Dextrocardia

Down in A+E today, I was casually listening to yet another chest. On the left side, I struggled to pick up anything suspicious, it all seemed fine. Breathing was a bit quick, but otherwise absolutely fine. Moving on to right side, the lungs seemed okay again, and the heart was beating strongly and regularly. I was struggling to understand why the SHO had told me to listen to this guy's chest, and was now hovering over my shoulder in excitement.
Hang on a minute. Right side.... Heart....... Right side................. Heart.

Right side.



Heart.



Isn't the heart meant to be on the left side? The rusting cogs that fill my head were finally heaved back into motion by a dropping penny. This guy's heart is on the wrong side, or as we medically inclined people say, dextrocardia. Affecting only 0.01% of people, most of whom will never know it, it's quite an interesting catch for a third year student. There are a few dangers of having the condition, mostly to do with sufficient oxygen getting through the lungs to the body, but to be honest I haven't done enough research to explain them.
I mean, it's not likely to come up in any of my exams, is it?

Layman's Terms

"Do you want me to take an ECG on him?", the extremely lovely nurse asks me. The junior doctors have all gone to lunch and she seems to think that in their absence I constitute some kind of feasible replacement. I bask in the glory of having somebody assume that I have the faintest idea what this patient needs, before sneakily telling her that he probably doesn't need an ECG but that she should double check with somebody else later.
"Could you fill out his drug chart?" She isn't taking the hint. Yes, I could fill out the drug form, with his name, patient number and known allergies, but despite the fact that me giving him any drugs is distinctly illegal, I wouldn't even know if aspirin would be a good idea. I smile, and say that I know how to but I'm not allowed. She smiles back. How rare.
The junior doctors finally reappear, smirking with each other about the 300ml of pus they just drained from a wound.
"300ml, about the size of a can of coke" I say, I am the embodiment of medical description. "Yep", says a junior doctor, with a giggle. They are mostly female and today they seem mostly cheerful.
At that second, a registrar, who has come to the ward to fill in my assessment form, appears from nowhere. Did he hear my razor sharp coke-can one-liner? Luckily, it appears not.
He gives me a rough grade for my attendance, interest, knowledge, and all manner of other vague criteria, taking breaks to ask me spontaneous questions based on notes he finds littered around the nurse's station. I do alright, mostly Bs and Cs. The last criterion is "communication".
"How would you describe yourself here?", he asks me, honestly expecting me to give an answer different to "good, fine".
"What about with patients, talking in layman's terms?" he asks. The junior doctors giggle close by, sipping their cokes.
Bugger, he heard me. Luckily, he turned out to be the most likeable surgical registrar in the entire hospital. We spent a further 20 minutes chatting about how irritating it is when patients describe their pus volumes using the empirical system. How much is half a quart anyway? We agreed that everyone should go metric, so we could quantify pus much more easily. Modern medicine, an ever changing science.

I should've played dumb

Today I answered a question during the ward round to which the answer was "erectile dysfunction". The consultant spent the remaining hour of the round pointing to me and patting me sympathetically on the shoulder whenever the subject came up. Slightly embarrassing.

Smacking

Isn't it strange that one of the ways parents use to teach their children the difference between wrong and right is to hit them? The difference between wrong and right. Hitting them. Funny kind of logic.
If your child doesn't behave, if they doesn't do what he or she is told, you can hit them. I won't sugar the pill and call it "smacking", because that paints a more placid picture. What it is is hitting. Assault.
You don't have the right to punch your friends if they don't obey your orders, so why the hell should you be able to hit your children? At least your friends are adults and can summon up some resistance, your children are helpless. And what is worse, they rely on you for survival, for food and water, for warmth and love. How do you think they feel when the two people who provide everything for them, and are the biggest role models in their lives turn around and physically abuse them? Yes, I said abuse. It's not a nice word, but look it up in the dictionary. It fits.
You wouldn't lock them in a cage without food for a week would you? You wouldn't leave them outside overnight? You wouldn't put cigarettes out on them, would you? So why would you hit them? Hide behind your safe word, "smacking", or your traditional image of putting your child over your knee, the result is the same as slapping them across the face.
It's going to torture their self confidence, and the conflicting emotions and confusion must be horrible. Let alone the possibility of them growing up to believe that it's acceptable to hit their own poor children.
I can't stand some of the arguments people come up with to defend this abuse. "You have to make children understand". "The only language they understand is smacking". "They won't forget their lesson now".
Of course they won't forget the time their own parents hit them. Ever. They're children. Nothing they could do in their innocent way could ever deserve to be punished by being struck. Yes, children need discipline, sometimes hard discipline, but what does physical violence and fleeting pain and fear teach them about life? Go on, tell me, I want to know.
If you don't have the love and patience necessary to teach your children about how grow into acceptable, responsible adults without raising your hand to them, then it's you that needs to be on the end of it, not your child.
[note: I was not abused as a child, just to clear that one up, mother.]

