This is no Teddy Bear's Picnic

My apologies for the severe lack of posts. I'm sure this one will do two things: that is, make up for it, and explain the blog silence:


Please sing this in the style of the Teddy Bear's Picnic song:

If you start work in the trauma unit,
You're in for a big suprise,
If you start work in the trauma unit,
You'd better be in a doctor's disguise!

For every doctor that ever there was,
Is frightened of that moment that comes,
When you have to do something that you've never done befo-oore!


Last Friday...oh no no no...wait! Let me first set the scene...

It was a gloomy grey Friday afternoon, and a lonely young lady doctor was the only medical service available to a very large, poor, sick community...

This was the first time ever since I qualified three years ago that I have been the only doctor at an institution. Everybody pisses off early on a Friday and the poor schmuck left in trauma has to be the heroine/villain until 5pm when the night staff arrive.


The trauma unit was pretty busy, and in the midst of the mad mayhem, the undertaker arrived with the request that I certify a patient that had died at home.

On my way out to the undertaker's death van, I am immediately accosted by a frantic nurse from the Midwife Obstetrics Unit. (MOU)


The MOU is a unit providing basic obstetric care for mums who have uncomplicated pregnancies. They have their antenatal care visits there and give birth there. There are no doctor's involved, it is run entirely by midwives. Although the MOU is on the premises, I avoid it at all costs as screaming mothers in labour, amniotic fluid, placentas and the like are really not my cup of tea.


I see the nurse gesticulating wildly and hear those dreaded words: "Come now! Emergency!". She disappears back into the unit.


My brain goes into paroxysmal neuronal short circuitry as it computes that, oh shit, I'm probably going to have to deal with one of two things. A dying mom, or dying baby.

Please let it be the mom,please let it be mom, please be mom, please be mom...the last time I dealt with dying babies was two years ago...

Nobody hears my plea.

As I burst through the MOU swing-doors, I'm confronted with a just-delivered, 5 minute old neonate. The baby is blue, gasping for air and barely moving.

The Mother looks at me with desperation in her eyes.

The Midwives visibly relax as I arrive, "safe" in the knowledge that "the doctor" is here and therefore everything will be ok.

The Doctor ( that's me) is silently freaking out as I have NEVER resuscitated a neonate before in my life. Oh in theory yes, I've been taught how, but have never actually had to do it.

"Today's the day sweety" , the evil bitch spinning my fated threads cackles, "let's see how you handle this!"


I. Am. it. there's no-one else to call. Weeks of pregnancy,a long difficult delivery and the parent's dream of a family are all riding on my next move.


I ask for the laryngoscope and intubation tube to pass through the baby's throat into it's trachea to help it breath. The nurse hands me the miniscule instruments and I try...

It's difficult, I'm working in a tiny space about 6 cm in diameter and the vocal chords are hard to see. Three, four five times I tried and eventually I got the tube in. At that moment the baby started making more of a respiratory effort and so naturally expelled the tube I'd tried so hard to insert. Dammit!


Should I try again? I check the baby's oxygen saturation and it is miraculously rising up from 50% to 70%.
Baby is no longer blue and is turning a nice shade of healthy pink. What is happening here? Did merely fiddling with the kid's breathing apparatus by trying to intubate stimulate it's respiratory drive? Shit I don't know.

I decided to apply nasal prong oxygen instead of trying to intubate again. O2 Sats picked up to 93%. By this time baby was pink, crying and although breathing quite laboured, was making better respiratory efforts.

Everyone looked at me like I was a genius. I felt like the village idiot. I wasn't exactly sure what I had done to improve this kid's situation, but whatever it was it worked.

Baby was stable so we called the ambulance and referred the child on to a specialised neonatal unit for further care.

I had been away from the trauma unit for an hour stabilising that baby. I wearily made my way back, but was hardly in the door when the patients start accosting me.

