Friday, August 12, 2011

(S)I am what I am

The name Siam rolls off the tongue like a silk scarf from a magical realm, but “Thailand” means Land of the Free. When absolute monarchy ended in the 1930s, the change of name reflected this. It is a beautiful, complicated country with beautiful, smiling people. (Rather like my own in that way!) I am happy to report that I’ve had the most wonderful holiday in my life – so far – and that we brought about exactly what we wanted: a happy hybrid of cheesy tourist beach relaxation and soul-enriching travel. I think the pic I snapped of this kitty, happily dozing uner the calm gaze of the Buddha, sums up our holiday nicely:

Kitty curled up in front of a Boddhisitava in Phuket
I found the clichés about Thailand to be all true – cheap, beautiful and a simultaneous culinary and cultural orgasm. I had no pretensions about “finding myself in the East”, and knew that whatever was the idyllic paradise of Phuket, is now buried deep under miles of resort concrete. Neither my wife nor I ever had the opportunity to take the fabled gap year after school and do the “Eat Pray Love” thing long before Elizabeth Gilbert wrote her memoir; sadly, this is all too often the preserve of those who have lucky access to trust funds. I do not begrudge these people. My parents had the luxury of three months in Europe in the sixties. This was a precious stone in the bijoux box of their forty year marriage, but I will not consider my life a failure if I am not afforded the same happy confluence of time and means. I have graciously accepted that I am 34, that marijuana does not mix with my medication and that I need clean sheets, hot running water and a gin and tonic whenever I travel.

My father-in-law, for all his disciplined thriftiness, has always considered travel an investment and encouraged us to splurge. I fully agree. If I have one wish for humanity is that all of us may experience that heady mix of anticipation and nerves that engulfs one when one sets foot on foreign soil for the very first time – and never lose that sense. Many have voiced their deep knowing sighs that Thailand is so last week and that Cambodia is the new black and why did we even consider the Western Islands when the Eastern Islands are so much more worthy of being splashed in an edition of Wallpaper. (It would have to have been five years ago; today it’s probably a Vivienne Westwood-designed retreat on the Mountains of the Moon, or maybe it's Phuket in a bracingly ubercool act of subversion). Too bad. I will not be the last to ignore all this and gleefully follow all the other tourists to gawk at the awesome massiveness that is the Big Buddha.

Images of the Buddha are everywhere.
Upon entering my first wat I had the same sense of giddiness as when, aged 13, I saw my first Gothic cathedral, the brooding filigreed stalagmite that is the Dom that towers above Cologne. I could write copious paragraphs about the sweaty mess that is Khao San Road, or the fluorescent ladyboy cabaret that had us screaming with laughter at the endearingly bad lip-synching, or the stupendous sunsets on the Andaman sea – better I inspire you to start finding your own travel nirvana on lonelyplanet.com and build towards that. (More web advice: Tripadvisor.com is great for sorting wheat from chaff, though don’t take it too seriously, and Agoda.com has great hotel deals for when you make that scary date with your hard-earned cash.)

It was so funny that Chiv and I reversed roles abroad – I became a penny-pinching Russian grandmother acting as if there was a war on while my usually frugal wife thought nothing of ordering cocktails from the room service menu when they cost a tenth of a price in the nearby village’s beach bar. (Yet, at 4.3 baht to a rand, Thailand is one of those rare places where the humble springbok coin goes very, very far.) Finally, on Phi Phi, mesmerised by the melee of azure, white and green landscape of karst formations and palms and sand, I finally yielded and drowned any wars against cliché in a torrent (almost expensive) of resort-controlled massage oil and pina colada. At the risk of sounding like a blockbuster trailer voice-over, I had escaped from the prison of four years’ of toil and self-loathing and castigation and gave myself permission to be decadent.

Approaching Phi Phi by ferry
Even so, it is planned decadence. Brutally, the vast majority of us work hard for our money and investing in travel comes with great (but oh so worth it) sacrifice. As South Africans we are plagued with frightening exchange rates and humiliating queues at embassies for expensive visas. Yes, I am envious of my friends who have the luxury of an EU passport. Good for them. I can’t help feeling that this is a great injustice to the little guys who jus wants to travel, order a few drinks in a humble street café and burn out the SD card in their digital cameras, without vomiting in the streets of Majorca after too many alcopops or planning to smuggle in heroim or blow up a subway.

Those who have tried to make themselves feel superior by brandishing their precious visa-exempt nationalities in my face, have been the unfortunate (but, I daresay, well-deserved) target of a little-known side of me which bubbles up once a decade from depths I don’t know I have, but is summoned by such grave disturbances in the Force. It is a very cold, very calm and very crystalline wrath that, I am told, has wilted plastic flowers and commenced years of psychotherapy. I can’t control it, and I don’t like it. Even if the recipient is being a wanker.

So I hope I haven’t inadvertently irritated those of you who haven’t *yet* been blessed with the opportunity of travel. The very process of leaving one’s homeland sets off very slow and very deep waves of change in our souls, even when this is firstly obscured by gaudy pageants of sights and sounds or jaded over by hours in airport lounges and conference venues. All this will suddenly articulate itself in curious moments - a flavour that is suddenly noticed while chewing through a hasty meal; a lilt in the accent of a passer-by. Such has it been for me.

You don’t have to be Livingstone or Drake or Cook.

You don’t have to worry that it’s all been seen by others.

You don’t have to see everything.

You just have to go.

Monday, July 18, 2011

A quick check-in

I'm very touched that I've been nagged by a few of you as to why I haven't posted recently. After all, I've been officially unemployed since the 1st of July! It's been an embarrassment of riches as far as time is concerned, certainly. Four years of registrar time... over, just like that. And I haven't even managed to do the unemployment thing properly. I've already done four locums in the past two weeks, when I could have given myself permission to just sit and watch TV like I've been promising myself for the past four years!

I've now realised that my registrar training time was in fact the longest job I've ever had, and as hard and frustrating it could be at times it was actually an enjoyable ride. Most importantly, being on the other side, I realise how lucky I was to have trained at an excellent institution. Change is always scary, and it's hard saying goodbye to the menagerie of people you meet working in a large hospital. Some of these have become more than acquaintances - there are close friends and one or two soulmates I've met.

But no need for cueing "The Way We Were" and vaseline on the lens. I'm staying in Cape Town. While there are no government consultant posts available, I'm keeping an eye out and opportunities look good towards the end of the year. It would be ideal to take up a junior consultant rotation for two years, rotating through the more demanding disciplines, a sort of anaesthesia finishing school if you like.

