house price crash, on average, house prices will continue to rise throughout most of the UK. The rate will be below previous years at around 3-4%. UK Interest rates will dip slightly before rising again.

6) Either Britney Spears (probably whilst pregnant) or Amy Winehouse will suffer a fatal overdose.

7) Portugal will win Euro 2008, The UK will fail dismally in the 08 Olympics, Lewis Hamilton will win 08 F1 championship. Man Utd will win the premiership but Chelsea will beat them in the final of the Champions League.

8) Petrol will hit 110p a litre.

9) I will purchase either an XBox 360, Playstation 3 or Nintendo Wii. Perhaps in celebration of number 10, celebratory kittens may also be in order.

10) I might, just might,actually become a doctor!

So there you have it guys, that's what I think will happen in 2008 (some of them are perhaps a bit bold). Lets hear your predictions for 2008, either here in comments or in your own prediction posts.

Monday, 24 December 2007

Christmas Eve...

24th December 2007
1 Day to go till Christmas!!!!!!

tlm fact: Christmas rocks my socks!


Twas the night before Christmas, and through the blogsphere
Not a blogger was sirring, not even our Veer.

Many posts had been made with care,
In hopes that readers would be there.

(I'll stop now before I do any more damage.)

Sunday, 23 December 2007

Advent Update

22nd December 2007
3 Days to go till Christmas

tlm fact: The Sunday Times is my favourite newspaper and I always get a bit cranky when I don't get a copy for whatever reason.

23rd December 2007
2 Days to go till Christmas

tlm fact: I am currently addicted to eggs, be they fried, scrambled or whatever. I can't get enough of them.

I failed in my bid to blog everyday - oops. I was just too busy and tired yesterday.

Friday, 21 December 2007

Christmas No. 2

21st December 2007
4 Days to go till Christmas

tlm fact: I was sicked on by a toddler today. It wasn't pretty and was over the only pair of jeans I've got at the moment.

I'm shattered. Today has been a noisy affair to say the least. We visited missbliss's 4 nieces and nephew. The accompanying troop of adults (made up of missbliss, her parents, brother + girlfriend and of course, me) took the tally to 10.

Many presents were opened on what is christmas number 2 for the kids and for us, much screaming took place, and there were plenty of barbies among other things. The youngest, 2, summed it up quite well, jumping on the spot at the sight of presents screaming "Cris...miss" staccato-esque over and over whilst waving his arms around frantically.

We gorged on mountains of food which included 3 joints, 45 Yorkshire Puddings (YEAH BABY!) and lorry loads of roast potatoes. More playing ensued, racing tractors up and down the corridor using our hands as gates. Missbliss was off bathing the youngest, who following that, promptly threw his stomach full of chocolate, matey bubble bath and goodness knows what else over me. missbliss just sat there laughing, and being happy that his jammies remained clean, pfft - just you wait.

We rounded off the day by tucking them into bed with made-up stories, mine being superior as it involved fairies and more audience interaction. Missbliss maintains her brief was more difficult (christmas, mermaids, and sleeping beauty) By this point, I was tired and could have done with being tucked in myself.

Bring on Christmas number 3.

Thursday, 20 December 2007

Jobs Ahoy

20th December 2007
5 Days to go till Christmas

tlm fact: I once spent 22 hours straight playing football manager.

This announcement which appeared on the UKFPO website yesterday was a welcome relief. Apparently all UK medicine graduates are guaranteed a 2 year foundation post. This comes after reports that thousands of non-UK graduates would push the numbers of people applying well above the number of posts available. Apparently there were 7000 applicants for 7200 posts. This will hopefully quash some of the rumours floating around such as there being thousands of applicants for the NW deanery alone.

I always suspected (or perhaps it was just wishful thinking) that things wouldn't be quite as bad as some of the scare mongers had suggested, so I'm very pleased to hear this announcement. Now we all have to sit tight until the 9th of January to find out which deanery we've been posted to. The UKFPO announcement also said that the majority of people would be placed in their first choice deanery which is also quite reassuring. I still don't know how my first choice deanery is going to allocate particular jobs. The NW are using a 2-round process, first, allocating people to trusts before the second round where people are allocated to particular tracks, this is all done using the same preference system and scores by which we are allocated to deaneries. This doesn't sound all that bad so hopefully it'll be something similar wherever I end up. There is a slim chance that interviews might be used but personally I can't see that happening. It is quite likely that I might have to sit down and rank in preference order 200 or so jobs, that would be fun (anything involving Psych being automatically rejected to the bottom.)

Of course all this is dependant on a couple of factors a) that I pass my exams, b) that my application hasn't been swallowed by the computer never to be seen again. Knowing my luck with 'random' allocation i'll end up in the Shetlands, or worse, the North West!

