Elbow grease.

There is an apocryphal story about accountants touring NASA, looking for people whose  jobs they could cut.

They come across an elderly man , clearly a cleaner, who is washing a floor.

What do you do here ? they ask him.

I help to put men on the moon, he replies proudly.

Now we can all agree that  he is absolutely correct in the sense that cleaners are needed in any organisation...even NASA.

And we can only but admire his dedication to the greater good.

But he is wrong, in the sense that his work and the decisions that he needs to make, can be done by anyone...and generally,-unfortunately-, in our Unit , cleaning work is typically done by someone who could pass for a zombie...and a militant 70's socialist zombie at that.

Our cleaners don't clean any 'biological' spills.Blood.Vomit.Urine.Faeces.

Sperm. 

(Don't ask!!)

The Nurses clean all biological spills.

It makes sense I suppose.

Although I don't really think it took 12 years of university for me to know that blood carries germs.

Or that I couldn't teach a monkey how to clean blood from the floor in about twenty minutes.

Whilst on roller skates.

The monkey, not me.

They also don't clean the rubbish bins directly outside our front door, despite the fact that we own them...and the sidewalk.

They also don't clean the kitchen where staff eat.

And so on and so forth.

They also tend not to clean my office.

I work most weekends.No secret.There are no managers wasting my time and the patients are more interesting because they are typically sicker.

Every single Saturday and Sunday for the past six  years I have started work at 0745 in Room 3.

I always use Room 3.

Like Sheldon , I have worked out the optimal ratio of access to radiology and the front door /availability to sunlight/best distance for shouting for a nurses-aid to come and do something for me/to be opposite the passage where the tea trolley is pushed.

Also, I have mild OCD.

Every single Saturday and Sunday for the past six  years Chakalaka Cindy has also started work at 0745 in room 4.

The room right next to mine.

She  always uses Room 4.

Every single Saturday and Sunday for the past six  years the cleaners have started to clean the Unit at 0745, 15 minutes before we open the front doors to that days coffin dodgers and snot jockeys .

Every single Saturday and Sunday for the past six  years they have started to clean at the other end of the Unit in Room 9.

Then Room 8.

Room 7.

Room 6.

Room 5.

Resus Room.

Triage Room.

Reception.

Room 1.

Room 2.

Every single Saturday and Sunday for the past six  years either Chakalaka Cindy or I have asked them to clean our rooms first..before the patients' come in...every weekend, they still start in Room 9.

Every weekend they get to our rooms at about 0900 and ask us to vacate the rooms so that they can be cleaned.

Every single Saturday and Sunday for the past six  years I have refused to budge.

I know its petty.

I know I could easily log off of my computer, grab all my bits and pieces and move to another room, but honestly, I just cant be arsed.

And then I get it at home.

I was sitting enjoying a sandwich and watching a recent episode of the "Good Wife" when my cleaner arrived today at my  flat.

After her usual 20 minute moan about her life, -on my dime-,she deigned to start cleaning.

Her moan today  included the fact that she thought that my landlord,-a nice old fellow of 92 who has just had a left hip replacement-, was looking morose and that she thought that he has developed postnatal depression and wondered what I was going to do about it.

Finally she walked into the bedroom to do the ironing and immediately screamed.

I was sure there were no naked women chained to my bed but I couldn't remember if I had picked up my underpants so I dropped my sandwich and rushed into the bedroom.

My flat is at the top of the building and overlooks our car park.

OhMyGod...she screamed...someones driven over a fox in the car park and killed it and squashed it flat...and I expect I'll have to clean the mess up...!!!

I looked  out of the window.

The big fat black and white neutered cat from next door glared back at me...and then continued to wash his face.

I came back to the lounge and printed her off a voucher for Specsavers.

Maybe she'll get the creases correct.

One testicle,two testicles, three testicles, four...

A few years ago, on the way back from writing an exam in Halifax, Nova Scotia, (and because I was using air-miles to 'pay' for my ticket) , I had a free day in Boston, a city I had always wanted to visit,particularly after reading all of the "Spenser" novels...

...and in particular I wanted to visit Quincy Market...which I did and where, to be honest, I 'ate myself into a coma' as we used to say in Joburg.

In particular I was in search of a dessert called a cannoli...which I found and immediately fell in love with to the extent that I would have married it and asked it to have my children!!

Every time I go to the US I hunt cannoli down and eat them with joy and much licking-of-fingers and wiping-of-cream-from-my-beard.