For the moment, though, I have to make my way in private. Medical professionals are rather saturated in the city, although there is a nationwide drought of specialists. But my wife and I have our house here and we love this city. I've swallowed my pride and put feelers out - and, surprise, surprise, there IS work. Slowly but surely I've gotten over my initial freak-out at entering a self-employed phase of my life, essentially pimping my trade to available surgeons... in private, anaesthesia and prostitution have many similarities - you have to make yourself as attractive to customers as possible and you charge an hourly rate!

That's on the back-burner though.

In just three days the wife and  I head for... Thailand!! We've been wanting to go since before "The Beach" made it uber cool. But whatever. We'll take it as it comes to us - we're immersing ourselves in Bangkok first and going tourist mad for two days doing all the tours and temple hopping and market shopping, then flying down to Krabi and hiring a car to wind our way down to Koh Lanta where we will be doing sweet nothing but looking at the beach, sky and ocean, and if it rains (it is the rainy season now) we will lie around in feigned ennui and read until our brains are soggy.

Then off to Phi Phi to hopefully experience its heartbreaking beauty for ourselves; I'm casting aside all pretenses and expectations and have quietly exorcised Alex Garland's "The Beach" temporarily.

We'll end off in Chiang Mai which just looks so amazing and lush and laid back compared to the throb of Bangkok.

I guess I fell in love with Thailand a long time ago - from the first Siamese cat I ever saw, that horribly cheesy opening song to "Chess", the first green curry I ate, the ektachrome slides of my aunt and uncle on Phuket in the 70s when the island was a green swathe of palm trees and only a few primitive beach huts dotting the coast.

We'll be hard pressed to find something similar. But I'm not at an age where I do want to do the sweaty back-pack shoestring thing. Apart from the city hops (where we have at least found some charming boutique hotels) the island days are to be my first concerted attempt at the art of slow travel. And I'm avoiding the high rise sprawl of Phuket as much as possible, though we will spend a day there driving up to the airport to catch our flight to Chiang Mai.

I can't wait to get out of Krabi Airport, fetch the car, and drive down the green Andaman coast to our little hideout on Koh Lanta and know: "we've come away :)"

Here's to reconnecting with ourselves, the universe and each other. I'll see you guys on the other side, hopefully a relaxed dude with sunshine in his eyes and sand in his brain. I mean, more than usual.

peace

 

 

 

 

Thursday, May 19, 2011

Finally...

I'm grinning from ear to ear... I passed my Fellowship exam! So after four years of registrar calls, haphazard studying, fractured social intelligence and frequent medication adjustments in the entire household I am finally a (it sounds so weird) specialist anaesthesiologist. Well, at least from the end of next month when my reg time is officially finished and I can register as a consultant.

The examination was one of the longest days of my life. The day before, the accumulated stress took control of my body as if I'd been invaded by an alien life form: eczema attacked my body in burning filigreed ridges; my viscera felt as if they were being knotted into strange non-Euclidian shapes by a voodoo mathematician. The exam itself was not as horrendous an experience as I thought it would be - but I felt, suitably, that I had had my knowledge analyzed to forensic precision in all four dimensions, but without any malice.

I would not be sitting here blogging happily on the other end of the examination rift valley if it weren't for my wife, who has been continuously juggling the household, my mood swings and her own career while I was attending the shotgun wedding of my brain to Stoelting's Anesthesia and Co-Existing Disease. On top of that she's done a Diploma in HIV Management at the same time as my FCA - her results came out today and (of course) she sailed through it.


It's things like this that make my jaw drop at the power of Female Multi-Tasking. The wife is definitely a Quad-Core i5 to my first generation Pentium. And on that note, I have to smugly boast about my post-exam present to myself: a brand new iMac, the top-of-the-range 27" model that just came out. I'm in computing nirvana and this is my first post from it's gorgeous svelte platform. The new iMac is definitely the computer equivalent of Scarlett Johannson. (I've even named it Scarlett. Yes, I name my gadgets. My iPod is called Chuck, my HP laptop Sabrina and my portable hard drive Marvin in honour of its expansive information content and what I suspect is a dysthymic electronic disposition - it somehow always is reluctant to engage when first connected.)

In all, I've been truly humbled and touched by all the support from so many friends, family members that it honestly feels as if you all wrote the exam with me. What now? For the moment, work continues for the next few weeks - until the end of June when my contract runs out. I would love to stay in the state service but there are unfortunately no specialist posts available, and since my four years as a registrar are done I must make way for a new trainee. So I'm going to be unemployed for a bit - for the first time in my life really, and although that sounds scary I daresay it's high time. I've been running in a hamster wheel since school, everything decided for me - first Matric, then med school, internship, community service, anaesthesia training... (ok, I took a 2 year working holiday in the UK but it still involved anaesthesia locums to pay the way.)

I'm planning to take 2 months off and then I'll have to start worming my way into private practice. Unless, of course, a consultant post opens up somewhere reasonable. And I'll probably write up my Master's dissertation, given that the basic fieldwork was done as part of a larger study I was a data collector for before I got my registrar training post. The wife and I need a holiday so we're planning to do... a Mediterranean cruise! More about that later, for now I just wanted to check in and broadcast to the world that I can write FCA(SA) after my name.

Thank you for your indulging me :)


Monday, May 2, 2011

Unto Thee All Flesh Shall Come

It sounds even more severe in Latin: Ad te omnes caro venidet. And hauntingly beautiful too, when set to music by Mozart or Faure. I’m referring, of course, to a line from the Requiem Mass; its words always leave me quiet and humbled. "All flesh" coming before its deity certainly echoes the basic tenets of the faiths that believe in a single omnipotent Creator - not just the Christian tradition into which I was born.

pawsesThe words provide me with comfort too, especially as I write this post: a dear friend of mine's cat was run over last night. She is devastated, and this comes in the face of a particularly tumultuous time for my dear friend. Life feels so random and cruel sometimes; I’m mulling over the old unanswered question, why do bad things happen to good people? I look at my two beautiful kitty babies playing silly buggers in the lounge and shudder at how quickly a life, no matter how small, can be extinguished.

I love animals. I grew up with cats and dogs and they have been present during profound moments of joy and tragedy in my life. Tiger and whale and komodo dragon thrill me equally. Fish enchant me, though they invariably end up floating belly-up in the tank when I’ve tried and keep them; I’ve realised I have bad aquatic juju. (Not as bad as my wife – she managed to kill a cactus.) Even the tarantula and the anaconda fascinate me, although I’d need Schedule 7 tranquilisers to come close to one of them. As far as I’m concerned, animals have souls. Some of you may might chide me for seemingly equating a feline life with a human one. Feel free. I need to write tonight, and I’m going to explore whether I can justify whether animals have souls.