"Doctor! I've been waiting to see you since this morning!"
"Where were you, were you taking lunch while we were just sitting here being sick?"
"I'm so sick of this damn hospital, the service is terrible."



I take a deep, deep, deep breath, and look at the clock. Fifteen minutes left of my shift. I am hoping to collapse into my chair, but there is a lady patient sitting in it.

I look at Sister Em with confusion. She just shrugs her shoulders and says the lady is refusing to move. I ask her how I can help her. She says that she has been waiting for 11 hours to be seen.

I look at her folder and according to the triage notes she has a very minor condition that will not get seen before all the serious ones, which is why she was still waiting. I explain this to her, but she just looks at me and bursts into tears.

I exhale that deep deep breath and decide to break all the rules. Someone has to give this chick a break. I quickly diagnose her with the flu. I give her the box of panados from our limited stock that we'd go and buy at the chemist, but that she'd been waiting all day to get.


By now it's Five pm, but I'm too tired to be excited. I just pack my bags and get the fuck out of there.

Driving out I see that lady waiting in the rain... soaked, exhausted, and disappointed by our "health system". She is fumbling in her bag for a few coins and is making a forlorn phonecall.To whom, I don't know....maybe somebody who cares about her. Despite the almost dead babies, and general trauma, somehow this scene is the most tragic thing I've ever witnessed.

I can't be brave anymore. The enormity of this community's plight is suddenly and inexplicably triggered. The floodgates of despair open and I sob like a bereaved widow all the way home.

humans versus computers

Once when I was a medstudent, I worked at an overwhelmingly busy trauma unit. Of the ten patients I admitted there one night, 8 of them didn't make it to the next morning.

I was slightly depressed by this. So gave the husband ( who was then just the boyfriend)a call for some sympathy.


"Eight of my patients died last night" I moaned.

"That's so very sad," he said, "I know how you feel,my computer died today."


Um...ja...it's not quite the same, baby. Last time I checked one can't exactly reboot a human.

Argh!

There was nothing wrong with today. A pretty average day in the trauma unit. I mean, to be honest, all things considered, it was a pretty damn GOOD day. These are today's reasons to be grateful in trauma:

1: Nobody died.

2: We had clean linen on the examination beds.

3: There was...wait for it...pink liquid soap IN the soap dispenser!

4: AND you'll never believe it, actual paper towel for me to dry my hands with!

I am not making this shit up! It really happened.



And yet, I am as cranky as my tik-addicted patients on a Sunday morning come down.


Why?


I have no patience with the patients today.

They are all irritating me endlessly. Why ? Why? Why!!!!!

Why are you calling me "sister"? I'm the fucking doctor. Perhaps you didn't notice my white coat, stethoscope and badge that says DOCTOR. Yes, I have tits and a vagina. These types of people can also be doctors.

Why do you insist on calling me "sweetheart" and touching me inappropriately you toothless-possibly-impotent-lecherous old fart? Do I look like your girlfriend? OR do I look like a professional with 8 years of medicine behind her. I will stab you in the eye with my pen and then shove the biggest catheter I can find up your urethra and then you'll know not to flirt with a pissed off lady DOCTOR.

Why do I have to explain things five times and in three languages before you understand that you take TWO panados FOUR times a day and not FOUR panados TWO times a day.

Why is everyone on tik?

Why are you speaking to me WHILE I am busy examining a patient. Do NOT interrupt my consultation!

Why do you, Mr Diabetic, suffer for four weeks with a festering pus filled sore before you come to see me? Now I have to be the bad guy and tell you we might need to amputate.

Why are you asking me for sick notes when it says on your folder that you are unemployed? NO! I am not putting you off for three weeks just because you have an STD. STOP fucking around without condoms.

Why didn't you notice that your child had gastro so that I don't have to bring your kid back from the brink of a dehydrated death, AGAIN.

