"Jou-moer" and the volcano

So I was off-road on Vesuvius when I slipped and hurt my ankle...

"What!?!"

I have many many irrational hatreds...and one of them is middle-aged men who wear pony-tails,-long,greying and greasy-,and who also wear 3/4 length trousers with more pockets than a commando...and who are also teachers.

They are invariably self-absorbed pontificating misogynists with a patina of ersatz intellectualism that extends as far as the wine column of 'Hustler' and the small ads in the London Review of Books.

When I went to call the patient in from the waiting room he was ensconced on one chair,and was resting his possibly fractured foot on another...this mind you, at a time on Sunday morning when patients were queuing out of the door and into the car park.
Most of the other patients appeared to be in awe of him because he was reading...a book...a book without pictures!!!
He took several minutes to collect his book and crutches and various arty-farty hippy bags before making bounding one-legged hops on the crutches.

"Right...so you were walking up Mount Vesuvius when you tripped and injured your ankle...okay...which way did it twist...do you remember?"

No

"Okay...I see that you have a plaster on that leg...did you break it?"

I don't know...I went to the local hospital and they took an x-ray and put me in the plaster and told me to keep it on for four weeks...

"So you don't know if its broken?"

No...but they did give me a letter to take to the hospital when I got back to England

He duly handed me a much-folded and sweat stained letter...written in Italian!!

"Well...Sir...I'm afraid that I don't speak any Italian beyond waving my arms above my head and shouting 'take me to the South African consulate'..."

I speak Italian...

"Okay...can you please translate the letter then...?"

Well...I don't actually read Italian...so if you could read it out,I'll translate it from the spoken word...as it were...

*sigh*

"Okay...well...that plaster looks dirty and worn and a little ragged...have you been walking on it?"

Yes...they told me not to walk on it but didn't give me any crutches...

"Why didn't you hire some...or buy some...?"

I didn't have any money for things like that...I was on holiday after all...

"And I suppose that you didn't have insurance...or a European health card...or a credit card either?"

No

*Oy!!*

Well...I just finished my holiday and then came back to England and came straight to hospital...I got these crutches from my brother...

"Okay...when did you get back then?"

Five days ago...I've been too busy to come in before now though...but now it getting really painful ...

"Okay...so...what have you been taking for the pain?"

Nothing...I don't like polluting my body with drugs...

(Take me now Lord)

And so...I cut the less-than-useless plaster off of his leg and x-rayed him...he didn't appear to have broken anything except my will to live...

"Okay Sir...well...I suspect that you have a grade one sprain...they take some time to heal...but you do need to start walking on the ankle now...and you need to take some painkillers...and I'll refer you to the physio to make sure you get proper evaluation and rehab of that ankle..."

Oh...okay...when will I see the physio? Today?

"I'm not sure...I'll write a referral letter now and you need to phone them on Tuesday afternoon and they will give you an appointment time..."

But I don't have any air time on my phone...can't you phone them now?

"Well Sir...perhaps you could ask your brother...or another teacher at the school...but honestly...the physios don't work on a Sunday because ankle rehab is frankly...not an urgent issue..."

Well...I work during the week...the weekend is the only time that suits me...

"Well...Sir...actually...'Emergency Unit ' is not a Latin phrase that means 'come in whenever the freak it suits you'...and oddly enough...'physiotherapy' doesn't mean that either!!"

Carlton Hotel menu...for Saffers of a certain age!!

Stuck on you

So the patient came in holding his head in his hands...well...that was my initial impression

In fact,his hands were stuck to his face...with superglue...
Lots of superglue...
Stuck symmetrically to his face just like in the picture of Macaulay Culkin

Julian had lots of fun separating the two... *ouch*

The patient said that he was walking along the pavement,on his crutches...
-he apparently uses them due to some unknown medical disability
- for which he naturally receives a state medical disability benefit
-weekly
-(no wonder I'm paying 40% tax)
-and he didn't have his crutches with him
-and in fact walked into the Unit with a normal gait so the nature of his disability remains a mystery unless we all just agree the guy has acute-FUO^

(sigh)

Anyway...he said that he had been walking along the road when some teenagers ran past him and squirted superglue onto his face...and that... naturally he tried to wipe the glue off and then his hands got stuck...