Regular readers of this blog will know that, try as I might, I haven't been able to conceive of a Universe without there being Something Out There, no matter how in vogue it might be to join Christopher Hitchens and Richard Dawkins’ New Atheism. I bear them no ill will and recognise they pose potently rational arguments against religion. But I believe - see an earlier post here if you want to delve deeper in to my disorganised soul-searching. And I have always believed that animals have souls (and no, we’re not going to fret about whether this applies to tiger or earthworm equally; I don’t know; deal with it.)

Of course it brings me comfort to believe that All Dogs (And Kitties) Go To Heaven. My heart feels this and my brain, bless it, refuses to comment. Both science and a lot of religion would beg to differ, the former supposing it is not necessary and the latter warning me that only Man has a soul.

This is an ancient debate. Aristotle believed that animals did have souls, but only primitive ones, whereas humans possessed a uniquely “rational” soul. Descartes was dismissive of the idea altogether, this stemming directly from his famous statement Cogito Ergo Sum (I think, therefore I am); implying animals were not self-aware, and that the concept of a “soul” for them was unnecessary.

I’m sorry Monsieur Descartes. That is too cold  for me. Here I conveniently turn to religious traditions for comfort. I realise now I don’t need – nor want – proof. I need to believe that the little kitty who gave my friend so much love is now part of something eternal, something beyond my understanding.


In Judaism, it is generally agreed that all created beings have a divine spark in them which is a manifestation of God; this divine spark is considered a soul (however primitive) and is furthermore immortal.

Christianity - starting out as it did as an offshoot of Judaism – follows generally the same belief, however the concept of an animal soul is not stated in any New Testament text that I know of. Islam is perhaps more explicit. In the the Qur'an it reads, “All of Allah’s creation, including the animals, will be resurrected. After Allah has judged between the animals, He will order them to turn to dust” (Surah Takweer 81:5). Buddhism, however, embraces the concept of animal souls directly and unequivocally, asserting that every creature has the potential to become divine through the cycles of birth and rebirth.

But Christian tradition does sometimes push the anthropomorphic envelope quite tantalisingly: consider Saint Francis of Assisi; the Catholic tradition has him as the patron saint of animals. (There is no patron saint of rocks.) St Francis’s Canticle of Creatures is high poetry, calling on “Brother Sun” and “Sister  Moon” (never mind all living breathing things) to praise their God. For those Christians who are Romophobic, the exhortation for all creatures to praise God occurs in the Psalms too - the book actually closes with this very thought in Psalm 150. The Psalms are, of course, revered by all Christians and Jews, whether Catholic or Protestant, Reform or Orthodox. Now, to praise something would mean to be aware of something other than one self, and this implies self-awareness, and… you see where I’m going. Call my definition of soul a desperate cherry-picking of logic, but it makes me happy. And while there are no equations for happiness that I know of, it takes a nanosecond for my soul, if you like, to assume that any God it would believe in wants me to be happy.

As an aside, I think people who are allergic to existentialism forget that the philosophy is not incompatible with the concept of happiness. Rather, I think Sartre, Camus and Co. urge that we have to create (what a loaded word) our own happiness in order not to go insane in an absurd reality. But the Absurd doesn't have to be so utterly depressing. From my limited perception as a human being, locked in three dimensions of space and a fourth of linear time, an absurd reality may sometimes be heartbreaking, but it is also very frequently hilarious. Is this not the same as "The Lord giveth, the Lord taketh away?" Why does black humour come so naturally to us when the existential chips are down?

My favourite author, Douglas Adams, put it beautifully:

There is a theory which states that if ever anyone discovers exactly what the Universe is for and why it is here, it will instantly disappear and be replaced by something even more bizarre and inexplicable. There is another theory which states that this has already happened...

(All this from a self-professed atheist who - unwittingly, or in a mammoth exercise of poking fun at himself - wrote one of the most spiritually moving books I have ever read, The Hitchhiker's Guide to the Galaxy. I just love the fact that Douglas ended up having an Anglican funeral for all his atheist sensibilities.)   

I could go on and on, and so often I do. But before I stop I have to mention the astonishing account of Temple Grandin, a respected professor of animal behaviour who is also a highly functioning autistic. Before autism was described as a medical / psychological condition, many traditions would have labelled an autistic individual as… soulless.  Grandin’s bestselling book Animals in Translation tugs at both brain and heart-strings: she discovers her own humanity (and her soul?) through her work with animals.

So what can I conclude? Not much, except what I feel, and my mind - still - is happy to shut up. And what I feel is this:

If a single purr from a single kitten can flood a single mind with warmth and fuzziness, surely it’s immaterial whether this is purely a cocktail of serotonin and dopamine tricking the brain, or a ripple of love traversing a cosmos that actually gives a damn. And if this fellow creature - fashioned like me from gnarled strands of DNA and proteins that look like coral forests - makes me stand in ancient awe, damn straight it has a soul.

So I say this on behalf of all those who have lost a loved one, whatever the amount of chromosomes they possessed when they flashed their divine spark across the planet.


Exaudi orationem meam;
ad te omnis caro veniet.
Requiem æternam dona eis, Domine,
et lux perpetua luceat eis.

(Hear my prayer; unto Thee all flesh shall come. Grant them eternal rest o Lord, and may perpetual light shine on then.)

Friday, March 18, 2011

The Migraine In Spain Stays Mainly In The Brain

Some of you have been wondering why I’ve been posting so regularly when my final exams are just days away - Tuesday the 22nd to Thursday the 24th of March, to be exact. Surely I should be devoting this time to revising? Fact is, I always feel more creative when there are more Grown Up Things To Do like passing exams or rites of passage. (You should have seen the bad poetry that spewed forth when I got my mortgage approved.)

I think I 'm writing so much more  because my brain is full; and full of exactly what I don’t know. I hope I’ve absorbed enough facts to regurgitate into passable answers for the nine hours that await me next week. I’m drawn to rattling off blog posts probably in an attempt to disperse some nervous energy. My family know me well – when stressed, I can run around the house talking to myself like a Looney Tunes character, so blogging is probably a more socially acceptable option.

In case you were wondering, my mental state is, I guess, like all people facing a final professional exam – suitably miserable. For non-medical peeps, the College final is essentially your professional board exam in your specialty, once you have it and your four to five years of clinical postgrad training are complete you can register as a specialist.

