Confession Time

Forgive me reader, for I have sinned.

I have lied to you.

In the way that an omission is also a lie.

I am not still working in the front room of that amazing hospital that is a beacon of light in a sea of poverty and despair.

My compulsory government service came to and end on the last day of December 2009.

I'm currently unemployed. ( Oh the shame!)

And for the first time since I was 6 there is no plan for my future.

This is how my life plan until this moment went:

1:School BANG!
2:Medical School BAM!
3:Internship BOOM!
4:Community Service KEPOW!

And now........?

Well now I have the peculiar feeling that I've been cruelly severed from the umbilical cord of institutional protection.
Like I've been ripped away from my comfort zone of striving together through shit situations with a team towards a common goal.
Or like my family has disowned me or something similarly nonsensical.

I miss my colleagues.

I miss the patients.

And I feel kind of...lonely?!?!

Take charge of my own destiny, you say?

Not sure if I know how, think you can help me with that? ( ho hum)

Three weeks of holiday later and I'm uttery dumbfounded as to what to do with my day.

I find myself praying that someone will collapse in a shopping centre and need resuscitation. (this has actually happened to me before, but that's a story for another post)

Or that I'll come across an accident scene with a patient in need of some kind of trauma assistance.

But it's not all doom and gloom...I have some things in the pipeline...

Namely:

*A possible post in Infectious Diseases as a medical officer at the end of Feb.(pending results of an intense interview that felt more like my final medical oral exam)

*A GP locum job seeing private patients with minor illnesses starting on Thursday.(This might prove mind-numbing after the madness of 2009)

*Joining MSF and going to work in some war-torn part of the world.

*Becoming a stripper.


Oh, this doesn't mean the posts will disappear...on the contrary! Now that I have all this free time on my hands, I might delve into all sorts of introspection and subject you to unending mundane musings about the most banal trivialities of my life...

Or I might remember the hundreds of mad medicine stories I didn't post purely because there wasn't enough time.

We'll see...

It's all up in the air right now...

Retarded Referrals (4): Passed Away Disease

Honestly, I have no words for this referral, which I am not shitting you, is exactly how it was sent to us, punctuation and all.

Read it and weep.

I did.


Dear Doctor,

Thank you for seeing above mentioned patient with Parkinson's Issues "best friend passed away" disease, otherwise stable, social.

Please assist with further investigations and management.

Thank you,

Dr Retarded.

Incontinence: The emotional kind

We're a funny bunch, us doctor-types.

Funny "strange", not funny "ha ha".

(Although some of us have been known to be in possession of a rather hilarious wit.)

What I'm trying to say is that we are not what one would call... normal people.

Oh, we can fool you, and put on our professional serious bedside-manner hats.

And pretend that we've shut down our emotions in order to stay objective.

But you need to know that underneath that white coat lurks a complete lunatic, who after years of desensitisation, and total sleep deprivation, is usually cruising along at work, at a speed known as, "this close to cracking".

And...well...somewhere along the line there's that one poor sod who's going to push that doctor over the edge.

Sorry for you buddy, but you were just in the wrong place at the wrong time.

Like the guy who stumbled into the front room, trashed out of his mind and stabbed in the hand... and proceeded to vomit, and bleed, on my chair.

"NOOOOOOOOOOOOOOOOO!!!!!!!!!!!!" I screamed at him, that's MY CHAIR!!!!! My chair, my place to rest my bum! My place to sit down and pretend to be civilised and write my notes. MY CHAIR!!!!

Not, "Oh dear, sir, I see that you are bleeding and having some trouble with your retrograde intestinal motility, how can I help you?"

Just, "NO". (What's wrong with me!?!)

En.

Oh.

That's known ANGER and IRRATIONALITY.

The IRRATIONAL ANGER was recently preceeded by SYMPATHY and DESPAIR, having just held a sobbing mother in my arms after telling her that we'd failed to resuscitate her son. He was stabbed in the back and brought in by the ambulance in cardiac arrest. She told me that she knew who had stabbed her son, and that this criminal had also killed her firstborn child one year ago. (Believe it, because it's true.)

And before the SYMPATHY and DESPAIR, there was MANIACAL ELATION when I checked the lumbar puncture result of my ?meningitis? patient and there were NO red blood cells in my perfect CSF sample, prompting a spontaneous victory dance in front of my colleagues in casualty.

Quite rapid cycling through some extreme emotions in the space of about two hours, wouldn't you agree?

I think it's safe to say that I was suffering from emotional incontinence...

That sphincter on my amygdala needs some major re-tightening, it's slightly worn out at the moment ... just dribble dribble dribble, emotions seeping out with no filter of restraint...

Someone needs to put a diaper on this mental diarrhoea.

Any offers?

Anyone?

Retarded Referrals (3) V-Fib

Write! ( Yes, I'm doing that.)