Hummh...I found his story hard to believe as I don't believe that any of the local teenagers would do anything with superglue except sniff it...

His old notes show that he has attended our Unit more than 50 times since we opened three years ago,including , -last year-, for the removal of a bottle of mayonnaise from his rectum.
His explanation for that event was that a burglar must have broken into his house when he was asleep and inserted it ...

Fortunately it was a bottle of Hellman's 'light' mayo...so it was easy to remove!!


^ F*ckwittery of unknown origin

Rome - part four - top tips for surviving Italy

Fly 'Alitalia' :-this will give you a head-start on the insults and indifference to which you will be subjected during the course of your holiday before you even get to Italy-indeed ,if you fly from LHR,before you even leave England.

You will also understand why the Pope kisses the ground whenever he disembarks from an Alitalia plane...and why Italians in general pray so much.

'Cheese' is considered to be one of the five-fruit-and-vegetables that its recommended that you should eat daily.

As is pasta.

And meat.

If you want a salad then find a McDonald's.Really!!

Many of the locals will be better looking than you are...almost all will be better dressed.Get over it...however try not to highlight the fact that you're ugly and that your mother has dressed you funny by avoiding the following common fashion faux pas:-

1.If you are from Europe,specifically the UK or Germany then please note that sandals are never,-under any circumstances whatsoever-,to be worn with socks...especially if you are wearing shorts and/or knee-high socks.People will quite rightly point at you and laugh.

2.'Plaid', the patterned material so beloved of Americans was originally designed as a joke by effete New York liberal intellectuals on over-weight middle-Americans;and in itself,it derives from 'tartan',a joke played by effete Scots on ...well...everyone.

If a snobby or rude waiter or hotel receptionist is trying it on, because you speak little or no Italian,remember the following phrase..."I'm sorry I do not speak much Italian...but I am a British (Allied) Army officer...and you can surrender to me!!"

This phrase will be helpful in most social situations.

Do develop your own phrase to us on other English-speaking tourists...there is no law that says that you have to talk to your countrymen when on holiday...specifically if you are on holiday.

Mine include the following:-"Nein hable Anglais" ;"Non parlay Italiano" and "Nie sprechten Inglisi".There is also the ever popular,"No speaka da English".Rest assured that most of your countrymen will have no idea what you have said to them but will be impressed that you appear to be able to speak three foreign languages simultaneously and they will leave you alone.

Roma - part three : the Vatican

So I just wanted to Giotto down some thoughts on the Vatican art treasures...and ...'yes'...that is probably the worst pun you'll read this month !

The first thing that struck me,as I walked from the Ottaviano metro station towards the Vatican was the very large lingerie shop called 'Intimissimi' .

(Have a look at their latest advert at http://vimeo.com/4197532)

Now given that the Clergy supposedly have vows of poverty and abstinence it seems like a really cruel and inhumane punishment for them to have to pass this shop on their way to work...of course,its entirely probable that some of the Nun's...and perhaps even some of the Priests, do in fact shop there...the mind boggles.

Secondly, the queues for the museums are long...loooooooooooooooong...its estimated that at least 30 thousand visitors a day pass through the turnstiles paying an adult ticket price of Euros 14...about £12/$20
Now I have to say that you get to see a lot of art...more than you could realistically see in six months apparently...but given the amount of revenue that is generated,I do think that they could buy something a little more modern...really ...they can't afford a Picasso??

Anyway...the three statues included below are apparently were all crucial in the development of Michelangelo's work...the head of the first was the inspiration for both his 'David' statue and for the painting of 'Adam' in the Sistine Chapel.
The second was the template for the figure of God in the Sistine Chapel.
And the last sculpture apparently changed his style forever...incidentally,he is supposed to have made the apophrycal statement that 'no one who ever painted a ceiling became famous'!!

Finally I include a copy of the museum ticket which rather bizarrely features the middle section of "The School of Athens" painted by Raphael.