Having said that, I’m strangely calm this weekend. One thing about an exam like this is that you can’t cram for it, it’s months of slow slogging, a very, very long bout of attentive reading. If I have one bit of advice to anybody attempting something similar is: SLEEP IS YOUR FRIEND. I’ve had to learn the hard way. Being a bit of a night owl, used to surfing the net and watching Cartoon Network till 2 am, insomnia crept up on me insidiously during the past year and – until day Iwas  looking and acting like a zombie from The Night of the Living Dead

And bad sleep is almost worse than no sleep. My wife has had to be a sergeant-major in forcing me to adopt a strict sleep hygiene regimen of regular hours (as far as is possible when one is doing night calls at least once a week) and taking “time-outs” to meditate. Even so it’s been necessary to supplement with pharmacological help. I dislike the idea of sleeping tablets but at the moment it’s the lesser of two evils. And then there are the migraines, that zoom to a bout of insomnia like flies to carrion. It’s always amazed me how something so excruciating ends up being temporary and – from what we know – harmless to the body in general. I always think I’m about to die. Even in their milder forms, my attacks (which are fortunately usually rare) feel as if a demonic pixie is water-skiing inside my skull, pulling on my optic nerve as it slices through the choppy seas of my throbbing head.

I can really sympathise with Francisco Goya, the great Spanish artist who, it is said, also suffered from crippling migraines. Many think that his darker, fantastic visions were painted during an attack, or at least inspired by the hallucinations that can sometimes accompany a migraine’s heralding aura. I’m particularly fascinated by Goya’s wonderfully nightmarish El sueño de la razón produce monstruos (The Sleep of Reason produces Monsters). It’s one of the 80 etchings entitled Caprichos  in which Goya “[condemned] the universal follies and foolishness in the Spanish society in which he lived.” (Wikipedia). I see him taking a jib at “civilised” society and demonstrating how reason is but a thin crust on top of a seething core of dark energy. (For those of you who might have noticed, I’m borrowing the term dark energy from astrophysics deliberately  – hmmm – that seems to deserve a blog post all by itself…)

Let’s look at the etching more closely. It’s considered a self-portrait, with Goya having fallen asleep at a table. A dark army of bats and owls, supposedly representing ignorance and foolishness, swirl around him menacingly. Is this a cautionary tale about the dangers of losing one’s grip on reality? Or, is it possibly a brutal reminder of the energy of the creative process?

Certainly in my case sleep (or rather the lack of it) has raised a lot of bats and owls of their own. Perhaps I could ask them to rather hover around my blog posts while the countdown to exams continues. Just for now. They can flock right back when I’m done and produce as much bad poetry as they like.

And now off to bed. I was last looking at a paper on the Cockroft-Gault equation for predicting a patient’s kidney function and that’s already enough for a full weekend’s supply of nightmares.

I hope you all sleep better than I do! 

Wednesday, March 16, 2011

Teuflische Schadenfreude

I'm furious and on my high horse. In the wake of the horrors that have struck Japan in the past few days, there are actually people out there saying "serves you right" to a nation reeling in shock. Just yesterday morning on the Gareth Cliff show some silly woman who evidently has tapioca pudding for brains proudly stated that the Japanese were getting their (ahem) just desserts because of their "cruelty". It of course never occurred to her that almost every other nation in the world has at some time or other been Satan's little helper in the treatment of their fellow man. Other fuckwits are intoning similar attitudes, citing Japan's whaling policies or ecological record as the cause of a monstrous karmic payback.

Of course. It makes such sense now. As if busloads of Japanese senior citizens go on daily dolphin-clubbing excursions. As if Japanese children are trained to be ninjas from kindergarten. Following this logic Spain should have been drowned by floods for the Inquisition. (The Rain In Spain, you see...) The Earth's very crust would by now havbe exploded open and burnt Great Britain to a crisp to atone for the evils of colonialism. Germany would be toast. Why, South Africa must be on constant astronomical watch for that giant meteor that's going to impact on Orania, any day now, to pay for the atrocities of apartheid.

Humanity would have ceased to exist millennia ago if there were a blood debt to be paid for all the things our species have done to the Earth and to each other. The Universe, fortunately in this case, has bigger cosmic fish to fry. Spare a thought for the cosmos; it must be exhausting keeping the total amount of energy in your system absolutely constant. That said, it must be even more exhausting to find pleasure in other people's misfortune.

The Germans have that wonderful word, schadenfreude. The philosopher Artur Schopenhauer is famous for his statement,  "Neid zu empfinden, menschlich, Schadenfreude zu genießen, teuflisch." (To feel envy is human, to enjoy schadenfreude [joy in the suffering of others] is devilish.) Unfortunately we're all guilty of it. Note that Schopenhauer says the evil is specifically in enjoying our pleasures in others misfortunes - who hasn't rubbed their hands together in glee when misery overcomes our enemies? I would go as far as to impose a statute of limitations on Schopenhauer's statement - sorry, but, wouldn't many of us be happy to be teuflisch to see a child molester deep-fried in oil or a rapist's offending bits be cut off slowly? It's very hard to live up to the teachings of the great religious figures to submit our rage and ego to a higher power. But I'm still shocked that people like that caller could paint with such broad brushstrokes.

Then there's the case of Christopher Hitchens who is dying a painful death from cancer. He's a prominent atheist, the author of the bestselling God Is Not Great: How Religion Poisons Everything. And there are people calling themselves Christians who are delighting in the fact that he has cancer. They see it as divine punishment. I bet they're just waiting for Richard Dawkins to get crippled by some awful degenerative disease. It freaks me out how these so-called Believers can get so drunk on self-righteousness that they wish a fellow human being a painful death... while at the same time espousing a religion of peace and love! Ironically, they're furthering Hitchens' cause by making the theists look bad. It almost makes me ashamed to say that I believe in God. Almost. Until I realise that we're obviously not believing in the same God.

Verily, man creates God in his own image. Perhaps some of us feel the need to rain down righteous anger because we have a pathological need for order. We crave answers.
We ask, "Why Japan?"

If the Universe replied "because they deserve it" we'd have a reason not to worry any more. It would be so much easier.

But the Universe always replies the same thing to every question: "Why not?"

Why not indeed? So - to try and attempt to turn the other cheek as it were, perhaps these people who would assign blame around every corner need love and understanding.

Then again maybe they're just assholes and I'd love to have them go through all the horrors that the people they condemn have endured...

Oops. Schadenfreude.