Wednesday, 19 December 2007

"Think About Those We Have Lost"

19th December 2007
6 Days to go till Christmas

tlm fact: I'm not allergic to but I absolutely hate nuts. I do love marzipan though which missbliss thinks is very odd.

Missbliss and I went to a primary school carol service yesterday evening at a local church. It was very short and sweet which is probably for the best. Now i'm not in the least bit religious but something the vicar said really hit me. At the end of the service he was leading a prayer and listed a huge number of people we should pray for including those that we've lost.

The point is it made me think about my nan who died of lung cancer 10 years ago. I've never known either of my granddads as both died before I was born and only one of my grandparents survives today. I shed a couple of tears there in the church thinking about her, although nobody noticed. When I was young I spent quite a lot of time with both my grandmas, mainly during the school holidays when my parents were out at work. It was great fun we used to go on adventures, build trains out of the the furniture, and all sorts of other wonderful activities.

She was in hospital for quite a while before she died and I remember it vividly. I can even remember exactly which beds she was in. I remember going to see her the day before she died and I can remember the morning she died like it was yesterday.

I don't think about her very often but I know I'll never forget her. It makes me sad that she won't ever know about my future but I know that she'd have been very proud of me becoming a doctor. I hope so anyway.

I guess it is important to remember those who we've lost.

Tuesday, 18 December 2007

The End of Days

18th December 2007
7 Days to go till Christmas

tlm fact: My 4 Favourite films are Leon, My Life Without Me, Eternal Sunshine of the Spotless Mind, and Lilya-4-ever.

Not quite the end of the world I know but term is finished for Christmas. Yipee, no more early mornings for a while. Won't be back in hospital now until March. That makes me a sad bunny because it means that i've got 8 weeks of community (GPs) to go back to on the 2nd of January, 2nd of Jan, what the hell is that about. Jeez. Last time I did community it was ok, and I quite enjoyed it but i'm dreading it this time, not least because i've been hearing very very bad things about the practice i'm going to! And for 8 weeks, the only respite will be PBL on a wednesday afternoon - great!

Hopefully i'll be proved wrong but we shall see, watch this space, i'm sure it'll give me plenty to blog about if nothing else.

In the mean time i'm going to enjoy Christmas.

Monday, 17 December 2007

Get Your Personal Data Here...

17th December 2007
8 Days to go till Christmas

tlm fact: I am quite seriously addicted to the interwebnet. Not to worry.

No I've not found one of those lost CDs or been routing through people's bins. If you're English you can't possibly have missed the multitude of stories in the news recently about CDs full of data being lost/mislaid/stolen/left in a taxi. That should be the least of the government's worries.

This morning I went to the Job Centre with missbliss for a 'rapid reclaim' (rapid my arse, she's still not heard anything about getting any money from the claim she made 6 weeks ago!). Needless to say, I wasn't in the mood for any bullshit. It is astounding just how ridiculous this place is. It is a completely open plan office, with desks right next to each other all around a waiting area of sofas. Who needs a disc full of data when, during half an hour of waiting you can pick up enough details about each and every person in there to adopt their identity entirely. It is no wonder identity theft is rife, and was so before these discs started to go missing. Honestly, I'm now completely au fait with Miss Brown who lives at 34 I Can't be Arsed To Get a Job Street, her national insurance number, phone number, qualifications. In fact, almost everything anyone could ever need to know about Miss Brown. Shes not alone, I know all about Mr Black, Mrs Purple and Ms Cream. Confidentiality? Pfft, what a joke, what a complete and utter joke. Any sort of confidentiality is a complete impossibility in that office. So much so that every person in there at the same time as you knows everything about you.

As soon as we sat down I suggested missbliss ask for a private office. A not unreasonable request given the relatively sensitive nature of the things being discussed. Unfortunately, we were informed that there were none, and we couldn't actually go anywhere else because he needed a computer. Yes that is right, there are absolutely NO private facilities available in this place. He even tried to justify it, its supposed to be "warm and welcoming to make us seem easily approachable" fuck that, you're all a bunch of useless wankers, and I would like just a little bit of confidentiality if you don't mind! I was not amused. His best offer was to whisper, although that, coupled with his annoying, impossible to understand voice meant we could barely hear him.

After sitting there for about half an hour, making absolutely no progress. Missbliss started to get slightly upset (understandable given the fuck-ups and uselessness of what is going on.) So, we sat there, in the middle of this "friendly" open plan office and missbliss began to cry. Not only was there no privacy from the freaks in the office but the useless man didn't even offer her a tissue. He did however suggest that we break up to improve missbliss's claim and even almost began to suggest that we should lie on the form. He was very careful with his words though, which unfortunately meant I couldn't jump on him for being a knob.

So after about an hour of him suggesting completely useless things and not actually making any progress at all we decided to call it a day. I had said very little throughout the consultation but couldn't resist a closing quip about the incompetence of every single person we've come across associated with missbliss's claim. It isn't as if I was even trying to be mean, they are all useless.