The two men are those well known Christians ,Plato and Aristotle...elsewhere in the painting you will also find Socrates...now the painting is allegorical and full of hidden meanings and codas which frankly are too much for a boy from Johannesburg.

And on the way out from the first art gallery part of the museum, don't miss the stunning Caravaggio representation of the Crucifixion...it is mind blowing.

He was the first painter to popularise the chiaroscuro technique...

I had always thought that it was a type of cured pork sausage from the Iberian peninsula!!

(Please note that there is no copyright to the photos as I took them all myself-although they were helped immeasurably by Picasa)

Roma - part two

So there I was on the open top tour bus doing the obligatory 'city-tour' of Rome...actually quite a bargain...I did the trip three times in full...

Anyway...it was about 1750 and we were sitting at a bus-stop just down from the Vatican City waiting for some more passengers...

The temperature in the top of the bus was approaching 40*C and I was basically just sitting in my seat melting...when out of the corner of my eye I saw the couple next to me clearly having a better time than I was...as the photo shows...

Veni, Vidi, Vici

Roma - part one

So being part of the Eurotrash/ idle rich... ie,divorced with grown up children and no mortgage to pay...I find myself -yet again-,on holiday...in Rome.

Ah...Rome...Roma...

Well...thank Heavens for American imperialism...I'm not at all embarrassed to tell you that my first meal in the Eternal City was the from the Eternal MacDonalds...the one just around the corner from the Trevi fountain.

Cos I suppose that I didn't really think this through before I came here but I only eat pasta about once a month and pizza about twice a month...in my quest to maintain my sylph-like figure

(No sniggering at the back there!!)

And,having lived in Jo'burg all my life where there are as many different cuisines as you can think off I suppose that I have been spolit...I just naturally assume that I can get whatever food I want no matter where I am...

Even in "Ingerlund" where I now live,you can pretty much get fish'n'chips with or without curry gravy and as much warm beer as you would ever want to drink jyust about anywhere.

And it is 27C here today...and the only food I could find within walking distance was lasagna or "spag boll"...and I really felt like a salad or some fresh fruit...apart from anything else I am a vegetarian...

(Well...most of the time Iìm a vegetarian...if however I am on a date with a hot woman who thinks that vegetarianism is akin to devil worship then of course I'll deny it and have a steak...honestly...the things you have to do for even the promise of the possibility of sex!!)

Now it must be said that the Italians seem to follow the Pom recipe book of salads... a few slices of dessicated tomato and some dry wilted leaves of something that at some time in its very distant past may actually have been in the ground...thats not a salad even if you charge me

£10 and slather it in olive oil and balsamic vinegar that was jsut drained from the sump of a trans continental lorry...

And so I found MickeyD's...yeah...and in my best Irish accent I ordered the biggest burger I could find and finally didn't have to worry about eating too much meat...

You're going to stick that WHERE??

I had a patient this week who came in with a history of what looked to be IBS...intermittent diarrhoea for several months...and it reminded me of a little problem I had a few months ago when I experienced (what is called by surgeons) a sudden and sinister change in bowel habits.

Now most of you know how full of crap I am…. but Lordy, even I was amazed by what was coming out…I’m sure that I even saw my tonsils at some stage-which was a bit of a surprise as they were removed 40 years ago!

But at least I didn’t need to floss for a few days such was the pounds-per-square-inch pressure in my rectum ...
(Wrecked him doctor? It darn near killed him)

And, Oy! Not to talk about the pain…now I know the answer to the old medical conundrum of, which is more painful?? To give birth, or to be kicked in the testicles??
Well I can tell you with some authority that the “giving birth” thing, wins hands-down !!
Lord only knows how I managed to persaude my ex-wife to have sex with me again after the birth of Number One Daughter...never mind actually have a second child!

And so after a weekend of magic and wonder…. wondering if the only way I was going to stay alive was through magic I dragged my tried and desiccated arse off to the GP .
(Now for the foreign readers amongst us, here in the UK, you have no choice over your doctor…. you basically sign up at the GP surgery in your Post Code area)

Well typically my luck has held and I’ve been assigned to a practice of Mittel-European skivs who between the lot of them have more gold teeth and less medical qualifications than the entire cabinet of any 10 African dictatorships

Except that day of course…. that Monday, I got the little female doctor who looks like she has stepped from the pages of Playboy-a magazine I once read at the dentist, and only for the wine column I hasten to add.