Sunday, March 13, 2011

No Greater Sorrows

nell
There is a wonderful scene in the film Nell in which Jodie Foster’s character is the subject of a hearing to decide whether she needs to be institutionalised. (Nell is a woman who has grown up in a remote wooded area with no human contact apart from her disabled mother, who has a severe speech deficit from a stroke. As such Nell speaks her own unique language and has difficulty integrating into society after she is discovered by authorities after her mother dies.) A doctor (played by Liam Neeson) who has learnt to communicate with her, acts as her interpreter. In exhorting the review board to let her be and let her live her life contentedly as before, Nell urges:

Don’t cry for Nell… I have no greater sorrows than yours.

I’m aware that the words “Don’t cry for [me]” are already famous, but I’m definitely not wanting to evoke images of a certain Andrew Lloyd Webber musical. I’m referring to our clumsy capacity as human beings to confuse sympathy with empathy.

The doctors and psychologists and social workers argue that Nell is emotionally traumatised and socially retarded, needing specialised care. They see Nell as a problem to be solved. The wolf-child, as it were, who must be civilised. And not gently either. Granted, the film is deliciously manipulative in showing us Nell living a life of Arcadian seclusion in the stunning wilds of the Pacific Northwest. But the film doesn’t paint the establishment as a totalitarian regime either – indeed, Liam Neeson’s character is a down-to-earth, strait-laced GP who acts as a bridge between Nell and the outside world. Nell’s character is lucky, because we have a Hollywood ending. In reality she would have ended up at best as a “special needs” social case and no doubt as someone’s PhD thesis. Yet her exhortation to her would-be “protectors” haunts me: I have no greater sorrows than yours. So don’t feel sorry for Nell, don’t cry for her. Try to understand, yes. Co-exist, yes. But that is, we know, so much trickier than “solving” a problem.

Clashes between worlds are inevitable, but I think the reasons can differ. Evil aside, often we act out of fear, sometimes out of sympathy; I put it to you that results can be similar: tragic. The road to hell isn’t paved with good intentions for nothing. Sympathy is all too often clinical; when faced with someone in circumstances other than our own, we convince ourselves that we can feel the same things as that person, yet assume we know better because our reasoning is superior. I don’t have to elaborate on the myriad examples at my disposal: wars, genocides, oppressions of peoples that in so many instances began as misguided forms of protection. Just think of the protectorates the British Empire founded. (Who or what did Bechuanaland need protection from?!)

Empathy yields better results - but this is only, of course, accessible to those who have undergone similar circumstances. When my father died there was the obvious reverberation of the words “I’m so sorry” around me. While I am eternally grateful for all the support my family received, the words that will always remain with me are from my cousin, who simply said: “You don’t have to be strong. Just feel what you need to feel.” As it happened, I was numb while everybody else seemed openly grief-stricken, sobbing and keening. Everybody thought I was so “brave”. Later I convinced myself I was a cold-hearted bastard for not shedding a tear and lived most of my university years feeling like an emotional fake, not considering that grief is a shapeshifting process. It was only in therapy with a very patient psychologist that I finally “forgave” myself (there was nothing to forgive) and my cousin’s words appeared, like a prophet on a cliff with arms outstretched, giving comfort, and I remembered. I was trying to feel how others felt and hadn’t acknowledged my own emotions.

If I were to really look unflinchingly at my motives for feeling sorry for something, I would probably see a whole lot of guilt poisoning a good intention. Guilt that I am in a better position for whatever reason, for example. Let’s take the horrors that have struck Japan this week. I see the reports, watch a few YouTube clips in morbid fascination and now, as I type this feel guilty about carrying on with my daily life. Herewith a live transcript of the snowball of my Catholic guilt rolling down the hill of my brain:

…Is there anything I can do? I could perhaps join Médecins Sans Frontieres and help out. But I’m not, I am writing final exams next week. I could donate online. Have I? No. And if I did, why haven’t I done so before? What about all the local charities that could use my support closer to home…

The thoughts could (and momentarily do, sometimes) paralyse me. But there is something I can do. I can realise I’m not responsible for the Sendai disaster. I can realise that the average Japanese victim does not begrudge me being spared, living as I am on one of the one of the most geologically (if not politically) stable spots on the planet. And, maybe, without channelling geriatric Disney choruses, be more grateful for each fleeting moment of my life.

I guess it is like all the Great Clichés in life: All About Balance. And balance is effing difficult. If we run away from tragedy in fear and loathing we risk isolating ourselves; if we jump in blindfolded we can become drunk on our own emotions. Think of true victims of molestation too afraid and ashamed to seek help vs. all the false accusations generated from fake repressed memories. True survivors are astonishingly strong people – they don’t need anyone to feel sorry for them…
As D.H. Lawrence said:

I never saw a wild thing sorry for itself.

Friday, February 25, 2011

The Pleasures and Sorrows of Humiliation

I can never sleep on call. And I can never win: if the night is busy, with one emergency bleeding into another, I'm utterly miserable by 3 am, lusting after sleep like Garfield after lasagna and swearing at the (equally exhausted) surgeon for daring to question my iPod playlist. Conversely, on a rare call like tonight when Cape Town seems to be behaving itself, do you think I can get some shut-eye? Hell no. The hamster in my brain sees it as a clear sign to resume training for the Insomnia Olympics. I just realised I finished anaesthetising an appendicectomy at 1 am and now I've started this post past 5. I tossed and turned in the on-call room for three hours until giving up and trawling Wikipedia for essential information like the geology of Oceania and why the Turkish language could be related to Korean.

It's not that the on-call rooms are uncomfortable. I seem to have a knack for fund-raising and recently helped our department source hotel-quality beds for the registrars on night duty. (Frankly, I found it perverse that those who keep others asleep should be denied comfort in the rare chance they themselves could sleep.) For some reason, when a work night is quiet my body reacts as if I've won an espresso drinking competition.

I think it's remnant post-traumatic stress from med school where as a fourth-year I was thrown in the deep end during my first (and worst) clinical rotation and was brutally torn apart from the joys of nightly oblivion for the first time in my life. (There's a small scared voice running around in the labyrinth of my subconscious, feeling guilty because there's actually no work to be done for the moment.)

Let me take a deep breath and revisit a derelict side of Memory Lane. My fourth year obstetrics block was like being locked in a lurid Twilight Zone episode directed by Aronofsky, Hitchcock and Kubrick simultaneously, with a screenplay by Stephen King and shot in bad 80s direct-to-video transfer (for that extra fluorescent shine).  Contrary to popular belief, interns are not always the lowest form of life in the petri dish of medical academia. Not when there are students to abuse, as was the case at my alma mater.