My Consultant, Doctor Invisible

I started my surgical placement 3 weeks ago, and in that time, I have met my consultant precisely zero times. For the first two weeks, he was on leave, and for the last week, I have tried desperately but in vain to catch a fleeting glimpse of the lesser-spotted senior doctor. Our lack of contact is not as worrying for me as it should be for you, seeing as he is the most important resource in the education of 3 people who will in the very near future be shoving their hands around in your guts and playing "eeny meeny miny mo" to decide which artery to clamp. I have parasitically sucked as much information out of the junior doctors as I can, and the occasional scheduled teaching session with another class is all well and good, but basically I'm on my own, and it isn't good.

At the risk of shattering the public's illusions of consultant surgeons as hardworking, humility-bound bundles of benevolent cuddliness, I have found a few incriminating photos taken during his time spent "at work". Observe.

Here he is shooting a personal best of 4-over-par when he was meant to be conducting an urgent radical nephrectomy.

Here he is in Monaco with his latest Porsche, whilst Mr.Smith bleeds out on the table thanks to his unsupervised cretinous underling doctors.

And here is Doctor Workshy again, coating himself in the gentle, relaxing sunbeams of Muscle Beach, as his own patients are ironically dying of untreated skin cancer.

Fine, maybe I'm overreacting, but it's not my fault if the weekly schedule of his activities I was given is 100% inaccurate. I'd ask the cleaners how to do a cystoscopy, but they only speak Polish. Just pray you don't need an operation in 10 years!

Children are not Accessories

Why the hell would Madonna fly to Malawi to adopt a child when her own fallopian tubes seem to be working fine? Why doesn't she just do the natural thing and actually have another child of her own? I've been theorising, and basically I think it's due to one of a few possibilities.

1. She thinks adopting a child from a third world country is the new black, and has upped the stakes in the hideous game between her and Angelina Jolie to decide who really is the most detached from reality by completing the entire set of ethnic children, like a football sticker collection. Babies are not accessories. Dressing them up in little burberry jackets and back-facing caps makes you look like an irresponsible dimwit who treats their totally dependant child like a Barbie doll. By the way Britney, I recommend sterilization. Drinking and smoking the amount you are already should do the trick anyway by around 2010.
2. In her own tiny little head, she actually thinks that ripping a child away from their entire culture, heritage, and groups of friends and ancestors constitutes saving the world. If she really wanted to do something helpful, she'd get off her fat fake-Brit arse, go down to the bank, and use the interest she accrued on her fortune in the last millisecond to build a new orphanage and furbish it with staff, beds, food and clean water, so that she could prospectively save thousands of kids. But, like the spoilt child she really is, she stands against the shop window, staring at all the poor faces of starving children and proclaims obstinately that she only wants one. The cute one. Well guess what, that's not how it works.
3. She thinks that black people are genetically gifted with better rhythm, so when the kid grows up he'll be able to write her a few albums, distancing her nose from the grindstone by a further million miles.
4. All of the above.