Until last Sunday...

It was a beautiful day in our little franchise of hell and so by 10h00 there were over 26 patients waiting to be seen...in fact I was still seeing patients at 23h30 that night despite the Unit having officially closed at 21h30...

My last patient of the morning, just before my lunch break , was a pleasant 70 year old gentleman accompanied by his charming wife.

He walked slowly in with that peculiar 'gun slingers gait' indicating that he had a "groin problem" of some description.

He slowly, carefully, gingerly lowered himself onto the edge of the examination couch.

"Good morning Sir...what can I do for you today then...?"

Well...what it is...obviously...I've got a swelling to my right testicle and its very very painful...I think its a boil...

Oh happy day!!

"When  did you first notice it then...?"

Well...I was driving back from London on Friday and my balls felt a bit awkward...

His wife nodded her head in agreement...Awkward...

"Right...well I suppose I should have a look then...stand up please and loosen your trousers and just let them fall to the floor whilst I have a quick look..."

I turned around to get some gloves and when I turned back he had dropped his pants and was presenting his testicles to me...

...all three of them...

...left...

...middle...

...right...

"Good grief!!"

Yerrh...its really painful and swollen...

"Have a lie down Sir and I'll have a closer look..."

Gratefully he sank onto the couch, still cradling his testicles like a juggler from the Mos Eisley Cantina on Tatooine.

"Julian...can you come and give me a hand here please?" I called through the door.

Julian bounced into the room , looked at my patient and gave a little scream...

...he was clearly so shocked and distressed that I  decided to excuse him since I wanted to get some  work from him later that day.

"Right Sir...I'm just going to have to examine all those bad boys then...."

I can't bear it, said his wife. I'm going to close my eyes

"Jah...well....I think I'm going to close my eyes as well..."

You can't do that...how will you know where to look...?

"Well I'm just going to follow the landmarks...start at your nose and work my way down..."

You're joking...?

"Jah...I'm joking."

His left testicle looked and felt normal.

His 'middle'  testicle looked and felt normal.

His right 'testicle' looked and felt like a huge freaking abscess...

...and naturally...

...as I palpated it, it burst...

...and about 3mls of gelatinous yellow, offensive-smelling and blood stained pus shot out from his testicle... 

...fortunately I was wearing a scrub suit which I was able to change before lunch...

...fortunately the cleaners had planned on doing a deep clean in my room anyway...

...fortunately the patient was lying down and so it didn't really matter when he fainted...

"Right Sir...I need to squeeze the rest of this pus out of the abscess, so try and relax..."

Really....do you need to squeeze it...?

"Well we need to get that pus out...I'll be giving you some antibiotics but they will only stop more pus from forming...really , we need to get all of that pus out...trust me"

(Trust me!!! Are you mad!!!)

But squeezing my balls....?

"Well, I'm more than happy to stick a scalpel into them instead if you would prefer that?" 

A scalpel....you want to cut my balls off...?

"Well....not off as such..."

He groaned.

His wife groaned.

Thinking of the four-cheese-ravioli in tomato sauce that I wasn't going to be having for lunch, I too groaned.

And then I started to squeeze.

It was difficult...the patient was simultaneously trying to stop me squeezing his testicle whilst isolating the abscess for me to squeeze.

It took some time with lots of crying and cursing and spitting...from his wife.

Eventually I squeezed out about a further 5mls of what can be best described as a creamy cannoli filling.

The patient lay on the bed for a few minutes composing himself whilst I got the antibiotics for him.

Finally he staggered to his feet...

I'm very grateful for what you've done...

He held out his hand to shake mine...

...the hand which had been buried in his groin...

...I had already removed my gloves...

*sigh*

My life.

Like a deleted scene form a Fellini movie.

And no more cannoli.

One settler...one sosatie !!

Back in the 1990's in South Africa, the PAC had a slogan that attracted a lot of attention...its was..."One settler,one bullet" and would be chanted at every possible opportunity.

The PAC believed that white people had no business living in Africa...and wanted to kill all the "Boers"...

*sigh*

Look...they had almost no marketing budget and a snappy slogan always gets the electorate...
...remember how you wanted to teach the world to sing?

One bitterly cold winter Wednesday morning I was in Soweto monitoring a march by a couple of thousand school children who were walking to the Protea Police Station to present some or other demand that neither side actually took seriously, because it was the process of unlawful assembly that was important and not the manifesto per se.

