saturday night on whitechapel

"paediatric trauma team to resus, paediatric trauma team to resus" my bleep crackles to life at 2 in the morning. What are children doing up at this time of night is the inevitable thought as one runs down the corridor toward A&E. A 14 year-old has been stabbed - once in the leg and once in the pelvis. He is just conscious, smells strongly of alcohol. His heart rate is 37 a minute - in other words, he is stoned. The team move swiftly; he is examined, blood taken, xrays etc. Then a plaintive voice from behind the curtain: "I was stabbed too." Another boy, who had accompanied the first, and is equally inebriated, shows off his war wound. At this point, I am sent away to Majors as a child with sickle cell anaemia has arrived. It is *Jermaine again, who has come in with excrutiating pain in his abdomen and groin. Before I have finished examining him, another patient is sent over from Adult Majors. It is a 17 year-old with cerebral palsy. He is microcephalic, gastrostomy-fed and in nappies, and has been running an intermittent fever for the past 6 weeks. Lyn, th other SHO sees him. I fail to put an IV in Jermaine, so he gets some morphine orally and is sent upstairs to the ward.
My bleep has by now gone off about 5 times; would I come and see a child who has developed blisters on her arm? One of the teenagers with cystic fibrosis needs a new cannula and he is refusing to have it put in by anyone but me (just because I had been lucky and gotten it in first time the night before). The 5 month old on HDU is needing more oxygen, could I come and see her?

last night of the poms

...not that I am rooting for Australia in the Ashes. Just that I may not be as British as I thought I was. Went to Proms in the Park - that plebeian adjunct to the institution that is the Last Night of the Proms - with an old school friend. We stopped to pick up ice-cream cones and union jacks - the latter essential for audience participation when the old Elgar came on. Funny how one never notices the words of anthems until one comes to sing them. I know from my time in Edinburgh that the unoffical national anthem of Scotland (Flower of Scotland) is all about giving the English a good kicking; and I guess that is what national identities are about - Us against Them. The words to Rule Britannia I found quite disturbing; ironic that when it was written the British were busy enslaving other peoples halfway around the world. Harmless (and half-drunken) flag-waving fun? Or something akin to Japanese people gathering in a park to sing Kimigayo and wave the Hinomaru?

eponymous syndromes

*Billie died at 6 on Thursday evening. She'd been at it for weeks. Billie had Batten's disease, a tragic condition where the brain and nerves gradually stop working. She had uncontrollable seizures, fitting for hours on end despite a full complement of antiepileptic medication - carbamazepine, phenytoin, Keppra, and a midazolam infusion. I was called at least once a night during her last week by nurses who said "Billie's fitting again, can you come and see her." My heart would sink, because I knew there was nothing further I (or anyone) could do. She was on an amount of midazolam one might use for anaesthesia. Rectal diazepam and paraldehyde had been given, and paracetamol for her fever (presumably from a chest infection). She lay there, a pale, floppy 9-year old in nappies, already dead to the world, her gurgly breathing and the beeping of sats monitors her only communication with it. Her eyelids flickered and her right arm jerked continually. Her mother looked on - her eyes no longer imploring, only resigned to Billie's fate.
*****
There is a little boy named 'Jihad' on the ward at the moment. I shall not describe his condition, but suffice to say it is rare, inherited, complex and life-shortening. Perhaps his parents had in mind a personal struggle rather than a holy war on infidels.
*****

nightmare

quick post before i have to get dressed for work...
rather bizarre episode last night. having done our rounds for the night and sorted out all the new admissions, i lay down on the sofa in the doctors' mess for a snooze. And within the space of those 2 hours, I had a nightmare! i dreamt that i was there, lying on the couch, and ravens were flying in through the open windows, clawing at me, and glaring at me with iridescent eyes. i was trying to defend myself with a battered copy of the Guide to Children's Medicines and a few coffee mugs. then my bleep went off. it was 04:45 and i was indeed on the sofa in the doctors' mess, but there was no sign of any invading birds. i was also relieved that i hadn't actually thrown the coffee mugs at them.

Madhouse

"Do you know what HRT stands for?" asks *Ali, the rotund Egyptian Gynae staff grade. "emm. hormone replacement therapy?" I say, knowing that the answer is most likely going to be some coarse joke. "no, no it's HUSBAND replacement therapy. All the old woman, they take, then replace the husband. haha." Ali retrieves his customary mound of chips and 5 halal burgers from the oven and heads to his room. "See you later, Ali...you should eat some vegetables.." I can't help adding, half in jest and half out of real concern for his coronary arteries.

My flatmates are a motley crew (i was the last to move in, and am trying to move away ASAP); apart from Ali, there's the benign big-haired Portuguese guy, the girl who told me off on my first day here for inadvertently using one of her pans, the Vegetarian med student who sticks "keep off" post-it notes in the fridge, and the one in the room opposite mine who i haven't even met and rather inexplicably avoids looking at me and keeps slamming the door in my face. I discovered yesterday (on talking to The Vege) that she'd had a quarrel with the girl who used to live in my room, and that she hasn't realised that a different person's moved in!

Of course the sickest joke was when my pay came through yesterday - I am earning more than I did as a House Officer, but only just enough to cover the rent on my matchbox-sized room, right down to the last pound. Still waiting for Ching to give notice on her flat so I can move out!! Meanwhile, am attempting to create a friendlier atmosphere by 1) leaving my stereo in the kitchen with a "use as you please" post-it and 2) proposing a shared (vegetarian) meal next week. I don't have particularly high hopes for this (so far Ali and Vege are coming) but one has to try...