Why, you stupid woman, didn't you know that you were pregnant. Are you mentally deficient? Sex+no contraception+no period = BABY. Get it?

Why hasn't the damn doctor that has seen you every 6 months for the last ten years noticed that you have HEART FAILURE. His fuck up is now my problem. I HATE you you idiot doctor. When I find you, I will stab you in the throat for your sins.

Why is your husband beating you with an iron rod? Your arm is broken. Oh, I see that you've been here before with a broken pelvis...same story. LEAVE HIM - don't you see you're worth more than this shit.

Stop looking at me with such trusting hope in your eyes. I'm not God. I'm not an angel. I'm not a magician. I'm just a human. Please don't hate me for just being a human.

Stop complaining that you've been waiting for four hours to see me. It's not like I've been sitting on my ass playing with my navel while you were outside. Chronic back ache is not as urgent as meningitis. Take it up with our government.

And by the way FUCK YOU government. What are you doing to help these people. to me it looks like NOTHING. You promised to build a brand new state of the art facility with greater capacity for care. You published it in the papers. You gave us hope. We're still waiting...assholes.

Like I said...I'm very irritated today.

Sister B wants to know if she can test my urine. She's convinced my irritability stems from the fact that I'm probably pregnant.

ARGH!


.

Can I get a lift, anyone?

Mr B's story:

I've mentioned before just how popular Sunday nights are in the trauma unit. Last Sunday was no different. I've often tried to understand why this is so? I've come up with these two answers:

1: By Sunday, the alcohol/drugs that were being consumed/injected/snorted since Friday have now worn off...and people are sober enough to realise that they are bleeding/limping/stabbed in the head.

2: Motivated by the awesomeness of the weekend, they are eager to extend it by just one more day, so invent random symptoms in order to get a sick note.


Mr B, however, was not one these patient's. He had just finished his late shift at Woolworths and was on his way home when he was assaulted and stabbed in the thigh.

He was stabbed in his right lateral buttock inferiorly and five cm laterally to the anterior superior iliac spine.

That is, nowhere near his abdomen.

However, despite the wound being less than 1cm in length and with no history of abdominal assualt, Mr B was groaning heavily about pain in his tummy.

We have no Xray facilities and no ultrasound in this trauma unit. We have our wits, basic equipment and our two hands. We noticed that Mr B's blood pressure was quite low, his heart rate was pretty fast, his abdomen was tender and that it was very slowly distending.

We quickly made a diagnosis of internal bleeding, put up two large bore IV lines to run in some fluid and called an urgent ambulance to take him to a secondary hospital. Ambulance control said they would send someone right away.

Mr B's vitals were currently stable so we kept a close eye on him while we waited for the ambulance and continued seeing other patients.

Two hours and numerous calls to the ambulance control room later, Mr B was still waiting, and his blood pressure was dropping. By this time, We were ready to load him into our own cars and drive him the fifteen minutes to the secondary care centre ourselves.

The damn ambulances kept on BRINGING us cases - nonsense non-emergency cases - but refused to TAKE our patients who needed to be transferred. When questioned, all we got was, "Sorry, take it up with Ambulance control, they decide where and what we do."
And then they'd leave, Mr B still waiting, his abdomen slowly getting bigger and bigger.

My colleague stepped outside for his first break in seven hours since starting work. At that moment, tired of trying to hold out until someone who cared came to fetch him...Mr B arrested. His heart stopped beating and he stopped breathing. We started the resuscitation mere seconds after his last breath...

Come on Mr B, you're 24 years old, you still have a long life ahead of you!

Endotracheal tube inserted, chest compressions begun

Don't give up now...I'm sure the ambulance is just around the corner!

IV adrenaline, IV atropine injected, continue manual ventilation and compressions.


Half an hours worth of CPR later there was still a flat line on the monitor and Mr B was showing signs of brainstem death.

We stopped resuscitating and cursed the ambulances to hell.

Mr B. died waiting for a lift. 24 years old, employed, only breadwinner.