I'm going to write a very strongly worded letter to as many people as possible about just how inappropriate that place is confidentiality and privacy wise.

Sunday, 16 December 2007

Advent Update

16th December 2007
9 Days to go till Christmas

tlm fact: I have strange thumbs which have made many a person wince in the past.

Saturday, 15 December 2007

Father Christmas

15th December 2007
11 Days to go till Christmas

tlm fact: I don't drink hot drinks. Yep, that means no coffee for me. I very occasionally have a cup of tea but not because I enjoy it. I much prefer juice or water.

Today's advent picture is hugely important. For those of you that don't know it is the front cover of a book called Father Christmas by Raymond Briggs. Christmas is just not properly Christmas without it. I used to love it when I was little and a year ago I was reunited with its amazing Christmasyness.

10 days to go! EEEEK!

Friday, 14 December 2007


14th December 2007
11 Days to go till Christmas

tlm fact: I currently look rather like a yeti, i've not had my hair cut since before we went to Solomon Islands, it is as long as it has ever been now. Desperately in need of a trim.

Today was my last day on gastro medicine, i've really enjoyed my time there and actually felt, for the first time, that I can do this doctoring business. I got a good evaluation too which was a nice way to finish off.

There was a sad part to today though, there is an elderly man on the ward at the moment, he's 84, it was his birthday today. He came in with a very mild MI, but has a multitude of co-morbidity. He is almost immobile, he is virtually completely deaf and blind, can just about whisper the occasional sentence and has serious trouble swallowing. He looks even older than he is but he's a really nice old man, even in his state he has a sense of humour.

Today the consultant did his ward round and after trying to explain to the old man what the plan was (by shouting in his ear), he muttered "why, don't you just shoot me", I suspect this was partly a joke but partly a plee to be left alone to die. It actually made me quite sad, this poor old man, who has a lovely old wife who does her best to look after him, is virtually bed-ridden, deaf and almost blind and dumb - what sort of life is that. Later that day it was reported that he couldn't swallow at all, and it was suggested he should have an NG tube passed so he can be fed. The consultant saw sense in my opinion by suggesting this might not be the best idea. In the end, the old man had said that he didn't want it. He will die, its just a matter of when, I hope he gets some enjoyment out of his last few hours/days/weeks. Bless him.

I guess it made me realise how vulnerable and fragile human life is, I don't ever want to get old :(

Thursday, 13 December 2007

The United States of Europe

13th December 2007
12 Days to go till Christmas

tlm fact: I'm currently addicted (quite seriously) to KitKats

I hate Europe, the EU and any concept of the United States of Europe. There are a number of reasons for this and things just keep on getting worse.

First of all, the EUWTD (European Union Working Time Directive), what a fucking waste of space that is. It is all just lovely that people are not supposed to work more than 48 hours a week. In reality its just stupid, doctors for instance, who used to work 100+ hour weeks as of 2009 won't be 'allowed' to work more than 48 hours. Of course doctors will still work more than 48 hours, they'll have to, it just means they won't get flipping paid for it! Not only does this mean that we'll get paid less than junior doctors in previous years, but we'll also be hugely restricted in terms of the amount of experience we get. Most doctors will tell you that the most valuable experience they gained as a junior was doing nights on-call etc etc, but there will be very little of that in future. Instead you might, if you're lucky, be treated by a night nurse-practitioner, whoop-de-fucking-do! So when you're in hospital in a few years time, just bear in mind that the juniors looking after you have perhaps half, or even a third of the experience that the juniors of old had. I certainly wouldn't want to be a patient in that situation. So anyway, the EU, with all their good ideas can go screw, in reality, these things just are not going to work!

Next we have the EU rules which state that all applicants whether they're from England or Poland should have exactly the same rights when it comes to job applications. Now I'm not going to sit here and say that UK grads deserve preference for UK jobs, but if because of this 'freedom' within Europe, any graduates from UK medical schools are left without F1 posts (which isn't unlikely since it has already been announced that there are too many applicants for too few posts) then something is seriously wrong. It costs £250,000 to train us medical students not to mention the fact that we're £20, £30, £40,000 in debt. We should all (or at least those who are competent) be entitled to a job at the end of our 5/6 year slog. But no, that's not the way it is. The EU gets to stick its oar in and control everything.

You can barely walk around a town centre these days without passing a 'Polski Sklep', there has been a huge influx of Polish people since they joined the EU and were able to come here to work. And whilst I'm all for multi-culture I'd hate to think that these EU residents were being given preference for anything over British residents.