Basically I drove in a car festooned with stickers saying "WitsVaal peace secretariat" and listened to Radio 702 to find out what was waiting for me at Protea...which was "no one and nothing" as it turned out.

The temperature continued to drop and by 1130 the school children had all gone home...

...and so the police asked if my team and I could go and monitor a gathering of local taxi drivers who had got together to try and thrash out a route-agreement...

...the Police had given up all hope of trying to stop the very public and very bloody feud between the different operators and I think felt that since I was 'white' that my death wouldn't be particularly bothersome to anyone in the community...

...whereas if a taxi owner was killed , then the blood would flow...

...I wasn't bothered...

...I still regarded myself as a practising christian in those days...

I stood at the door to a local church and asked them to place their weapons onto a table and gave them all a receipt...

...gradually I collected a small arsenal of AK47's, 9mm pistols, pangas, knives and even a spear.

Now the only advantage to being a monitor was that the Secretariat provided lunch....

...which for a lot of  long term unemployed 'black' South African monitors was a huge incentive...

...for me, not so much...mainly because I was a practising vegetarian in those  days.

So at about 1230 a car had arrived from head office with the boot full of chicken take-away meals from 'Chicken Licken' and everyone,-monitors, taxi owners and drivers, the Police, media, and various assorted hangers-on-, all helped themselves to a meal...

...and stood arguing and shouting at each other and looking evilly at me.

At about 1315, a 'flying squad' car pulled into the church grounds with much skidding on gravel and flashing of lights...

...a big fat red-faced white sergeant jumped out....

Who is the bleddy vegetarian? he shouted.

I raised a hand.

Jissis man, he snapped, we were told to bring you some lunch because you don't eat chicken!!

The assorted crowd all looked at me.

"That's correct "

I took the tin-foil wrapped vegetarian meal and opened it....

"Ahhhhhh....one settler, one sosatie..."

The cops started to laugh...then the taxi drivers...then me.

And so yesterday I found myself at another church hall...waiting to cast a vote in the local elections.

I got to the venue at 0655 as they were supposed to be open from 0700 to 2200 and I was working from 0730 to 2200.

It was raining.

I sat in my car reading the paper and listening to the news...

The signal for seven o'clock came and went on Radio Four...

...I listened to how people were about to go and vote...

...so decided that I would as well.

I opened the door to the church hall and saw 4 people sitting at  desk...a bottle blond returning officer and 3 nondescript staff members who were either male or female....I think one of them had a beard but I couldn't swear that the bearded person was male. 

"Good morning"

We're closed...its not seven o'clock yet...

"Hummh...well...its seven o'clock on the BBC..."

Not our clock its not...

"Hummh...well its also seven on my watch...and my cell phone...."

Well its not seven according to our clock so you can go and wait outside...

"Okay...well...here's the thing...
...its raining...
...the door is open...
...and its seven o'clock in the rest of the country...
...so if its all the same to you, I'm just going to stand here until you decide that it is time for me to vote."

Well...stay behind that line on the floor...

I stood , dripping onto the floor...

...for about 1 minute.

Okay...its now officially seven o'clock...you may approach the desk.

"Good morning"...I handed over my papers and they started to look for my number.


The returning officer looked at me....
I know you...


"Oh jah...?"


Yes...you looked after my son when he broke his arm...


"Uh huh...is he all better now?"


Oh yes...you did a wonderful job...


"And was I polite to you...?"


Oh yes....you were so nice.


I voted.
To fire her and her minions.

My "accidental outlaw" score

Have a look at my  accidental outlaw score

Its disappointing I scored so low (ie, that I appear to have turned into a 'citizen')....it must be the knee injuries....I can't run from the fuzz any more!!

Mind you...it just really means that I am *aware* of which laws I break...but actually I still break quite a few.


If you blog or tweet in the UK then do yourself a favour and take the test...its free and its quicker and easier than going to jail.

Its saturday morning in Little Britain...its not a wedding in Cana !

The patient was a young man working for a chain store as a general dogsbody...unpacking goods, repacking goods, unloading goods...a general schlepper...

...but a nice enough fellow, polite and keen to return to work after a colleague had inadvertently dropped a pallet load of goods  onto his foot from about 1m...

...he had been wearing trainers...

...was limping...

...and his foot was swollen and bruised and deformed with bony pain to most of the meta-tarsals.