We called his mother and asked her to come in urgently. We never give bad news over the phone. What was she thinking on the way to the hospital? Was she paralysed with the possibility of tragedy? Did her mind attack the fear with the weapon of hope?


The rest of that call was spent listening to her screams.

Cerebral Palsy is Dangerous

Today,in the trauma unit, I got kicked in the groin by a child with cerebral palsy.

It was F@#$ing painful.

Not the child's fault, she had cerebral palsy, but really, it was f@#$ing painful.

The hubby wants to have sex. I tell him I can't because I got kicked in the groin by a brain damaged child.

He sighs, says I'm a very creative liar and that if I'm tired I should just say so and not make up stories.

Willie Wonkies: episode 1

Penis. dick. willy. winkie. piel. tollie. stywe stokkie.

I've seen all of them. I've probably seen more tollies than the sluttiest nymphonmaniac prostitute.

I usually, very politely, and professionally REQUEST to examine the male jiggly bits at an APPROPRIATE time during the consultation, after an APPROPRIATE penile symptom has been experienced by my patient.

I am NOT usually introduced to the penis BEFORE I say hello to the owner of said penis.

A few weeks ago, at the end of a long day, an elderly Xhosa gentleman shuffled excitedly into my consulting room. Before I could finish my standard introduction "Hello, I'll be your saviour today, how can I heal you?", the gentleman had unbuckled his belt and dropped his pants with a flourish. He was then standing proudly in front of me, arms outstretched and beaming. Beaming, in a way that could only be interpreted as a facial manifestation of "Behold! This is my glorious penis!"

I was slightly confused. There was nothing particularly spectacular about this penis. It just looked like a regular old man's penis, shrivelly and flanked on either side by a very saggy wrinkled scrotum.


"Please sir," I plead, " pull up your trousers and let's talk for a while first."
( after all, I like a little chat before I go near anyone's genitals...it's only polite)

"Noooooooo Doctah!" he beams enthusiastically. "You see, I likeh the young gahls!"

English being probably his third language, his pronunciation was sightly off. I do enjoy that Xhosa accent. I couldn't do so at this consultation though, as I was distracted by this naked 60 year old Xhosa man, who was by that time excitedly slapping his penis from side to side and beckoning me to watch.

"He likes young girls?" I thought. I look like a young girl, is this some sick perverted way that old gentlemen get their rocks off? Pretending to be a patient with a penis problem so that a young lady doctor can touch their dicks?


I was too shocked to engage my three years of karate training. The man continued abusing his genitals, while I stared at him, mouth agape.


"I likeh the yung gahls Doctah! I likeh make sex with tha yung gahls. But my pinass, it does nahthing!"

"Look! You see? Look! You see?"

more enthusiastic penis slapping

" nothing is happeneeng!?"

" Why doctah? I am luckee. The yung gahls, they don't like yung man. Yung man is not good. Yung man have AIDS. They likeh old man likeh me. I say to them 'Come, come to my flat. I got a flat. I got a cah.' Then I want make sex with them but my pinass it does vokol nathing!"

That's when I understood. He has impotence. And it is severely impeding his sex life.
Now how can one be offended by a naked penis-slapping 60 year old Xhosa man after a story like that? I thought it was quite an ingenious way for him, a third language English speaker, to really drive the point home that I needed to fix his penis.

People have unbelievable faith in us medics. He had diabetes, hypertension, high cholesterol, was obese and was a smoker. If anyone was on a highway to impotence, it was this guy.


I felt sorry for him. In my broken Xhosa I explained to him that his diseases made his penis this way. The only thing I could do was refer him to the erectile dysfunction clinic where they would do embarrassing tests on his winkie and probably tell him that the way forward was a penile prosthesis as he would never get it up again.