Today, Gordon Brown is going to sign even more of our power over to the EU, I really hoped that he'd have the balls to take a step back from Europe when he took over as PM but sadly it seems that I was wrong. It won't be long before we join the Euro, don't even get me started on that! If we join the Euro, I'm off to Australia (or at least I would, but I don't think missbliss would go for it), fuck the United States of Europe.

Two serious posts in a week, I don't know what has gotten into me.

Wednesday, 12 December 2007

I'm tired.

12th December 2007
13 Days to go till Christmas

tlm fact: 2 months after we met, I took missbliss to Paris for her birthday. Well I've got to do something to pay back her cake making.

Oh so very tired, today has been a long day. More blogging tomorrow. Time for bed.

Tuesday, 11 December 2007

One Laptop Per Child (OLPC)

11th December 2007
14 Days to go till Christmas

tlm fact: So far in my life I've broken 9 bones although I've not broken anything for many years now so I must be less careless nowadays.

Today I'm going to talk about the One Laptop Per Child (OLPC) project. You might have heard a bit about this in the news but in case you've got no idea what its about I'll give you a quick brief. The idea is to give children in the developing world a $100 laptop each. Whatever you think about the idea, its certainly ambitious. The vision is to connect the developing world and therefore stop it being left behind as technology in the developed world surges ahead. In principal, I think it is hard to argue against the idea however there are plenty of arguments to be made against it, for example that money would be better spent on providing basic teaching facilities.

The OLPC project has advanced slowly and is currently in the late testing/production phase. The $100 laptop is currently the $188 laptop which is about £93. Testing has seen varying success in places like Nigeria. One thing is for sure, the children love the idea, but hey, who wouldn't? In one Nigerian school, given 300 to test, after only a few months 40 had been broken, lost or stolen.

Orders have been slow as politics and price have prevented many countries from gambling on this venture but orders have been received in the hundreds of thousands, as more orders come the price will go down and the laptop will become more available.

It is all very well giving children in the developing world laptops but it could be said that this money should be spent on providing basic education rather than throwing technology at people who are lucky if they can read. This is only one of the potential pitfalls of the project, laptops being lost, broken or stolen would be a significant problem and there would have to be some way of managing this. If you lost your laptop would it be replaced? If not, would you ultimately lose out on your education because you didn't have one? Each area would require technical support and help in these situations. Interestingly, in some test areas it is the children themselves who become the technical support by setting up workshops to fix broken laptops. To me this is part of the genius of the project and why I think it is a wonderful idea.

I remember when I first was given computer, I was absolutely fascinated. So much so that I had it in bits to see if I could work out how it worked. This was way before the Internet became popular and virtually every house had a computer. By the time I got access to the Internet I was 11, I'd just started high school and was amazed by the wonders of the Internet and email (I still have my hotmail address from then). Since then I've grown up with computers and the Internet around me, so much so that I can't imagine a world without the Internet (as lame as that sounds) and it is the connectivity that I missed most of all in the Solomon Islands. Without the Internet my life would have been SO much different, for starters, organising my elective in the SI would have been virtually impossible.

So where does this leave the developing world. Well, the reason I think the OLPC vision is so important is because I believe it will unlock a whole world of potential. We are talking here about children who might have never seen a computer before, let alone heard of the Internet. Much of the OLPC vision is focused on providing education through the laptops which is undoubtedly important, but to me, it is the potential for use at home (as the laptops are owned by the students they can take them home) which could really be the exciting part of the project. For example, the children who in the short periods of testing have learnt enough to provide support to others with broken machines. These children have the prospect of a better future ahead of them complete with technological skills. These children will pick up the how to use the laptops very quickly, and who knows, maybe the next Bill Gates is currently in school in Nigeria waiting for his OLPC to delivered so he can change the world of computing for ever. Connecting these children to the Internet gives them access to virtually anything (which is of course good and bad), educationally there can be no better resource than the Internet. At the same time, it is also open to abuse, I don't think it would take long for the laptops to become riddled with porn, violence, viruses and goodness knows what else, but strict control might be able to control this to some extent. Are the pitfalls of the Internet really a good enough reason to prevent half of the world having access to it? I certainly don't think so.

Interestingly we met a young man in the Solomon Islands who was there introducing the concept to the SI government. SI are currently testing the OLPC computers and it is countries like the SI who have the most to gain from the project in my opinion. Having experienced the SI culture, I don't know how it would be received there or what would happen if every child in Lata was given an OLPC laptop. I can only imagine how I would feel in that situation, being introduced to a whole world that I didn't even know existed. I think the children there would have a lot to gain from such a project but what they'd lose in return I'm not sure. Perhaps missbliss, having taught in the SI would be better placed to comment on this than me.

