I listen to miserable stuff because misery is a feeling.

Mystery and magic

I could use a bit more mystery and magic in my (personal) life.

Work life is full of mystery- why is the potassium dropping, how do pneumatic pods work......among other things. Magic abounds- how people get well when we've done absolutely nothing and how some people look so well when their blood tests look so bad.

The day-to-day on goings are far more mundane. There is little sparkle, only cold. Le garçon is nowhere to be seen; i eat lots because R* has to have 3 breakfasts, 2 lunches and tea. God knows what he eats at home. And he's complaining that he's losing weight. I'm barely able to keep the weight off, that's with lots of pills and exposure (to the cold, burns more calories)

I guess you could call it mystery: where has le garçon gone? Did he see me in town? Does he think my bum looks that big in those trousers? There is a little magic as well- my seniors bought me lunch that day and i bumped into my housemate's crush's best mate today- who i cordially invited to our Christmas party. He said he'll bring himself and housemate's crush along. Well done Liez!

After sunday's incident housemate think's i'm a total social retard. Hence the congratulatory note; to myself.

Actually, i'd settle for more magic. Mystery makes things complicated.

* I work with R. We are 2/3 of the surgical house officer team.

Oh, oh.....and music. Listen to this. It's amazing. If you have uber-amazing headphones that pick up on every sound, put them on.  This is a slow build eargasm. The video is pretty too.

When somebody wants something, the whole Universe conspires in their favour. The warrior of light knows this.

- Paulo Coelho, Manual of the Warrior of Light -

I take a deep breath as i ask the Universe: let me have this one.

I will not let this one pass. Because i deserve this, because i want it. I will not say no when the Universe gives me the opportunity- i will embrace the chances im given.

I will be brave, i will be bold.

I will be fearless- there is nothing to lose. 

And she asks, "IS THE SOMETHING WRONG WITH YOU?!!!!"

I was wearing my spotty woolly tights, my warm 'burlap sack' multicoloured, striped big jumper, purple wellies and my hobbit cape.

Happy and filled with buying-the-perfect-gift promise i walked along the highstreet.

And there you were, in my peripheral vision. Well i think it was you. Standing alone in the cold, smoking.

I hesitated. It took me half a second to kick the proverbial cute big-eyed gift puppy into the gutter.

I walked away. It took me about 10 seconds to regret it. Too late, I can't walk back.

At least i got gifts for my dad and brother. Shit, i forgot the chocolates. Oh fuck. *Double face palm*
There is something wrong with me.

Love

if you ask me why i do anything.....i tend to say, 'for love'.

Have you read Love in the Time of Cholera? It's a lush book- reading it is like drowing in treacle and honey- slow and sticky sweet.

What i liked was that he loved all of them- not in the same way, but it was love. It's difficult to say what love is- a mixed bag of affection, sexual attraction, adoration, loyalty, trust, camraderie, friendship.....and whatever else.

and when i say i do it for love- it means i do it because i want to make you and yours happy. You being happy give me a sense of joy and purpose in the world.

And this is why i love.

Mushaboom by Feist. When i hear it i think of you Shazzers! It's my sunday morning tune today. It's blanketed white outside, gorgeous snow!

Dharma

I bumped into the concept of dharma recently- having always believed in the laws of karma (my own personal interpretation involving the wisdom of God and 'fairness' in everything that happens). 

What i knew of dharma was nothing except the show Dharma and Greg where Dharma was the hippie blond chick with the straight laced guy.

Apparently the Bhagavadgita has an in-depth explaination of dharma (which i have yet to bring myself to read- thanks for the copy, Wenxian).

Since i take explainations that i like (and somewhat ignore those i dont), im gonna go with this one.

There are 3 paths of salvation- one of them is dharma. It's fulfilling one's role in the universal scheme of things- following a personal path that will lead to personal salvation as well as upholding 'rightousness'; within that maintaining harmony in the world.

There is a deeper explaination of dharma- as meditated on by Buddha; but it is too late and too much to ponder on- now.

I like the idea that each us of has our own 'dharma'- our role to play in the world and in finding it and fulfilling it we are keeping the universe and ourselves in balance.

Ruined reputation

I showed up to work an hour and a half late on sunday. My alarm died and i was out partying till 4 am.

So hungover. I was useless that day.

Im still useless.

The so called 'mission' was an epic fail because the one person that should've been there wasn't. So i got utterly wasted instead. Utterly butterly.

the next 4 months i have to try and redeem myself. And not party when im working weekends.