In the labour ward, fourth years ran around in Shock and Awe, years before George W.'s regime used the words for military strategy. On paper we were supposed to assist and observe x number of deliveries. In reality our job was to do... everything, certainly everything boring or demeaning or exhausting, while being crapped on by the entire hierarchy. And no matter how efficiently you tried to do it, you'd be made to do it again, and then, when you thought you could finally sit down and possibly close your eyes for a bit you'd be made to do something inane to keep you awake - and everyone else went to bed. Our intern whom I remember as Mr Slick - he bathed in hair pomade - seemed to spend the entire call smoking and chatting up nursing staff - who, at this particular unit, were permanently on tea - pausing briefly to check up on (translation: rip to shreds) the 6th years who admitted new patients (actually, the intern's job). They in turn, riled and humiliated, would do everything in their power to make the youngest and most vulnerable students feel smaller and more fleeting than an antiparticle in a bubble chamber. All of this usually in front of a patient in labour. (On rare moments the registrar would appear to dispense wisdom to the intern.)

I'm not complaining about any of the actual work, understand, I'm just a little sore that since joining a different medical school for postgraduate study I've seen students (and interns) treated like... gasp... human beings for a change, and, shock, horror, they haven't automatically devolved into jellyfish for not going through some inane hazing ritual. There has been a sea change in the past decade with a gradual and refreshing realisation that letting exhausted medical personnel loose on patients is not perhaps the best standard of care. In my field it's been in practice for a while now. In the EU they've gone to the other extreme, with complicated working time directives regulating hours so strictly that trainees are not getting enough experience.

Not so when I was a fourth year. The final year students then, enjoying their first rush of superiority, were particularly cruel to their minions (us); it was high school all over again and we were newbies doing tricks and running errands for shits and giggles. Worse, it was a cowing conga-line of contempt: the intern would do the same to the final years, and the registrar to the intern, right up to the Professor broadcasting fear even as he slept in a hotel room thousands of miles away on some international congress. The law was a reversal of the Golden Rule: do it to others as it had been done to you. And so a succession of gradually lightening humiliation ensued until one day my undergraduate studies were over.

The sum of all these fears is that I don't remember anything about those twenty or so babies I delivered but instead a simpering tide of criticism and pettiness. The question was - would I do the same when I ascended the ranks to 6th year, intern and beyond?

No. And not that I'm a morally superior head boy either. Fate would have it that on my first final year call for obstetrics I pricked myself with a needle while assisting for a Caesarean section with an HIV positive patient and spent the rest of the block spaced out on antiretroviral medication and anti-emetics to counter the rolling waves of nausea they caused. There simply wasn't enough headspace available to even consider that there were others to humiliate. For whether the cocktail of AZT and 3TC fried my dictatorial neurons or not, I've never pursued the role of Great Dictator in any clinical scenario. Even today I am a Type B island in a Type A world. Difference is, where I am now - a thousand miles and seeming years from those student years - I'm generally tolerated; and the very least I can do is tolerate back.

Even if a student clearly doesn't even get basic physiology when you're metaphorically hitting them over the head with a textbook while trying to keep a patient asleep.

Even if a colleague interprets my lack of screaming and shouting during an emergency as being disinterested in my profession. (I may be disillusioned, but I've never thought I don't care.)

Even if all this is just a case of protracted sour grapes. If so, I think I've digested them well.

It's great getting this out there. It's going to be even greater to get into bed...

Wednesday, February 16, 2011

A Pale Blue Dot

Perhaps because I've been studying all week, buried at almost atomic level in cellular processes from "mitochondrial failure" and "remote ischaemic preconditioning" (it's ok - only I have to know about these things seeing that I'm just over a month from my final specialist exam... eish!) that my mind is urgently wanting to pan out, as far as possible, from inner space to outer space. And what I'm left with is a sense of smallness.

Consider the incredibly moving picture of Earth, taken at a distance of 6.1 billion kilometres by the Voyager 1 probe as it reached the edge of the Solar System in 1990. It's become famous as the "Pale Blue Dot", and that great man, Carl Sagan, campaigned tirelessly for it to be taken. Before entering interstellar space, Voyager turned its cameras back one last time and snapped this astonishing image of the tiny world it was sent from. We really are just a pale blue dot in the vast seething mass of the galaxy. As Sagan put it:

That's here, that's home, that's us. On it everyone you love, everyone you know, everyone you ever heard of, every human being who ever was, lived out their lives.


... Think of the rivers of blood spilled by all those generals and emperors so that, in glory and triumph, they could become the momentary masters of a fraction of a dot...[our] posturings, our imagined self-importance, the delusion that we have some privileged position in the Universe, are challenged by this point of pale light. Our planet is a lonely speck in the great enveloping cosmic dark. In our obscurity, in all this vastness, there is no hint that help will come from elsewhere to save us from ourselves.

Perhaps for some, this evokes angst and loneliness; for me, however, our utter insignificance in the Western Spiral Arm of the Milky Way instills a great slow wave of awe. I am moved that we are placed, by evolution or a great deity (or, as I believe, both) on this Goldilocks planet, blanketed by a Universe that is ever expanding, while we hold the power to destroy or nurture our little bastion in the infinite. No-one can look at the stars and not wonder the primal, protean why in their marrow. I would go as far as to posit that this very thought unites atheist and believer, man and woman, scientist and proselyte, bunny-hugger and banker-wanker.

If we gaze deeper and deeper into the inky void, perhaps we could find comfort in E.M. Forster's words... "at the side of the everlasting why, is a yes, and a yes, and a yes." And even if the Universe gives us no clear answer, we will realise more and more that until, say, Kal-El crash-lands from Krypton there is nothing but ourselves. More humbling is that even without us, the Universe is not empty: physics has discovered that energy lurks, phantasm-like, in the very vacuum of space.

Could I go as far as to say that evil exists only because potential goodness never craned its head up and saw that vast silence? Or that, frightened and obstinate, it resolved to gaze at its feet instead? We will never know. But we can swallow our pride and yield our fear, and, one night, perhaps lie back on the grass and let the stars move us.

Wednesday, February 9, 2011

More Medical Mayhem

I'm (pleasantly) surprised that you all would find my misadventures as a patient entertaining. To continue, the sutures were barely a day out from my head's unfortunate encounter with our bedroom door when fate decided to zone in on my right index finger.

It was New Year's Eve and I was the lucky sod on call for a certain hospital that I can't name, suffice it to say that it's neither a private nor civilian institution. Ahem. I had always suspected that those working in the interests of national security are of a different breed... this was to prove an underestimation when I met my arch-nemesis.