Still I thought, she’s a professional and will probably be able to contain her lustful feelings when she is exposed to the legendary Lucien 'abs-of-steel'………

(A pause here for laughter)

Fortunately it wasn’t necessary
Having explained that I had had this sudden change in my motions, accompanied by the most dreadful abdomen pains, she proceeded to examine my abdomen through the twin layers of my T-shirt and denim shirt .
Outstanding!!

Even the non-medical amongst you will be able to detect the fatal flaw here…and there is an old maxim in medicine that says, “if you don’t put your finger in it, then you’ll put your foot in it”
(Oddly not a phrase that I have ever used successfully on a date. Anyway)

Well I don’t think there’s anything wrong, she said

"Oh? Ok? Really?"

Possibly some D&V bug…. maybe Diverticulitis…maybe cancer

"OK…humm…Diverticulitis"

Yes, it’s a disease in PEOPLE OF YOUR AGE

(Well what does that mean exactly? MY age? I’m 16.Well in my head I’m 16)
(Couldn’t I have got something more interesting like Green Monkey disease or leprosy…even herpes?)

"So let me get this right…I may have cancer…probably have D&V…but really you think I have a common-and-garden gut disease of old age? "

Yes, she says, smiling, but its probably cancer given your age. So what you need to do is go away and if there are no changes in 6 weeks then come back and well put you on the 2 week fast-track for a colonoscopy

"OK. So that’s basically in 2 months time then…so if I’m not dead of dehydration, or my stomach doesn’t explode like the guy in the Monty Python skit, or in fact, (say it quietly) cancer, then I can come back and be rushed through the surgical gut team "

Yes, she says, and please don’t let the door hit your arse on the way out

Well in truth you do have to leave things for a couple of weeks. Bugs like camphylobacter take a good eight days to resolve…needless to say, it didn’t settle down.

And so I saw another doctor who put me on fybogel

An interesting drug with the side effect of wind…. indeed, lets not be coy, flatulence. Huge amounts. Indeed at one stage I was farting with the speed, fluidity and desperation of an ack-ack gunner trying to shoot down a kamikaze airplane .

In fairness the fybogel did take away the abdominal pain but not the underlying symptoms

And so, let me say this…for any of you who do not believe that money makes a difference to your quality of life, then pay close attention

I contacted my private health insurance. Now when I took out the insurance my colleagues fell about laughing. Why, they asked, as they rolled on the floor in mirth, tears streaming from their eyes, would you need private health care when you can just go along to the NHS?
Well, you cant actually rely on the NHS…. its to busy giving IVF to asylum seeking lesbian dwarfs to take care of middle-class, middle aged (did I write that) men.

And so miraculously, I was delivered into the hands of the private health economy.
Ja, well.
Fortunately all of this was happening whilst I was on Annual Leave.

Anyway, so I met with the surgeon.

The first thing I noticed was that he had big fingers, a crucial thing to note.

The second thing I noticed was that he was English. Now, no offense, but that’s not something that you look for in a surgeon.
I want my surgeon to have felt kilometers of bowel during his training, feeling blindly for the stab wound or bullet hole.
I want him to be more familiar with the bowel’s of strangers than he is with his own. I want someone …not to put to fine a point on it…. who has cut up lots of people. Bizarrely, not something they do very often here, the rise in knife culture notwithstanding.

And, thirdly, he was wearing a tie. Now I know-from a professional view how close he’s going to be getting to my bum and frankly I prefer my surgeon to wear a bow tie. Still, at least it looked like silk

So…that’s an interesting accent, he said

"Ja. I’m from Joburg"

Oh…what work do you do?

"I’m a trauma nurse "

Oh, he said, his face lighting up, did you ever work at the Johannesburg Hospital

"Uh...JAH!!"

O.K. ..do you know Ken Boffard?