Self-Serving "Musicians"

Some "artists" are really beginning to piss me off. I like my music as much as the next guy, but some "musicians" are testing my patience just a little too much.
I am especially beginning to despise rappers and R'n'B singers who insist on singing their names at the start of every one of their identical, uninspiring tracks. No, it is not part of the new way of recording, it is arrogant. And anyway, if you where any good at all I might remember your name in the time it takes to get the CD from the case with your name on it, to the player. Not that I ever buy your music anyway, it sucks. You never heard a Beatles song with John Lennon and Paul McCartney shouting out "The Beatles, yeah The Beatles!" at the start, did you? That's because they were so good people remembered them from their last song, and the ones before that. They actually had a body of work, not that you'd know about that, what with being replaced by someone more "bling" after just one awful, idiomatic single, which by the way rapes the memory of real rappers, who could actually discuss issues other than guns, bitches and cars.
Leading on to my second point. Who the hell gives a flying fuck that the profits from your last album (impressive, 10 or more identically soporific tracks in one year) bought you a Ferrari, or a pointless medallion which is bigger than your youngest illegitimate child? I certainly don't, and it sure as hell won't make me want to go out and buy the new one. Quit talking about guns too, I know you get all stroppy when people accuse you of being irresponsible, but maybe if your songs didn't paint you as moronic imbeciles without the ability to tie your own shoelaces without four hands, we might possibly let you own a gun that doesn't fire red plastic arrows.
And quit being so hypocritical. If I'm not wrong, Ms Dynamite managed to squeeze out two albums of sanctimonious bullshit about teenage pregnancy and surviving the "ghetto" (East London) before she moved to Surrey and got up the duff to her best mate's husband. Dumb.

Creationism: How Gullible are you?

I once read a book about elaborate hoaxes, and how the very best cons are so good that when the ringleader finally tells everybody that it was all a joke, no one believes him, and the hoaxed people refuse to get wise.
Creationism is like that. Honestly, if someone tried to pull that one on me on April Fool's day, I would have believed it for precisely zero seconds. Nobody would have, because the whole idea is totally ridiculous. The only reason any one falls for it is because the whole idea is such an elaborate hoax, just one idiocy in the mile-long list of religious lies, that deluded people find it easy to go along with anything you tell them.
I'm not against the idea of a higher power, I don't think it's possible to tell if there is one or not, but some theories are quite clearly absolute tripe. I mean, really, if my mum had tried to bring me up as a creationist, I would've had her committed.
Let's examine a few minor flaws-

1. God created the world in 7 days, creating one thing a day. Firstly, how can there be days if you haven't created the world yet dumbass??? A day is a revolution of the planet.
2. God took Saturday off because he wanted to rest. This is bullshit. You could get this kind of stuff from the Brothers Grimm. If there is a God, he wouldn't need a day off ever. He would've done the job in one "day", and might even have had some time left to make humans less idiotic.
3. He did this a few thousand years ago. Okay, fine, that just goes against all the real evidence we have, like how we can carbon date things to millions of years ago. This is usually where creationists go "yeah, but science is fallible". Wake up and smell the moronic assertions, you idiots, it's not science, it's common bloody sense.
4. God left traps like fossils to test our faith. No, he didn't. What is this, life, or a giant game of Cluedo? Maybe God created the world in the study with the candlestick, or maybe you're a dipshit. Stop trying to incorporate things into the Bible just because you've realised that they totally contradict your half-baked ideas. In the real world, if an idea is stupid, we drop it, not twist it beyond recognition just to keep it alive.
5. Creationists love to break open the argument explaining how the world we live in, "which is perfect", must have a designer, like a finely tuned pocket watch. Have you ever opened your eyes, ever? The world is a shithole. Half the world's population is starving, or fighting over nothing, or diseased, or French. It's not a very nice place. And as for the universe, it's basically a massive mess of burning gas and icy rock, as we cling to the only barely habitable rock in the galaxy. Great design job, Laurence Llewelyn-Bowen makes you look like a child with crayons.
6. Animals are totally different to humans. Guess again you mindless clones. Humans eat, breathe, reproduce and shit like, let me think, animals. And then I could go on about DNA but you'd probably burn me at the stake. In fact, I'm quite happy to be related to apes, they show remarkable signs of intelligence, like not falling for dumbass children's stories.

I reckon there was some middle eastern man, walking around Jerusalem around 2000 years ago, seeing how dedicated people had become to Christianity. He'd mumble under his breath, "bloody hell, they actually fell for it".