“Hope is definitely not the same thing as optimism. It is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out.” 

Vaclav Havel

Day 3 atas panggilan (on-call)

Hmmmm......still feel fairly incompetent. Not cryingly incompetent, but a quiet desperate hum in the background that's a buzzing that indicates im not exactky sure what is going on.

That just sounds like me everyday of my life.

So, the moral of the day:

1. GP patient summaries are useless. Try calling NOK if any doubt, but it's hard. Hard hard. Confused little ladies are tough.

2. Look up: criteria to CT head.

3. Risk factors for PE and well's score. Virchow's triad: hypercoagubility, stasis and vessel injury. + PMH of DVT or PE
   Well's score (thanks wiki)

• clinically suspected DVT - 3.0 points
• alternative diagnosis is less likely than PE - 3.0 points
• tachycardia - 1.5 points
• immobilization/surgery in previous four weeks - 1.5 points
• history of DVT or PE - 1.5 points
• hemoptysis - 1.0 points
• malignancy (treatment for within 6 months, palliative) - 1.0 points

Traditional interpretation^[5][6][11]

• Score >6.0 - High (probability 59% based on pooled data^[12])
• Score 2.0 to 6.0 - Moderate (probability 29% based on pooled data^[12])
• Score <2.0 - Low (probability 15% based on pooled data^[12])

Alternate interpretation^[5][8]

• Score > 4 - PE likely. Consider diagnostic imaging.
• Score 4 or less - PE unlikely. Consider D-dimer to rule out PE.

Scoring system for DVT

1. Active cancer (treatment within last 6 months or palliative) -- 1 point
2. Calf swelling >3 cm compared to other calf (measured 10 cm below tibial tuberosity) -- 1 point
3. Collateral superficial veins (non-varicose) -- 1 point
4. Pitting edema (confined to symptomatic leg) -- 1 point
5. Swelling of entire leg - 1 point
6. Localized pain along distribution of deep venous system—1 point
7. Paralysis, paresis, or recent cast immobilization of lower extremities—1 point
8. Recently bedridden > 3 days, or major surgery requiring regional or general anesthetic in past 4 weeks—1 point
9. Previous documented DVT-1 point.
10. Alternative diagnosis at least as likely—Subtract 2 points

4. Heart failure- diagnosis and treament.

5. Cellulitis- criteria for IV abx.

6. Must carry spare pens on person. Had emergency of no pens with a consultant. Im so blond.

7. Must make a point to drink water and have a biccie after each long clerking. If i didn't wish i was dead so much i'd wish i was a robot. Being human is tres difficile.

Someday, i will be intelligent and self-assured and then, everything will be better. Day 2 oncall

Ward cover was awful. I wanted to cry. I actually had a proper mope when i got home. And then had a mini emotional/mental breakdown in my kitchen, binged on undercooked pies and brussel sprouts. Slept on my sofa and pissed of my housemates.

Lessons from today:

1. Be faster and more through.

2. Start planning work early.

3. Do not get distracted. Nurses must be handled. Use the DR power. Do not pander to anyone. No one.

4. The 6 Ps of ischaemis: pallor, pulselessness, perishing cold, parathesia, pain and paralysis. Ischaemic foot on my watch, yo. At least i spotted it. Remember risk factors: AF, coagulopathy.

5. If an ABG is venous, say it. Or else ITU will scream down the phone at you.

6. Follow your gut instincts. If you think someone is a CO2 retainer, he probably is. Don't wait for repeat ABG. Just watch out for a flap.

7. Use your brain. And more chocolate bars for oncalls. Especially weekends. And water bottles.

8. Work on ECG skills.

9. THINK, THINK, THINK!!!

"A trainee Dr is like a light bulb - not measured by how bright they are but by how much they can illuminate everyone that surrounds them."

If only, if only.

A smile at work today!

It doesn't follow the theme, but this might be seem familiar to those who know me well. Down to the facial expression and posturing. Im such a squidward.

I dont want to believe it!

I hate when astrology readings tell me things i don't like. Tell me lies, tell me sweet little lies.

I hate it when i hear things like:

Ruler of 6th house in 4th:

You feel secure when you are working, for it fills your emotional need to serve and be needed.  Your most fulfilling task is to stay "home". Mundanely, you love to be involved in domestic projects, and put your greatest energy into your home and family.

Mundanely......mundanely! Me, mundanely domestic goddess?! Wah, must get someone to pray and change my fate.....

Day one oncall

I think i get to caught up in my own misery to be a doctor. Too introspective, to self-involved.

