Baby Fat

A few days ago two young parents brought their baby in for a consultation.

They were so terribly worried that their pigtailed 2-year old child had a runny nose.

When I looked at the child I nearly fainted.

"How many children do you have?" I asked them nervously.

"Just this cute little one." The dad beamed proudly.

"You're lying!" I almost screamed at him! "You actually had THREE kids and this child ATE the other two!"

This kid was the size of three kids.

What in the hell were they feeding this child?

Fried fat wrapped in pastry covered in cream, basted with lard and a side-order of baby?

And she had that hungry look in her eyes.

I examined her very quickly with my left hand.

The left one I was prepared to lose in case she desired a quick snack.

The right was too precious to risk.

Nothing wrong with your child, folks, except that she's morbidly obese.

I explained to the parents the horrors of this delicious death trap they were setting for their little one, and how I would be referrring them to a dietitian for expert advice.

All the while I kept one eye nervously on Junior, and one hand gripping my patella hammer in case she decided to attack me.

With each stomp around my consulting room desk her pendulous belly rippled and a tsunami of fat travelled infero-superiorly up her abdomen, threatening to engulf her head, but then thankfully richocheted off the two Dolly-Parton-sized fat pads that should have been her chest.

It took all my strength not to jump through the window behind my desk and run for the hills screaming that The Blob was going to eat us all!

Baby fat is cute.

Obese fat baby monsters are not.

The Sore Sound

This one's for you, Dr MJ.

There is a sound, made by patients, that I am incapable of reproducing.

This sound is akin to nails screeching down a chalkboard in its ability to cause me physical pain.

Needles, like poison-tipped needles puncturing my tympanic membranes.

It is not the agonising groan of the patient with the ruptured appendix.

Nor is it the gasp of the patient being given the horrifically painful bicillin injection to cure their syphilis.

Oh no, it is the sound made by the “otherwise well” patient.

The patient that you spot happily chatting away to the receptionist in the waiting room.

The patient, that jumps up when the receptionists calls their name.

The patient that, as soon as they walk into your office, and see your face, immediately makes “THE SORE SOUND”.

No, “ Hello Doc”.

No, “This is my problem”.

Just. This. Damn. Sound.

I can’t even describe it – let me try,

“SSSsssthhhhhhmm”.

NO wait, that’s not right, it’s more like,

“Phffffffffffffffhhhhhshhhtttmmmm”.

Jees, I’m not doing this properly...

It’s like the sharp indrawing of a breath while at the same time exhaling and whistling through one’s teeth and moaning.

It is also invariably accompanied by sorrowful head shaking, the avoidance of eye contact and the slow rubbing of a fat thigh.

They make the sound for about sixty seconds. Unmercilessly.

By this time I am hiding under the desk...whimpering, clutching my knees, and rocking slowly back and forth while a little drool dribbles out the side of my cheek.

My regression into a basket case is due to the knowledge of what the Sore Sound actually means. It is signal that announces that the next seven hundred hours of your life are going to be spent listening to this patient complain about a painful something - usually a knee, or foot.

A knee or foot, that is under immense physical pressure from the unjust weight of the gargantuan monstrous thigh and buttock that is certainly the cause of the pain in the first place.

Oh no you don't, don't you dare call me a fattist!

Only when you have a morbidly obese patient sitting across from you making the sore sound, who:

1:Refuses to listen to your multiple counselling sessions to lose weight.

2:Refuses to keep the many appointments you have made for the dietitian because they coincide with the annual church cake sale.

3:Never went to the orthopaedic surgeon you referred her to because the state health service is so overwhelmed that an appointment could only be made for 7 months down the line and therefore was forgotten about.

4:Prefers to sit in your office and make the sore sound, and complain about the pain, so that she can just be prescribed the damn voltaren tablets that, "the other doctors know to give me, Doctor."


Then, only then, after suffering all of this, are you allowed to tell me I'm being rude...

Of course,by then it will be too late...

I won't be able to listen to you seeing as the patient has just successfully worked on my last nerve, namely the cochlear!

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...

Sloth and Competence and knowing when to use them.

It's half past two in the afternoon.

I've just managed to teach my brain to communicate with my body again.

My brain was awake for an hour trying to convince my skeletal muscles that listening to what it has to say is a good idea.

Brain was saying that Skeletal Muscle should help Body get out of bed, hunt for food and evacuate the bladder.