It was hate at first sight. Sister X loathed me from the tip of her faux Crocs to the top of her badly-crocheted theatre cap. Her pasty complexion flushed peuce and her tiny dormouse eyes switched their built-in passive aggression beams to "kill" every time I entered her gaze, contorting her doughy face into expression that I like to call "The Blancmange With Teeth".

I could never do anything right. Whether I'd forgotten to put on my mask (contrary to popular belief, several studies have shown that only personnel directly over a surgical site have to don a mask) or a shoelace was a tenth of a millimeter too long or I'd forgotten to initial some copy of a copy of a form in triplicate, this Nurse Ratched on steroids would notice it and bark her disapproval. Did she have a vendetta against all doctors, or did the Spider-Man stickers on my textbook recall some traumatic memory? I'll never know.

While I resolved to make peace with her enmity, I was left speechless by her vitriol when I was on call on New Year's Eve... barely a week after my fateful encounter with the bedroom door that I rattled on about in my previous post. I arrived in the early evening for a minor surgical case and chose to ignore Sr X (who always seemed to be on duty with me) while I saw the patient and prepared theatre for the case. Soon the patient was on the table, monitors attached and ready for me to send him off to oblivion when I remembered one drug still had to be drawn up, so I reached for the ampoule and snapped it open... why I did it with bare fingers, and not in the usual safe way by covering the glass top with the edge of my shirt as I usually do, I don't know.

I can still see it happening in slow motion in CinemaScope, but minus the cheesy Vangelis soundtrack from Chariots of Fire: the ampoule shattering into a kaleidoscope of shards like the planet Krypton finally yielding to the wrath of Zod; the largest shard slicing through my finger and the blood cascading forth in a small crimson fountain. Ok, not really a fountain but I'd sliced the tip of my index finger to the phalanx and I was soon looking like an extra from the prom scene in Carrie.

The poor patient nearly got up to help me. "Are you ok doc?" he asked - bearing in mind the poor man was in significant pain of his own. Sr X, already scrubbed for the case, stood silent, glaring, aiming her alcohol swabs at me as if they were flamethrowers. Several other nursing staff scattered around helpfully fetching bandages and making sympathetic noises. But first I had to get the bugger of a shard out.

The air-conditioning warbled slightly: Sr X spoke.

"Is this going to be long, doctor?" she said icily.

I was flabbergasted. What would get a sympathetic word out this dragon? A dagger through my eye or a telephone pole in my aorta? I shrugged, disengaged from my instincts to utter a stream of profanities and instead gave my own death glare back (usually reserved for projectionists who get the focus wrong during a movie) and excused myself from the theatre, leaving a trail of blood behind me like a scene from a bad detective thriller. In the scrub room I yelped as I got the shard out under running water. It would need sutures. But the case had to be done now. Fortunately the posse of nurses - evidently insurgents disobeying Sr X's totalitarian rule of the theatre complex - arrived with an armamentarium of bandages, gauze, swabs and crepe. Five minutes later a pressure bandage had been assembled around my poor finger and I walked triumphantly back into theatre.

The case proceeded uneventfully, with the patient - bless him - asking me on awakening if my finger was ok, never mind his own condition!

But the hospital had no idea to help a civilian injured on duty. There were too many forms to complete and they'd need authorisation from A who'd have to have it ratified by B who needed to countersign C and fax it to D who was in Pretoria and on leave. Enough was enough and I informed my consultant that due to a horrible ampoule accident he'd have to cover the call for two hours while I got myself sutured ... at the same hospital I had my head seen to on Boxing Day!

I was hoping the pressure bandage would be enough, but the SCW (Sexy Clever Wife) took one look at the wound and shook her head. So off it was for another bout of suturing. I wondered what accident I'd be having next.

An ancient but affable physician sutured me. It appeared to me that he'd last put in sutures during the sixties. It took a while, and the lignocaine hurt like ten circles of hell going nuclear simultaneously, but I didn't care as the SCW dosed me up on a cocktail of tramadol, paracetamol and diclofenac (Power-Myprodol, we like to call it) reserved for really really bad pain days like the migraines that strike me four or so times a year or when Chiv's back decides to flare up like a row of cheerleaders with gaudy pom-poms,

Both the trip for the head and then the finger surgery set me back a cool R2 000. And of course, like most medical aids, they don't cover casaulty cases except if you have savings.  Grrrrr.

But I would have the last laugh on Sr X.

The next day my war wound practically became a purple heart. Is it something about men in uniform who are injured that makes women all broody and caring? I practically had my own harem for the day, running errands for me, enquiring whether I lost a lot of blood or whether the sutures were painful, supplying me with care packages of coffee and rusks. It was awkward at first but quite pleasant for my ego. From her Dark Cave of Evil - sorry I mean office - Sr X watched with displeasure etched on her face.

Relaying this, I had to restrain the SCW from driving in from work and giving Sr X a snotklap. After all, in a few weeks I would leave this Gormenghast fiefdom and be back at the great, lumbering, happy, amazingly efficient chaos of my home teaching hospital - where doctors and sisters have minor hissy fits over silly things but share big hugs and rude jokes, and music plays in theatres and no-one thinks twice about a graphic novel or Sudoku compendium or the Confessions of St Augustine being on the anaesthetic machine next to the BJA and other august journals, provided the job gets done.

We are so shaped by the people we work with. I wonder what Sr X is doing now? Perhaps she has a secret lair next to the oxygen supply bank deep in the bowels of the hospital where she hacks into governmental agencies and feeds WikiLeaks their prime fare. Or is she training an army of nurse fembots who will go online during the next solar flare and eliminate all men? Or crocheting a blanket made of cyanide-laced spider silk and wool from her late Alsatian called Beelzebub? One will never know... but I'll be there, like Chloe in the Watchtower in Smallville, keeping an eye so that the streets of Cape Town will never be brought to its knees by the terrible wrath of her Total Passive Aggression! [cape flaring, standing on top of the Cape Sun building with badly scrawled "S" on T-shirt, peering queasily down the edge and wishing he had a double whisky before he attempted this stunt]

...fade out to the titles and rousing John Williams soundtrack...

Thursday, January 13, 2011

Something for now: Medical Melodrama No. 1

Aaah, my poor famished readers (irony ringing very loudly here – all I can say is, if you’ve bothered coming back here, I’m very humbled) – here’s my first post of 2011.