There is one exciting part of the project which perhaps solves one of the problems, (the fact that the money should be spent elsewhere). A scheme in the USA called Give 1, Get 1 (G1G1) allows Americans to buy their own OLPC at twice the normal price (which still isn't a bad deal) with another machine being provided to a child in the developing world. This pilot scheme could be the key to introducing the OLPC cheaply and fairly without compromising other educational resources. I know I'd certainly join in such a scheme if it came to the UK (and I had any spare money). I really like this idea and it seems the Americans did too as quite a number were sold under the scheme. If it were my scheme, I'd have some way of linking the machines, perhaps a unique email address for each machine which would allow the beneficiaries of the scheme to say thank you to the person who paid for the machine under the G1G1 scheme. I think this would add another dimension to the project, although again it would be open to abuse although I don't think many paedophiles would travel all the way to Nigeria to indulge their fantasies but lets not even go there!

Sure there are problems, for starters the money really ought to be spent on providing a basic education first before giving each and every student their very own laptop. There is potential for abuse, and what happens if one student loses, breaks or has their laptop broken, will their education suffer or will it just breed a generation of spoilt, jealous, technologically able evil people? Who knows, only time will tell but in my opinion, the OLPC vision is a fantastic one and one which should be pursued in one shape or another.

Monday, 10 December 2007

Communication of the feline variety

Thanks to MrsHappyAnna over at The Happy Couple for these great videos. (Missbliss spotted it)

Watch this first:

Now watch the translation:

Tales of an Island Adventure (part 1)

10th December 2007
15 Days to go till Christmas

tlm fact: I once ate 5000 calories of flapjack in one sitting. Needless to say, I didn't feel particularly well afterwards but it was worth it!

In an effort to re-live some of our time in the Solomon Islands, this is the first part of a series of short (true) stories about our summer adventures. Some of the stories will be things we did ourselves but others will be tales told to us by the Dr Gunter Kittel, the doctor in Lata.

First of all, let me fill you in on some facts; in recent years there has been some 'ethnic tension' in the Solomon Islands, the majority of this tension happened in Honiara, the capital. As a result of this, a group of South Pacific countries formed a coalition called RAMSI (Regional Assistance Mission to Solomon Islands) to offer help to the Solomon Islands. RAMSI have a significant presence in Honiara and on the other islands for quite a while.

The RAMSI police have an outpost in Lata on Santa Cruz island, the island we were on. Feelings seem rather mixed towards the RAMSI group, and RAMSI don't exactly do a lot to integrate themselves into SI society. For example, the outpost on Lata receives its own weekly flight (bear in mind that there are only 2 at best, Solomon Airlines flights per week), on this flight is a supply of food; beef, chicken, apples, oranges, pasta, cheese etc etc. This food is stored in the huge chest freezers in the RAMSI compound. The RAMSI police are told not to buy or eat any local food because it might be dangerous (it didn't do us any harm), they are told not to go into the local police station because it has asbestos in it. (How the RAMSI police are supposed to work with the local police without using the same building I don't know). They are told not to socialise with the locals and especially not the women. I'm sure you get the idea by now.

Dr Kittel doesn't have the best relationship with the RAMSI police, there are a number of reasons for this and we spent many a night listening to Dr Kittel recount stories of his relationship with RAMSI.

One day, a young man presented to the hospital with a laceration to his hand. It was a serious injury caused by a machete. His fingers were literally hanging off his hand, the muscles and tendons having been severed. Dr Kittel doesn't have the equipment at Lata to deal with such an injury therefore the patient had to be referred to the main hospital in Honaira. The patient would have to wait for the next cargo ship, which could feasibly be weeks, by which time he would have lost his hand - maybe even worse. It just so happened that shortly after the patient presented the weekly RAMSI plane, which is empty but for a supply of food and pilot, was heard landing down at the airstrip. Dr Kittel cycled down to ask the RAMSI people to take the patient back to Honiara where he'd be able to receive the treatment he needed. The RAMSI people on the island refused and told Dr Kittel that he should go and contact the main RAMSI base by radio. He persuaded the plane to wait until he'd been back up to contact the main RAMSI base but as he cycled back up to the hospital the plane took off again.

Apparently, RAMSI are not supposed to help out Dr Kittel by transferring patients unless there is a life-threatening situation. This young man might not have been immediately dying but if he lost his hand he wouldn't be able to do much to support his family.

To me its absolutely ridiculous that this empty RAMSI place couldn't be used to take this patient to Honiara which potentially would have saved his hand. It is no wonder that the relationship between RAMSI and the local is quite difficult. It must be said though that after contacting the main RAMSI police, Dr Kittel did get a RAMSI funded plane to fly out a few days later to transfer the patient. What a waste of time, money, resources.

Sunday, 9 December 2007

Blogging Issues

9th December 2007
16 Days to go till Christmas

tlm fact: I have ridiculously bad eyesight. I'm shortsighted to the extent that without glasses I'm pretty much legally blind. I once tried contact lenses and it took me 2 and a half hours to get the damn things out of my eyes, I've avoided them like the plague since. Instead I wear glasses which cost ridiculous amounts whenever I get new ones as I have to get the 'thin' lenses so I don't look like I'm wearing milk bottles. Eyes are the only thing that I'm queasy about so opthalmology is definitely a specialty to avoid.