I hate saying that i'm a doctor. Because i feel like a faker- i dont actually know what im doing.

Need to stop wallowing in my own my misery and expending neurons of being depressed and instead, use my brain THINK.

I just need to apply myself.

Lessons from today:

1. Better systems review!!

2. Bring pen torch- and do proper cranial nerves!!! Dont forget visual fields, sensory inattention and cranial nerve 12. Really liez!

3. Chloprodiaproxide 10 mg PO QDS +PRN for DTs! And pabrinex is I +II OD (IV!!)

4. Headaches- types and sorts!!

5. Symptoms of salicylate and paracetamol OD.

6. Happiness is something i need to find in myself.

Quote

From an earlier blog entry:

"I wonder when you're gonna get tired of it. I wonder how bad it's gonna feel when you do. "

I've not seen my flirt buddy in weeks. It's like there's no fate, no red strings. Coincidence or chance not being kind to me or God just telling me, 'patience, child'.

Bukan sedih, tetapi bosan. A more bereft sort of bosan, like a little bit of my daily joy is missing. It doesn't feel as bad as it makes my life dull. I also kinda miss glowing.

*switch to gossip mode*

apparently said boyo was seen making his way outta the nearby woods with a girl. I know her, and this is entirely possible to be valid gossip. She also wanders the hospital with him. Hmmmmmm....

Can i make a quick mention of Dr Barbie? All intelligent blonde blue eyed girls would wanna be her. Hell, i can't compete. I raised my arms in defeat to long blonde hair, perfect legs and mile long lashes. She be bangin' but not my type. I think i definately look for personality in my women.

Delusions of grandeur / self importance

I am starting to see think my patients (who would be doing fairly ok) tend to die the day after i go out drinking.

My God is not a vengeful God.

that was my first thought after the initial statement crossed my mind. and the fact i think God would sacrifice another human being to warn me of the errors of my ways is very delusional. i must be so full of myself to think God would pay me that much attention.

God is merciful and kind.

Really. there is always much to be thankful for.

i start on calls tomorrow. im so scared that God won't be on my side that i won't even have a cigarette.

God is merciful and kind.

Hmmm... these are some sweet melons

The art of buying melons:

1. Smell them- they've gotta smell sweet.

2. Percuss: it's B-flat.

3. It's gotta feel dense- nice and heavy like.


My friend's mom once told us, "all young people are beautiful".

As i was putting on my warpaint this morning i realized i am one of those girls who wear make-up everyday.

Thanks to certain things said and my hair sorting itself out im beginning to believe that i could be beautiful (with a little bit of help).

Nov 18 is......Have sex with a guy with a moustache day.

You don't say

From urban dictionary

Muppet

1.  A person who defies explanation with regard to common sense and logic, exhubing an air of confidence that is mutually exclusive to that of their accomplishments or ability

2.  General name given to a large cast of bizarre comedy puppets created by the late Jim Henson. While many performed on "The Muppet Show" (and numerous movies and spin-offs) others appeared on the children's television series "Sesame Street."

3.Noun: See entry- Idiot.
"I don't care who you use, as long as they aren't complete muppets." Harry the Hatchet in Lock, Stock, and Two Smoking Barrels, 1998

I had my dresses and my Kocani Orkestar CD sent to my old house. 
I'm having a Bruce Banner moment.


OK, it's over. Now i just have to go pick up stuff.

Caroline you're angry cos you sleep like a spinster and you're 28

You've been thinking late, you couldn't catch a cold

-raincoat song, decemberists-

I hope i dont catch a cold. Just wanna catch a man to keep the bed warm.

Im tired and i have hip pain and i should quit jogging and stop taking pills that give me the runs and tummy cramps but this girl is kinda dedicated.

I like my routines, but i like it just a wee bit more than i like not being in pain and having a happy tummy.

My dresses aren't here yet, im still so fat and ugly and it's fucking cold outside.

If i sleep i should sleep forever.

Dream

I dreamt i was accepted to an exclusive scholarship program with a dozen people i know.

On the second day of the program, the coordinator comes up to me and says, 'your application for this program is contested and is in the process of being rejected'

I took that decision well, in my dream.

I fell asleep after my run in the fog and cold last night. I was hungry but sleep won- my snack was left on the table. I have recurring visions when i go on these jogs of big iron nails being hammered into the back of my neck, my temples and shoulders. Like how you kill a pontianak.

That and a slightly scary demi-wish that i get hit by a car and get killed instantly. But i still look before i cross.

I wake scared this morning of the coming day.