Any men out there reading this? If the threat of a heart attack, stroke, kidney disease or blindness is not enough to motivate you off your ass to go to gym, eat properly and quit smoking, remember Xhosa man and remember impotence. Because I know you, young man. Soon you will be an old man, and then you will definitely be liking the "yung gahls". They, however, will not be liking you if you are :



15. 180 degrees shy of heaven

14. Performing with Flaccido Domingo

13. A few parts shy of an erector set

12. Sch-wing and a miss

11. Not rising to the level of impeachable offense

10. The Null Monty

9. Disappointing Miss Daisy

8. Taking the gold at the Lake Flaccid Olympics

7. Ascension Deficit Disorder

6. Bouncing the Check of Love

5. Less-than-Magic Johnson

4. All Doled up with nowhere to go

3. Welcome to Flaccid City. Population: You

2. Serving boneless pork

1. Unleavened Man-Bread

( from www.lotsofjokes.com)

TV shows that don't scrub up.

Thank GOD for TV shows. Without them we would be exposed as the boring grumpy old farts we really are. TV shows keep us cool. TV shows give us street cred.


Here is my Doctor's opinion of the most popular TV medical dramas: With a rating, out of 5 as a factor of how they enhance our coolness. 1 being uncool. 5 being the most supercool, like Snoop Dog cool.

ER

1/5

I absolutely have major issues with this show. It has been running for too long. Give it up already! We can't euthanise our patients when they're terminally ill, so let's kill the things we can! George Clooney left, and then they should have shut the damn thing down. In my opinion, it's just...not really doing anything to make me seem cool in the eyes of the public. The only reason I would ever watch it is for yummy yummy Luka from Eastern Europe. Hotteeeee! As for Noah Wyle, ugh! Read my post about Dr Vinegar and you'll know why I'd rather not comment on him.


Gray's Anatomy

3/5

I would have given this a 4/5 if it wasn't for that annoying Meredith Gray character. Us lady doctors are not all that annoying, I promise. This show, actually, does not really deserve to be classed as a medical drama, as it is in fact a soap opera that is set in a hospital, and the characters just happen to be medics. But, the public are unsuspecting, so because most of the doctors in this show are superhot, and brilliant at what they do, it gets a 3/5.


House:

Aahh, Dr House. You get a 4/5. You get 4 because of your grumpiness, your addiction to prescription meds and your brilliant medical mind. There are more than a few real doctor's out there like you. I admit, sometimes your show is slightly ridiculous, and reminds me of CSI in the way it endeavours to solve an apparently unsolvable "medical mystery". Anyhow, I forgive you that because you show the world that Dr's are cool like detectives, cool like Horatio on CSI, cool like Sherlock Holmes...

Private Practice:

4/5

This show get's 4/5 because it has Dr Addison Montgomery a hot female surgeon role model who is a millionaire and has AWESOME clothes. It also has Dr Peter Wilder ( the sexy guy from Wings who plays a rugged former Doctors without Borders physician and alternative healer man. MMM....sexy....sometimes the hubby and I play the "Private Practice" bedroom game. I'm Addison, of course, and he's Pete...and then we practice our bedside manner...

Scrubs

5/5

AAAH! My absolute freaking favourite medical show in the history of the universe! This show is undeniably the most realistic of all the medical TV shows out there. Brilliant writing, excellent actors, good looking actors,fantastic humorous interpretation of life as medic. THE BEST of them all. After a 30 hour shift as an intern, this was my drug of choice. Coming home...settling in with my friends at Sacred Heart Hospital and laughing myself into oblivion was my favourite way to OD. More often than not...events from the night before would materialise in the episodes...and that's when I knew that God created Scrubs to get me through internship. Thank you God.

Noah Willie and the amazing Dr Vinegar.

So right...big up to the Trauma Sisters.

Those of you not familiar with primary health care in this country, probably have no clue what I mean when I say "trauma unit".