I'm finding blogging quite difficult at the moment. It isn't because I've not got much to say, on the contrary, I've got lots to say, I just don't know how comfortable I feel about saying it. I'm not sure why, it might be because people I know read, but I've always known that so why should things change. It always makes me think twice about some of the things I say and some of the topics I blog about. I don't feel I can be as open as I want to be which makes blogging slightly less worthwhile.

I could use the real little medic to get some of these things off my chest in a more secure environment but I'd like the things I've got to say to be open to a wider audience than those at the real little medic so that doesn't really work for me.

I've also found it quite difficult to write about things recently. I tend to just confuse myself when I'm writing and end up not really explaining things how I want to explain them.

I'll keep on going and hopefully work my way through this strange period. I'd like to think that I won't really care and will be able to write free of constraint as I have done in the past, only time will tell if that is the case or not.

Saturday, 8 December 2007

What a difference 5 minutes makes!

8th December 2007
17 Days to go till Christmas

tlm fact: I once won a spaghetti eating contest in the middle of ASDA, I was fairly young at the time and felt rather ill afterwards. Disappointingly the prize was prize was rubbish; a bag of sweets if I remember correctly.

I had a bit of writer's block for this evening's blog post (it is hard work having enough to blog about each day so apologies if you're getting bored of me scraping the barrel occasionally).

missbliss and I decided that tonight should be take-away night but unfortunately we had no cash (I don't think the take-away man would appreciate being paid in 2p coins), this meant that I had to go out to the cash machine which is a short drive away.

My 5 minute journey infuriated me, the roads full of useless fuckwits today. On the way to the cash machine I had to turn right at a traffic-lighted crossroads, these always piss me off because you have to wait till the lights go yellow so you can go across the lane of traffic. It REALLY fucks me off when people go through yellow/red lights so you can't cross the line of traffic before the other road starts moving. I've not explained this very well but i'm sure people who drive will know what i'm talking about. Anyway, tonight someone came through the lights leaving me stuck in the middle of the junction. For a change there was some justice, I laughed my head off when the traffic light camera flashed at him (at least I hope it flashed him and not me stuck in the middle of the junction - after all it was him that went through the red light) I hope he gets a big fat fine. I therefore propose that all junctions have traffic light cameras installed to catch these cheeky bastards!

Then on the way home I encountered two fools who insisted on blocking where I wanted to go. One car just stopped right in the middle of the road I wanted to turn down, she was obviously lost but seriously, can't you stop just 10 metres further on so people can actually get past you. Only 30 seconds later did someone else do exactly the same thing. Why? Get the fuck out of my way you useless fools!

Anyway, thats enough of that, time for curry, beer and x-factor.

Friday, 7 December 2007

Things i've been pondering this week...

7th December 2007
18 Days to go till Christmas

tlm fact: Despite my blogging name; The Little Medic, i'm not actually that little. I'm actually almost exactly 6ft tall.

1) Do swans have arguments? Swans pair for life, and there are a couple on the pond at my hospital. I've spent many an hour this week wondering if they argue with each other in their swanny ways. (This is mainly because they've spent most of the week at opposite ends of the pond which is unusual.)

2) I've become obsessed with the time it takes for my journey to hospital. It is just over 40 miles and I usually set off at 7:00am or so (8:11am by my car's clock which i've yet to put back an hour for daylight saving time and which is always fast anyway - i'm never late for anything!) Its virtually all motorway and i've been obsessed with doing the journey in 45 minutes. I managed it this week but now I'm determined to squeeze a few extra seconds to the extent that I'm even obsessed with the traffic lights and trying to get a clean run through them. I know..... i'm strange

3) I went to the doctors this week with missbliss and unknowingly had my stethoscope in my pocket. About half way through the consultation she noticed it and asked if we were both medics. I found the whole consultation quite hilarious, felt slightly patronising but only because the GP was trying to explain things in the very simplest of terms.

4) Thank god its Friday.

Just 1 more week of gastro before Christmas and on Friday I have to make a presentation on diarrhoea, joy. I'm still really enjoying the placement although the house officer isn't quite as good. I am absolutely dreading after Christmas, 8 weeks of community, I've been hearing exceptionally bad things about my GP too which isn't reassuring. I'm not a fan of GPs at the best of times but for 8 solid weeks? I did try and change my placement to one closer to home as when I gave my preferences I picked place X because I thought we'd be living there. Of course this changed when I decided i'd rather walk barefoot over a bed of nails whilst being showered with lava than live in place X. As usual the medical school were exceedingly understanding and helpful in that they said no. It was my own stupid mistake in the first place but I should have known my medical school well enough not to even bother trying.