I mean,

Right! ( In that authoratitive, I'm the doctor in charge, let's get this shit on the road voice)

This, my dear readers is another lesson in retardedness.

The moronic, blockheaded, boneheaded cretin-ness of this, the dimwitted,nincompoopy, pinheaded sheer stupidity of this referral, defies reason, defies logic, is as a matter of fact simply incredulous, spectacular in its stupidity, so utterly mind-blowing that my brain actually exploded all over the front room when I read it.

Please sit down before you read this:

Dear Doctor,

I have diagnosed ventricular fibrillation via Ultrasound in my consulting rooms.

Please do ECG and manage further.

Kindly,

Dr Retarded.


Ok just breathe.

Calm down, take a deep deep breath,

Here...have some of this sweet milky tea while I collect your grey matter off the floor and shove it back into your cranium through your nostrils using a spatula.

Yes,my darling, I know... VENTRICULAR FIBRILLATION! *insert blood curdling scream here*

V-fib ( which is what us cool kids call it) is a medical EMERGENCY.It is a sudden, lethal arrythmia characterised by twitching, fibrilliating, unco-ordinated heart muscle contractions that will kill you in seconds as there is no output of blood from the heart's ventricles to the rest of the body's vital organs.

Like the brain.

Which is why the patients I've seen with V-fib are unconscious.
Always unconscious.

This patient,totally raped of his hard-earned cash, had this v-fib medical lethal emergency "diagnosed" by Dr Retarded, and was then given a letter to bring to us, and as such, walked, fully conscious, into the front room with it.

(Makes the v-fib diganosis highly unlikely hey!)

Secondly a diagnosis of V-fib warrants immediate CPR and defibrillation (Electrical shocks delivered to the chest).

Which Dr Retarded, after making "this brilliant diagnosis" via ultrasound, did not think it necessary to do.

Wrong. Wrong. Wrong.

Fail.

Do not pass go.

Do not collect your R200.00

Go directly to jail.

Christmas Carnage

I worked every single day of the Christmas weekend.

It was tough. Doctors, paramedics, police throughout the country celebrated Christmas by working themselves to the bone.

Oh but there's one dude responsible for this:

I blame Santa Claus...you drunken red-suited buffoon!






Well done buddy.

Good Job.
Good Job.


Maybe you did you not read the freaking tourist manual to the Cape Flats that I sent you?!! Huh??!



Rule ONE: Do not drink the tik-laced milk and dagga cookies left out for you. IT’S A TRAP!

Oh it seemed tasty did it?
Oh you just couldn't help yourself, right?
What's that? It would have been rude not to partake of what was offered to you then hey?

Is that why you screwed up and rewarded the good little gangsters, and drug-induced psychotics, and alcohol sodden short-tempered aggressive folk with knives, and guns, and bullets, and other such cheerful weaponry? Huh? Because you were HIGH?

Panga's: The gift that keeps on killing.

Tra la laaaa! ( That's me warming up my voice for the Cape Flats Casualty Christmas Carol)

Ready? Here we go:

On the weekend of Christmas, those shifts they offered me:

One dead child
Two thoracotomies
Three gunshot abdomens
Four beaten wives
Five drunk drivers
Six stabbed chests
Seven drug-induced psychotics...


Can you tell that I was not impressed by the Christmas weekend's holy shitstorm and emphatically not overcome with the spirit of Christmas joy and love?


So here's a tip for next year, Santa Claus: Rudolph and that gang, me thinks it best to leave them at home. That red nose of his is like a shiny conspicuous beacon, and that jolly red suit of yours - BURN IT!

To achieve successful delivery of the goods, without getting stabbed or forced to feed on narcotics, you need to blend in man!

First, remove your two front teeth. ( This will have the added benefit of making you sympathetic to the plight of those cute freckle-faced munchkins who desire just that waiting for them under the christmas tree.)

Next, get a tattoo of something obscene on your forehead. Something like, "I kill for fun and rape for joy". That's just a little something I read on the face of one of my patients a while ago - maybe you could use that one.

Learn some choice phrases in Afrikaans to throw them off the scent that you're actually a do-gooder come to bring light and joy to the dark corners of the Cape Flats.......you know the filthy vulgar ones I'm talking about.
No?
Go back a few posts and have a little read - you'll be sure pick some up from those.


This way - you can wander around the freaky scary place our patients call home and offer those in need some assistance. Your goodie bag may need to be slightly different from the one you're traditionally used to. If you can fit in one first-class education system, a health system run by competent people and some regular nutritious FOOD for the poor...perhaps I'll reconsider your current low-ranking on my list of favourite people of all time...

At the moment you are down there with the Easter Bunny ( who dropped mandrax laced eggs over the Easter Weekend) and the Tooth Fairy - who went rogue and is making a killing off the lessor-incisored natives of this crazy town, used her takings to start smuggling drugs and is now known on the Flats as...the Tik Fairy...*drum roll *