Get A Life

I had a good night out clubbing tonight, and after the club closed at 2am I brang 2 of my mates back to my house to play a few hands of social poker and drink a few beers. It only took 5 minutes for one of my socially deprived housemates to crawl out of her room of Christian idealism to mumble to me that I was being "quite inconsiderate".
Well, okay, let me check my watch. It says it's 2007, which means that I'm 21, which vaguely infers that I should be having some fun. If she wants to prematurely surrender her youthful years and willingly become geriatric then fine, but don't bitch onto me about it. Don't whine to me because your tender ears can't take the awful sounds of us chatting through the wall at 3am. Don't cry because we are staying up past your bedtime without mummy's permission and it confuses and scares you. Don't tell all your friends that I am the spawn of Satan just because one of my mates wanted to take a fag break and I opened the back door for her.
I know you want to needlessly surrender you life and aspirations in return for a future of hollow promises and regretful traditional gender roles, but don't impose your pitiful choices onto my life.
Get over it.
Live a little.
I know I'm not Jimi Hendrix, I'm not going to start a love revolution with my social stance, but for fuck's sake, even I realise that chilling out and not caring is a good thing sometimes.
I know that this post has next to no relevance to most of you, but please, I beg you, relax.
Cool down. Take that iron rod out of your backside. Everyone will hate you less.

"Retard Probable"

Sorry for my recent absence, I've been in France checking up on my multilingual globetrotting girlfriend.
Anyway, as I waited for my return train, I noticed that the train operator saw fit to include the comment "retard probable" next to the details of several trains on the departures board.
A number of thoughts entered my head-

1. It's quite un-PC to actually advertise the fact that there may be people with learning disabilities on board the train.
2. It's also fairly un-PC to call them retards.
3. Will the retards be driving the train? Positive discrimination gone mad.
4. Isn't "retard probable" French for "probable delays"?
5. The French are morons in a general sense.

Yes, my train did end up being late. And my connecting train was also late. And my third and final train, a poor replacement due to me missing my original choice by 5 minutes, was also late. This leads me to the conclusion that the French are responsible in some way for the vast majority of human suffering. Consider these points-

• Thievery. French cricket. French toast. French fries. Stop stealing our perfectly valid inventions, attaching your prefix, modifying them in some tiny detail to make them easier to understand/more pungent and pretending that you thought of them yourself. Especially stop claiming to have invented the theory of the republic, Plato did it 2000 years ago, you morons. Also, invent a proper sport. We came up with football, rugby and cricket, not to mention snooker, darts and many athletic events. You have tennis, which frankly is about as enticing as your body odour.
• Body odour. It is not acceptable to smell overly of urine or cheap aftershave, which on my limited experience applies to around 90% of French people. Foodstuffs are also not fragrances.
• Introductory cheek kissing. He is a man. I am a man. No. What the hell is wrong with a masculine handshake involving a non-spoken competition for superior firmness between the two participants? Too manly for you? Thought so.
• Mint sauce, baked beans and marmite are not "specialist" foods. They should be stocked in all your shops regardless of whether that means you have to move the horse or the dog to a different shelf.
• Stop surrendering. You've used up all you credits for us coming to your rescue, so the next time you get invaded by Albania or Zambia, we're going to get out our telescopes and watch. We might even have a celebratory baked beans party as the smoke of your burnt-out onion fields drifts across the Channel.

Not Dead

That's right, despite your pessimistic predictions, I survived my 10km race. I actually managed to achieve all my goals, including to do the whole thing without stopping, and under an hour (actually 53 minutes, I'm chuffed). It was pretty painful, lonely at times, embarrassing when kids kept up with me by the side of the course for half the race, and nauseating when I decided to sprint the last 100 metres and retched up a load of air on the finish line, but I did it.
My whole lower body aches like hell today, but I managed to squeeze out a slow 3 mile jog to try and get the blood flowing again. I think it worked, but maybe the pain is just waiting until I least suspect it.
My support crew (mum, sister, uni mate) seemed disproportionately proud of me, maybe they didn't see that about 80% of the field, including octogenarians and part timers with jean-shorts and iPods were driving home by the time that I'd finished. I don't care though, I'm constantly told that I should only be competing with myself, which I'm beginning to really appreciate.
The next step, apparently, is a half marathon. And if I'm competing against myself, I don't think I can lose.