Thursday, 6 December 2007

One Year On

6th December 2007
19 Days to go till Christmas

tlm fact: I am related to Gordon Brown and have had tea and biscuits in 10 Downing Street.

One year ago today I was sat in a GP surgery working on a project, by working I of course mean surfing the Internet. I came across The Angry Medic and from there, I found a plethora of blogs from medical students, doctors and other health professionals. Despite my addiction to the Internet, I'd never previously discovered this phenomenon. I spent hours reading about the experience's of others and that day I decided that perhaps I should have a blog of my own.

(I tried to use this as an excuse to get missbliss to bake me another cake, unfortunately she was having none of it - although she did make a very tasty trifle)

From there I came up with I'm a Medical Student, Get Me Out of Here and wrote my first post. I really didn't expect anyone to read my moans and groans and was very pleasantly surprised to find that I soon built up a small following. I'm not the most articulate of people, especially when it comes to explaining my ideas in writing, I often forget things and I'm sure my vocabulary, spelling and grammar often leave a lot to be desired. Never-the-less, here I am one year on, I'd started blogs before but only written 1 or 2 posts before getting bored and giving up but I was determined to stick with it and I've succeeded so far.

I've enjoyed blogging, its a very helpful release, I enjoy getting some of my moans off my chest here (although I still moan a lot in person too). There have been some great times in the last year, and some really shit times but overall I think blogging has been a positive experience for me. It isn't exactly a portfolio but blogging has also had its uses, it is a way of reflecting on some of the experiences I've had in the past year. This came in useful when I had to write my foundation application form. The writing experience has also done me the world of good as I've improved my writing style and learnt things too.

I'd like to say a huge thank-you to all those who've read my blog and those who've left comments. There would be much less enthusiasm for blogging if I knew that nobody was reading.

I hope I'll be able to continue blogging over the next year. There will be PLENTY of challenges and lots of things to moan about over the next year so stay tuned. There will also probably be a sparkly new blog to come if I pass finals and finally become a doctor.

Oh, and you should all read this post by missbliss, the pictures are hilarious!

Wednesday, 5 December 2007

The second first day

5th December 2007
20 Days to go till Christmas

tlm fact: It is my lifetime ambition to own a brand spanking new red Ferrari bought from the showroom, in cash. Hopefully before I'm 45. I daresay missbliss might have something to say about this.

A confusing title indeed, today is the day that all the F1s (junior doctors) in my hospital (and probably most other hospitals) rotated to their new 4 month posts. I suppose it must be better now they've got 4 months experience but it must still be quite stressful, especially going from surgery to medicine for example. I missed that day in August when you should never under any circumstances go near a hospital because the wards are full of junior doctors on their first day but personally i'd give hospital a miss today too if you possibly could as it was somewhat chaotic and it rather scared the shit out of me thinking that i'll be in this position in 8 months!

What scares me the most is the ridiculously little amount of support the F1s on my ward received from their seniors today. My new F1, who is a pleasant chap who has just come from 4 months A+E, I helped him out quite a lot today by doing jobs, hopefully I'll be able to help him settle in a bit as I've been on the ward for a couple of weeks and know how things work. The SHO, who was supposed to be there at 9 ended up walking in at about 9 45 and neither the consultant or registrar were anywhere to be seen. Now I know its unrealistic to think the whole team would be there to greet you on your first day, but it'd be nice if someone was there to explain what the fuck you're supposed to do.

The other F1 who started on my ward today had even less success, nobody from his team turned up so he just took off and did the ward round on his own without having the foggiest idea what the hell was going on.

This situation can't be good for patient care, I know for a fact that things were missed today because of it and patients treatment has been put back by at least a few days until everyone is back up to speed.

Note to self - must make sure when I'm an F1 that I've got a reasonable idea of what I'm supposed to be doing whenever I change jobs. I'm hoping that I'll at least have some support wherever I end up, but I suppose I shouldn't expect there to be much in the way of help.

Tuesday, 4 December 2007

The Adrenaline Rush

4th December 2007
21 Days to go till Christmas

tlm fact: All through primary school, I was obsessed with becoming a policeman. So much so that I used to wear my little uniform whenever possible and whenever I wrote my name on my school work, I always wrote: PC Little Medic so I could pretend to be a policeman. Fortunately I did grow out of this and spent many years after that wanting to be a vet. I changed my mind only a year or so before applying to medical school. I've not yet taken to writing Dr Little Medic on my work so I can pretend to be a doctor.