Skeletal muscle was telling Brain to go fuck itself.

Brain won in the end, after a lengthy hour long debate.

Skeletal Muscle got it's own revenge though, and operated like a sulky teenager after being told to clean up it's room...apathetically, slowly, and with no respect.

Which is why I looked something like the illegitimate retarded offspring of Shrek and a three-toed sloth...slouching round the house half-blind, in last night's scrubs top, underwear and socks...mumbling incoherently while in search for the kitchen.


My keen sense of smell led me to the fridge - On which I pinned all my hopes and dreams for a nutritious lunch.

I opened the silver doors and the holy light from within flooded my sleep encrusted face ...

Aahhh *insert choir of angels here*

# Leftover pizza that someone ordered last night ( Score! It's mine now!)
# Crackers with gourmet prawn dip with real prawns from Woolworths.
# Zoo biscuits.
# And a jar of Nutella's spreadable chocolate.

This surely is heaven, and just reward for the shitstorm of last night. Thank you, Fridge Gods!


My call was insane. Which is why I was so tired that when I got home, I couldn't even perform my usual post call ritual of jumping in the shower and scrubbing off the evening's filth, until the top layer of my skin has washed down the drain.
I just shoved an energy bar down my gullet - took off my pants and collapsed on the bed.

The bullshit started out when the locum doctor, who was supposed to be on call with me, arrived two hours late.

While awaiting his arrival, I called the emergency contact number for the locum agency he was from to find out:

Exactly.
Where.
The fuck.
He was.

The middle-aged lady that picked up on the other end could possibly have been a product of incest.

Product of incest:"Oh, um, ja, who are you?"

Me: "It's Dr S from ________trauma unit. Where is the locum you are getting paid to send us tonight?"

Product of incest: "Oh yes, he called three hours ago to say he would be late. But, where is the other doctor for tonight?"

Me: "I AM THE OTHER DOCTOR. If you knew that he was going to be late - WHY HAVE YOU NOT INFORMED US of this fact timeously."

To which the product of incest replied...and wait for it...this really was her excuse..." I was in church!"

Me: "Being in church is no excuse for incompetence. You should stop using your religion to justify not doing your job properly. We'd all LOVE to be in church, or in mosque, or at home on the couch watching the Sunday night movie. But we aren't. We are here doing our jobs. "

I was too pissed off to listen to her ranting and raving that "being in church " was a valid excuse for letting us flounder in primary health care hell on a Sunday night without assistance. So I very politely put down the phone. That woman should take a good look at herself and pictures of her uncle/mothers cousin. There will possibly be very striking similarities.

When the guy eventually arrived - the tragic thing was, I realised that I was probably better off working alone as he was NO HELP whatsoever.

In total, we saw 100 patients from 17h00 to 07h00.
I saw 70. He saw 30.
He would do things like, send a patient off for a urine sample and then WAIT until the patient came back. One can see up to four patients by the time it takes a paralysed stroke victim to go to the bathroom and pee.

When a man walked into the unit and immediately collapsed while having a generalised tonic-clonic seizure, he just stood there and watched me ( 5o kg, petite female me) try to move the man onto a bed to begin treatment.
What a dick. I ended up asking the porters and security guards for help.
They were brilliant and knew exactly what to do - handing me the correct fluids and instruments for IV access.
Fuckwit doctor strode around the bed with hands in his pockets issuing instructions which I, of course, ignored. I don't take advice from brain-donor men who believe that they are automatically in charge - just because they own a penis.

The sisters and I spent the rest of the night ignoring him and swearing at him in Afrikaans. The guy was from Durban so had no idea what we were saying. They don't speak Afrikaans in Durban. Mean - but necessary.

The cherry on the top was when at o3h30 he announced that he had a plane to catch and would be leaving to get his things in order. He then asked the sister in charge to sign his on call sheet from 17h00 to 07h00 so he could get a full night's pay.

He clearly did not know about Sister CrL. She didn't sign his sheet at all. Good girl!

Can I just say - that as I am a community service officer - my rates are standard, very low and fixed regardless of how hard I work. These locums get paid more than double what I make as they are from the private agencies -so in effect I got paid half the amount and was working more than twice as hard.

Did I mention that it's five weeks and counting?


Jeez - just got a whif of myself while reaching over the table. I smell like the hospital!!! AAAAAAAAAAHHH!

I thinks it's time for that shower now...