That image you have in your head right now of "ER" doctor Noah Wylie (or Noah Willie as I like to call him) charging through a state-of-the art trauma unit with excesses of doctors and facilities...um...well that's the wrong image.

Our "trauma unit" is a 5X15m rectangular room with another tiny "room" / store cupboard attached to it.

*It has one telephone. The telephone is only used to call our referring hospitals to tell them that we are sending patients to them who need further care.

*A noticeboard

*A small L-shaped desk which the nurses and doctors have to share. The nurses do the vitals and the two doctors in the unit can see patients. The patients are having their vitals done and histories taken right next to each other at this one desk. Privacy is not an option. If you have genital warts, the guy next to you is going to know about it.

*Three yes, three examination beds. There is no linen on these beds, let alone pillows. Just a bare cold plastic mattress.
Often, the remnants of the previous patient's faeces/urine/blood/sputum/vomit is still left on the bed.
Oh don't worry, it does get cleaned, wiped down with some disinfectant fluid and then it's good to go for the next patient's examination.
Sometimes, on a good day, we have plastic linen savers to put on the mattresses. But even then, they don't last and usually run out by lunchtime.

*Grotty bloodstained curtains that do not close all the way around the bed. My apologies if you need a rectal examination. We try to do our best by clamping sheets in the curtain deficient places...if we have sheets that is.

*Minimal stock of the most basic equipment. However most of the instruments are from blood-letting times. Sometimes they come with leeches attached.

*A cupboard of the most basic emergency medicines.However, the clinic pharmacy is not open after hours so there is no way to restock if we run out. Thus, when I arrived for my call this evening I discovered that we did not have panado, panado syrup for the babies with high temperature, or amoxyl. NO PANADO!?!? That's like trying to cook with no heat.


It's as basic as you can get and not a box of gloves more.


The patients know this, so they have taken things into their own hands. No panado? "Screw you health system, we'll find our own remedies", they say. "We don't need panado! Who needs panado when you have the amazing cure-all, VINEGAR!"

Here is an actual conversation between me and a woman who had just brought in her friend after she had suffered a stroke.

ME: What happened,how can I help you

Woman: My friend, she is having a stroke. So I am throwing vinegar on her face.

ME: Um...what?! What do you mean you threw vinegar in her face?

Woman: Yhu Yhu Doctor! You don't know? * staring at me incredulously* Don't you know vinegar? You MUST use the vinegar.

ME: What MUST I use it for?

Woman: *excessive cicking and tut-tutting* Doctor, you must use it F O R . E V E R Y T H I N G!


She said it like I wrote it, loudly and slowly, like when one is talking to one's deaf demented grandmother.


I often have to listen to the stories of amazing Dr Vinegar.
These are some of the things my patients swear to me vinegar cures.

1.mental illness
2.strokes
3.high blood pressure
4.TB
5.STD's

I'm sure that for the mild skin irritation and sore throats , vinegar can be of some benefit. But as for the listed conditions above, I can tell you with some certainty and a great deal of sadness, these are not going to be cured by Dr Vinegar.

Poor patients, clutching at vinegar soaked straws to keep from drowning in our overflowing health system.

(p.s I dislike Noah Wylie and call him Noah Willie after I read an interview with him in the Sunday Times Magazine. The actor was shooting scenes for ER in SA, and told the Sunday Times that after ACTING as a doctor for so many years on ER, he feels that he could study medicine and be a doctor in real life. You are a buffoon Noah, really, you are an ignorant fool.)

Sister C

19h00: Here we go, Sunday night call...

According to Sister C, who has worked every night this weekend, Friday and Saturday were peaceful.

Have I told you about Sister C?

Sister C is a veteran Cape Flats warrior nurse. One of a dying breed and one that I am eternally grateful for. She is my personal bodyguard and heroine on nights when the patients threaten to riot in the waiting room. With one cut from her sharp tongue she can silence even the most hardened gangster. A vehement follower of the word of Jesus Christ, she has a voice like an evangelist preacher and an unfailing intolerance of "strond" ( nonsense). When Sister C is on at night, the radio is locked on Christian FM, and woe betide you if you even suggest switching stations.