Yesterday, I went to see some endoscopies, expecting a nice relaxing morning. Fortunately for the patients, everyone was normal. That was until there was an addition onto the list, an elderly (70+) lady who'd recently had a GI bleed. She had already been scoped but they couldn't find where the bleeding had been coming from. Her haemoglobin was already ridiculously low (i'd never heard of a Hb so low). They scoped her again and found where the bleeding must have come from and made an attempt to stop any future bleeding. Unfortunately, right there in front of our eyes (well, on camera), an artery started spurting blood inside her stomach. From this point, my heart started pounding in what must have been an adrenaline rush. By now the endoscopist couldn't see a thing because there was blood everywhere so he couldn't do anything about it. He called down the best endoscopist in the hospital to see if he could do anything and he also called the surgeon on call to take the patient to theatre if nothing could be done. Before I knew it, the room was crammed with people. Endoscopists trying to stop the bleeding, the surgeon on call and an anaesthetist assessing him for theatre. Various other doctors were running around like crazy putting cannulas in and taking blood for cross matching. Blood and fluids were being put up by the bucket load. Meanwhile I was in the middle trying to hold the patient down as she fought to remove the endoscope despite being sedated.

They couldn't do anything endoscopically, so they took her down to theatre to open her up and try to stop the bleeding. Unfortunately thats where I had to leave, so I don't know what happened. I guess I'll find out today. I hope she is ok.

I feel bad that I was sort-of excited by the emergency response to her rapid deterioration. I suppose it must have been the rush of adrenaline as people were running around me trying to do their best for the patient. The whole team were fantastically calm despite what I thought was quite a serious situation. I think it was dealt with really well and maybe the adrenaline rush that each member of the team must get helps them to do what they need to do efficiently.

Monday, 3 December 2007

Advent Calender Update

3rd December 2007
22 Days to go till Christmas

tlm fact: I have a severe phobia of earwigs. The evil monsters scare the living daylights out of me! That is my only phobia.

Sunday, 2 December 2007

Things that rock about Christmas

2nd December 2007
23 Days to go till Christmas

tlm fact: 2 weeks before starting university in 2003, I almost wrote off my brand new car. Since then I've driven 75,000 miles which is the same as driving round the world 3 times! During this time I've spent about
£9,000 on petrol and £6,500+ on car insurance. Despite that, I still enjoy driving and I've spent most of the 3000 or so hours i've been behind the wheel day dreaming (not the best idea whilst behind the wheel I admit), all sorts of things go through my head when I'm driving including lots of blog ideas, unfortunately I tend to forget them when I get out.

1) Christmas cake - quite possibly the best cake ever. Especially when there are huge amounts of icing and marzipan all over it.

2) Clementines/Satsumas - best fruit ever. They are always on offer in ASDA or Salisbury's and we buy them by the crate load. I don't even know if they're particularly christmassy but its a good enough excuse for me to binge on them.

3) Mince pies - oh my god, why don't they sell mince pies all year round. In previous years I have pretty much lived on mince pies from late November to January. Missbliss has tried to put a stop to that but I can often be seen munching on them. The thin ones from Salisbury's are my current favourite.

4) Presents - well it wouldn't be Christmas without them would it? It is always an excuse to buy presents for yourself too!

5) The Christmas cheer - it usually starts on the first of December, people can be heard humming Christmas songs to themselves, and most people just seem to be happier than usual. We went to a Christmas market last week and EVERYONE was smiling and generally being happy.

6) Christmas markets - mulled wine, dutch pancakes, mince pies, and hog roast, oh my god hog roast! *drools*

Leave a comment and tell me what you like about Christmas (if you don't like Christmas then go and watch the "Holidays are coming" advert until you've changed your mind!

Saturday, 1 December 2007

"The Holidays are Coming"

1st December 2007
24 Days to go till Christmas

TLM Fact: On Christmas eve 1997 I was running down
the stairs and I tripped and fell, I spent the evening limping
around in pain. My mum and I spent Christmas morning in A+E
and later that morning, I came home in plaster having broken my foot.
What a way to round off the worst year of my life during which my parents broke up,
I had to move house, and my nan died.
(I promise not all the TLM facts will be as miserable as this one)

Its true, its the 1st of December and Christmas officially starts now. (I'm not even going to say how long our Christmas tree has been up!) I've already seen the Coca Cola Christmas ad on TV once or twice which made me ridiculously excited so I thought I'd share it with you all. Whether you've never seen it at all, or just not seen it yet this year, watch it. I promise it will stir up the Christmas feeling inside you. (If it doesn't you must be some kind of anti-Christmas monster)

December also marks my 1 year blogiversary and to celebrate this momentous feat, (I never expected to still be blogging regularly a year later, nor that I would ever get any readers) I'm going to try my hardest to write at least a short post every day during December. Will I manage it? Probably not, but we'll see. Also, in the spirit of Christmas, I will also be running my very own advent calender with a new Christmas picture each day, and rather than a chocolaty treat to go with it, there will be a TLM fact of the day (which will probably be exceedingly boring but we'll see how it goes)