It was nearly written to pass the time for an overnight stay at the local hospital for a vicious bout of gastroenteritis, which must have been a bacteriological immaculate conception, as everybody else in the household are poster children for a spa resort. It has been my third medical drama in as many weeks. I might as well spread it over three posts, as I’ve just heard I’m being discharged and won’t be rattling off self-indulgent tales on a gurney all night long. If you really must know my progress, my friendly doctor who is – grumble – younger and more handsome than I am – is satisfied I am adequately rehydrated and the normalising salt content in my urine shows that I am handling fluid - if not thoughts - properly…

Boxing Day, instead of being the pleasant nadir of the Christmas gorge, turned out to be a bloody comedy of errors when I bashed my forehead against the edge of our bedroom. What I remember most about the moment my skin split open was not the pain or the blood but the protean rage I wanted to direct at the door, making it and every cheaply-varnished, badly-planed wood fibre of its being feel sorry for ever being the ugly eyesore that I’ve been meaning to rip out and replace with a proper Orgeon facsimile for months – as if it really were the doors fault. I pictured the infamous scene in Fargo with the wood-chipper and – ok, chipping an item of wood with a wood-chipper – not as funny as I intended.

Whatever reflexes that were suppressed, thank God for those neural tracts described as “descending inhibitory pathways”, or, “anti-moron-wiring” as I’d like to call them. My clever wife did the best thing and applied so much pressure (aren’t wives supposed to do that anyway!) with her dressing that by the time we arrived at casualty all the bleeding had stopped.

But oh the drama and idiocy that played out at the local private hospital’s emergency department whose name I won’t mention except to say that it’s in this general area. Ok, it was a public holiday and the doctor working the afternoon shift had cancelled. But here is a summary how the scene played out:

The author enters the waiting room of emergency unit supported by his wife. His head is bandaged, blood is clearly visible around the injured area. The waiting room is empty except for a security guard, a patient being discharged by nursing staff, and a receptionist playing Solitaire on the computer.
RECEPTIONIST:    [not looking up from playing Solitaire]: Yes?
ME: Hello there. I need help. I’ve injured my -

RECEPTIONIST: What medical aid are you on sir? [Wife’s jaw drops open. Author
sighs. ]
ME: It’s a hospital plan, so I’ll pay cash if I’m not admitted. As I was trying to say I’ve lacerated my forehead and I think it will need suturing. I’m feeling a bit dizzy so I’d like to lie…
RECEPTIONIST: It will be a deposit of R1250 plus around R500 for suturing and any other extras. 
ME: [irritated]. Yes that’s fine, could I please be seen to? 
RECEPTIONIST: [shoving forms across desk] Please fill these in. 
WIFE: [furious and shrill] For heaven’s sake! Can he at least lie down? I’ll fill in the forms! I hate to say this, but we’re both doctors and he’s hit his head so I think that’s more important right now!
RECEPTIONIST: [raising eyebrows] Ooh, are you doctors? Very well then. [saunters across room, pokes head in casualty door and mumbles something.] Just be patient sir, someone will help you now. Doctor is just busy.

10 minutes later, author brought inside casualty onto gurney, given tetanus shot and wound cleaned and inspected by nurse.


NURSE: Ooh, it’s quite a deep laceration. 
ME: I had a feeling it would need suturing. 
NURSE: [worried look]. Ooh, no, the doctor here doesn’t put in sutures. 
ME: What do you mean the doctor doesn't put in sutures?
NURSE: Ooh, no, he doesn’t like to do it. We’ll have to call in a plastic surgeon.
ME: [blistering] A plastic surgeon? For a simple head laceration?! 
NURSE: Oooh, yes, we’ve got a very nice plastic surgeon here. I can call him. On the other hand if you don’t want a plastic surgeon, I can glue it, it doesn’t look too deep actually doesn’t it? [pads away at wound] 
ME: [flabbergasted] How would I know? Could a doctor at least see the wound so we can make a decision? [gathering up flair for the melodramatic] I mean, let’s at least make double sure my brains aren’t leaking out! 
NURSE: Ooh, well isn’t your wife a doctor? 
ME: [slightly confused] Um, yes? 
NURSE: Well why don’t I call her inside and let her decide. Maybe she can suture you?

Ten more minutes pass by while author is given tetanus shot, but left speechless wondering about the fate of poor patients who are not medical professionals. Too stiff upper lip to walk out and go to other hospital, he and wife get plastic surgeon on phone.


WIFE: Dr S says he’ll happily come through and suture you up. 
ME: [placated]. Ok.

Casualty doctor waddles in from behind curtain. A small, bronzed creature, resembling a spray-tanned trilobite in a white coat. He speaks without punctuation
CASUALTY DOC: Hi hi hi hi I see you’ve gone and bashed your head open let’s  have a [cell phone rings] oh hello there good to hear from you [wanders off behind curtain babbling on phone]
WIFE: [flabbergasted] What the f-? Thank God the plastics guy is coming to fix you. 
ME: I know. How rude.
RECEPTIONIST: [from behind curtain] Excuse me sir, but what did you last have to eat and what time was that? 
ME: Huh? I had a burger and chips two hours ago and – wait a minute – what the hell? I don’t need to be starved for sutures under local! 
RECEPTIONIST: [nonplussed] Ooh, no sir, the anaesthetist will have to see you, and if you ate now, you can only be done after 10 pm. 
ME [indignant] Why the hell do I need a general for a few stitches? I am an anaesthetist myself! 
NURSE: [helpfully] Ooh, the plastic surgeons don’t like doing their cases under local, you see. 
ME: Get me out of here!

This is, alas, not fiction! Needless to say, we stormed out of that particular casualty and headed for a hospital at a more southern latitude in the Cape Town suburbs. However, a mutual decision was made to first go home again,  let the wife do her hair and then meet a friend for drinks at their favourite spot.

PARTING SHOT


Later, the same evening, at a bistro in Constantia with close friend. Author looking much better, wound neatly sutured (total turnaround time at hospital no 2 less than 45 minutes, despite it being very busy) and clearly enjoying himself.


WIFE: Well, baby, that was stupid now, wasn’t it. 
ME: [sipping wine, munching pizza) I know. I should have looked when I got up.
WIFE: No, you idiot! How the hell am I going to know if your consciousness drops because of the head injury or because of the combination of alcohol and painkillers? Oh God, I’m becoming such a Southern Suburbs housewife…

I’ll continue with my next medical soap opera in a while, studies permitting. It’s been great having these few hours without an excuse to study for the looming Part 2 exams since I’m still recovering.

Peace to you all and may 2011 bring you blessings, peace and abundance.