On a seldom-fulfilled quest to uplift her community and instill pride in its people, Sister C does not even tolerate a patient's improper body language.

These are grave signs of immorality according to Sister C:

1: slouching
2: not greeting in an appropriate manner
3: not referring to her as Sister
4: speaking to the Doctor directly without first asking her permission to do so.
5: daring to question the authority of the trauma staff.
6: complaining in any way.
7: forcing her to repeat herself after her very clear initial explanation.
8: Not having front teeth
9: interrupting her while she is busy with another patient
10:not tucking your shirt into your pants

These signs, are indicative of a lack of morals and will result in one of three things:

A vicious tongue-lashing in Afrikaans about the lack of respect, being ferociously educated in the importance of the Lord in one's life, or, if you've really pissed her off, having your folder moved to the back of the queue.

I live vicariously through her. Often I've envied her ability to utterly verbally annihiliate her victims in their own vernacular. She gets away with this because she is a brilliant nurse. The best. She can do everything I can do, She doesn't need a Doctor, she can run that trauma unit single handedly. She can put in chest drains, suture,apply plaster of paris, resuscitate, intubate, rattle off drug dosages as if she's reading it from the textbook...she is always ready and willing to help and I know she's got my back. She is a very precious gem in this hellhole mine dump of a health system. When I have my own hospital I am coming back to get her.

Nurses like her are keeping this health system running, not the fat cat health administrators with their bullshit ideas and ignorance about how the patient's are suffering and how underappreciated the health professionals are.

Sister C is one of a few excellent nurses at this Community Health Centre.

There is also Sister L,who is quite excellent too.
She gets along well with Sister C because she also loves Jesus.
However, I don't think Sister C knows exactly why Sister L loves Jesus so much.

I know why.

You see, Sister L was married to a philandering fool. He cheated on her excessively despite her efforts to improve their marriage. She was miserable, and so sought solace at the local church.
Soon thereafter, Sister L's philandering fool of a husband, and his mistress, were both ploughed into by a truck on the N1 and instantaneously killed!
This was enough proof for Sister L that God exists, and has since, never missed church on Sunday.

feast on my flesh

Just once, in my life I would like my body to be flea-bite free.

Clearly, the MAN is sneakier than me. He punished us for daring to sleep, he punished us by infesting the bed with fleas.


Thus, post-call there are 8 red, angry, itchy flea-bite-feasting sites on my body.

EIGHT!!!!!!

illegal blog time

23h37
What is the difference between a cockroach and a cricket? they're both pretty disgusting and make me want to vomit. One of the two is half dead, half squashed and crawling cross the on-call room floor, leaving a trail of yellow goo behind it.

Oh well..the cricket/cockroach must be penance for actually being IN the on-call room. So I do what I can't do to my half dying patients with no hope, I end its suffering.

By the way....
This is a secret blog post! Yup, I'm actually on call RIGHT NOW. But actually am NOT on call right now! hee hee! Lucky for me, My friend and I are both on call, so we are beating the system by "splitting the night" which guarantees each of us at least four hours of sleep. It's our way of sticking it to the man. Up yours, man! You want me to work like an unpaid slave, well screw you, my friend and I are both sleeping tonight!

However. I'm not asleep.Why? Why? Because, there is a screaming child wailing its guts out in the waiting room. Screaming like it's being stabbed in the eye. It probably will get stabbed sometime in it's life while living on the flats, but does it have to practice the screaming right now? Where is the mother's breast? Someone find the breast, shove that breast in the wailing mouth and get the kid to shut up so I can shut my eyes in peace!

Honestly. Kids can be really insensitive.

Relax, dammit!