His foot looked painful...

...and he was cold and wet because he had been working outside in the loading bay in the rain.

I decided to x-ray his foot.

In a moment of weakness , I handed him a towel to dry his hair.

"Have you taken any analgesia? Any tablets for the pain?"

No mate...I didn't have nuffink at work...

"Okay...would you like some pain killers?"

Yes please...

"Okay...do you have any medical problems?"

No...

"Do you take any medicines on a daily basis for any reason, medical or otherwise?"

No...

"So you don't take any medicines ever?"

No...

"Are you allergic to any medicines...to anything at all?"

No...

"Good...well I'm just going to get you some Kapake tablets...its a nice mix of paracetamol and codeine and will kick in quite quickly...irrespective of what you've done to your foot, we need to start to get the pain under control as quickly as we can...okay?"

Thanks...

I went to the pharmacy, popped two Kapake tablets into a little plastic medicine cup (that for all the world looks like a shot-glass) ( and which they frequently become at the Christmas party) and returned to my office.

I placed the medicine cup onto the tablet next to his right hand.

I pointed at the medicine cup..."Okay bud...those are the pain killers...I'm just going to you some water..."

I reached into the cupboard above my desk, picked out a clean disposable plastic cup , and turned and walked the two steps to my sink...

...I was standing directly beside him....

...he got splashed with some water in fact...

...as I  filled the cup up with cold water.

I handed him the plastic cup...."Okay...pop those pain killers down and lets get you off to x-ray...." 

He reached out, took the cup and drank the cold water in one continuous swallow.

He sighed, wiped his lips on his shirt sleeve and handed me the cup back.

He smiled at me and settled back on his chair, gingerly adjusting his foot.

"What.About.The.Pain.Killers...why didn't you take the pain killers?"

I did....I drank the whole cup....

"Good grief...the tablets on the table in the pot are the pain killers...just like I told you one minute ago...that was water in the cup to help you swallow them..."

Water....I thought that was the pain medicine...?

"Why would it be the pain medicine...you saw me go to the sink, open the tap, and fill the cup with water...."

Oh....I thought it was fancy water...for the pain....

His foot was broken ...I could fix that.

There was nothing I could do for his lack of common sense except suggest he have a vasectomy.

Whose a pretty boy then...?

Its because you are so good looking...that's your problem...

*WHAT??*

Also...you look too clever....

*WHAT??*

I was working my last session with my "clinical mentor"...the doctor who tries really hard to put 'mad' back into 'medicine' and it had been a long tedious day...mainly because of the patients but partly because my mentor was trying to share as much of his wisdom as he could in the remaining time we had together.

We had just spent an hour with a patient who had come into the surgery with a shopping list of drugs he wanted...and when I wouldn't give him anything except those absolutely necessary to keep him alive, he demanded to see my mentor...

...who in fairness also declined to give him the sleeping tablets, benzodiazepines, assorted painkillers and coal tar shampoo he wanted.

Instead, my mentor thought he would show me how to do a psychiatric intake interview.

I wasn't really sure who was madder at the beginning...

...but I think the patient won hands down when he explained that he had never worked because of 'the fly'...

"What 'fly'...?"

The fly that came into my room when I was 16 and just about to leave school and start work...

"What did the fly do...?"

It watched me for the next 25 years...I couldn't move out of my room....

"Oh...okay....are you on any psychiatric treatment for that?"

No...I manage to leave my room to get my shopping...

...and to go to the pub...

...and I'm all right going on holiday...

...and getting married was okay although shes left me now because I don't work...

...I cant work...

...its not my fault...

...the fly watches me...

"Rigggggggggggght....so you can do everything you need to outside of your house except work?"

Yerrh....I sign-on like...the benefits office don't understand why I can't work either...

....that's why I want the drugs....

*Sigh*

I looked at my mentor...

...he looked back at me...

...and then reached for his prescription pad...

The patient left happy .

Or as happy as he was choosing to be.

You see...it helps if you have a stupid dull face like mine...

I couldn't argue with him about that.

They don't expect anything from me...

I raised my left eyebrow.

But you...you are so good looking...that they think you care about them...that's your problem...

I raised my right eyebrow.

Also...you look too clever...they think that you are interested in your job...

I raised both eyebrows

Look at me...they know I don't care about anything!!

I couldn't really argue with him about that.

Perhaps I should cut down on the Aramis though.

And refer my mentor to the optometrist.