Oh I feel so naughty...this must be illegal, to be lying here in my Cosmo featured bikini,on this heavenly stretch of Atlantic Seaboard, mercury at 40 degrees centigrade...IN THE MIDDLE OF THE WEEK!

Ha ha suckers, I'm on leave.

You can't get me now you stubborn sugar-munching diabetics!
Take THAT you tik-smoking teenagers!
Eat THIS you alcoholic epilieptics with your three-in-the-morning-defaulted-treatment-alcohol-binge induced seizures!
I'm on the other side of the world , and you can't get me here...



I really, truly am on the other side of the world to my patients. I'm surrounded by the wealthiest piece of real estate in Cape Town...those that live in this area have no idea what life is like on the Cape Flats. A bottle of water sold on this beach goes for a whopping 20 bucks. I have patient's who struggle to find the R6.00 taxi fare every month to make it to the hospital for their medication. I can't tell you the number of times I've emptied out my wallet after hearing these stories...here's one from last year:

The story of the abused and battered woman.
She was terrified that her drug-abusing husband would burst through the door and start beating her. She had gained some courage, made the impossible decision of leaving her kids behind, packed her small bag and made a run for it. The only way to get away, she explained, was for him to think that she was at the clinic collecting her monthly meds. She asked me for some small change to call her pastor who would come to fetch her and take her to a safe place. I gave her the R100.00 note I had in my wallet.

Argh...seems like they're always in my mind, no matter where I am. Sometimes I have a secret wish to be a vacuous airhead with no clue that people are suffering. Sometimes, I have a secret wish to have my memory erased by Will Smith in the Men in Black movie.

It's hard to selfishly enjoy the luxuries when you've had an education in people's suffering. But dammit, I'm going to try! At least for the three days of precious leave I have taken.
Not all of them have sad stories. Usually, they're ok. And sometimes they're just bloody fools who never take the advice you give them, default on their medication,continue to abuse drugs and stab their friends.

Yes, thinking of THOSE patients makes me feel slightly less guilty...

I think I'll continue sipping on my icy cold beverage...

what's wrong with you lady,this is your fifth abortion in three years

and watch the seagulls slip across the blue sky...

Being looked at funny is not a reason to knife someone in the eye, sir

And marinate in my spf 40 under this glorious sun...

Don't lie, I know you smoke cigarettes because I saw you puffing away outside my consulting room!

dozing in and out of my vacation induced semi-consciousness...mmmmm.......they can't get me here...

Zippideedoodaa!

Good god! I woke up the other morning, on my first morning of my THREE days of leave and was literally, delirious with joy that I didn't have to drive to work. Yippeeee!!!!! That's what I shouted ( I literally shouted out loud) as I cheerfully waved the hubby goodbye at 06:30 am. And then...Oh my God, and then....you'll never believe it...I gleefully skipped back down the passage, launched into the air and shnuggled right back down into the duvet to continue a glorious night's rest...zzzzzzzzzzzzzzzzz

This. is. pure. luxury! Woohooooo! A whole day without disease!

The "bergie bath"

Sometimes the patients are really very very poor. Indigent in fact. So indigent that no-one cares for them and they are unable to care for themselves. So destitute that they cannot afford to wash themselves...for months. These patient's somehow manage to make it to hospital.

The day hospital is the one place they can come to where people will care about them. That's not not saying much if this place is better than being at home.

We wash them here.

In the place called the "bergie bath"

It's an open area with a hosepipe. They strip, and then we hose them down. with a hose. It's a barbaric act of kindness but it's necessary. Sometimes they have body lice. Body lice really scares me. I had an HIV positive TB riddled patient exactly like this who got hosed down, because the other insensitive patients in the queue complained viciously about the way my patient smelled. One of the nurses phoned her husband who brought him a bag of old, but clean clothes to wear once he was thoroughly washed.

What the hell is NOT happening in this country in order for a "bergie bath" to be necessary. It's shameful and pathetic.