"Oh jah"

And then the heavens opened and God’s glorious light bathed me and rescued me.

Well , he said, I did my surgical training in Joburg in the mid-90's because I wanted the best training. Did you ever work in the “Pit” at Bara?
(The surgical resuscitation area at Baragawanath hospital, still the largest in the southern hemisphere)

Verily there were choirs of seraphim singing at that stage!!

"Yes" ,I responded. "Thank you Lord, yes I did "

And so, my mind once more at peace, he started to examine me.
At the end he mentioned a couple of possible procedures that he could do but suggested the ever popular combo of a flexible sigmoidoscopy followed by a CAT scan

This sounded like a plan ...

Good he replied,what are your plans for this morning?

"This morning ???"

Well, he said,you’re the only surgical patient at the clinic this morning and the scope room is free,so why don’t we just crack on?
(Crack-on! Geddit?)

And so we did. Really glad that I wore my khakis’ that day then.

And so dear reader, in a matter of moments I found myself lying on my side with a BEEEEEEG pipe being inserted…and naturally discussing the rugby world cup...

To be honest it’s not as bad as it sounds ...
As the bishop said to the actress

But I have to say that lying bollock-naked on a bed on a Monday morning, and seeing your sigmoid colon on a 24-inch TV monitor is a slightly surreal experience. Particularly when they start to alternate with flushing the gut with the water (cold) and the air (even colder)
And then he found some diverticular pockets and so got all excited...


Yeah for fybogel!!
Viva Bara Viva!!

Don't talk if your mouth is full !!

The first patient of the day,looking fearful and apprehensive ,was a shaven-head, muscle-bound steroid gorilla...

His arms and chest were so overdeveloped that he needed a stick to scratch his nose...don't ask me how he wipes his bum because you just don't want to know!!

He walked into the Unit with that idiosyncratic mincing manner of the power-lifter,partly due to preening self-aggrandisement;partly due to the fact that his thighs were simply too large to get past each other when he walked with a normal gait.

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

Well...what it is ...obviously...I been bitten

"Right...okay...lets have a look then."

Well...I'd prefer not to have to show you...

"Uh huh...well...I'd prefer to be at home in bed with Pamela Anderson...but since I'm being paid to sit here and wear a scrub suit...and you've booked in as a patient...well...we're just going to have to do the whole 'show-and-tell' thing..."

Well...I was having sex last night...with my girlfriend...and she bit me...

"Okay...lets have a look and a feel then...please take your trousers off and lie down on the bed Sir"

He dropped his track suit pants...and no surprise...wasn't wearing any underpants...and held his hand over his rapidly shrinking member.

I slapped on some gloves,and maneuvered the examination light into position,flooding his groin in bright light...there was no where to hide!!

"Julian...could I get some tweezers please?"

(Now naturally,I didn't really need forceps...but sometimes God gives you an opportunity that you just have to use.)

I unwrapped the blue plastic forceps and advanced on the patient,who tried to melt into the mattress...I fiddled with the light for a few moments and then asked Julian for a magnifying glass...

Sure enough,his penis bore clear evidence of having been bitten...even perhaps having been chewed...

"Right...after you were bitten...were you able to regain and then maintain an erection until you reached a satisfactory apogee and payoff was achieved?"

What...?

"Did it all work okay afterwards?"

Yes

"And you have no problem passing urine?"

No

"Right...well I see that Julian has already done a urine dipstick test and that its clear so we can assume that there's no real problem...nothing to worry about ..."

So what can you do for me ?

"Julian...could you please get me some plastic suction tubing?"

'How big a piece do you need?'

I waved my little finger at him.

I cut the piece of thick clear plastic tubing in half,-horizontally-,effectively ending up with two gum guards.

"There you go Sir...get your girlfriend to pop those over her teeth the next time you're settling down for a night of carnal knowledge together and you shouldn't have this problem again..."

I suppose you think you're funny??

"Honestly Sir...we're not laughing at you...we're laughing with you...You have a nice day now Sir...somewhere else."

Mr and Mrs Dumb and Dumber

I'm not really sure when or why it became a normal practice to take your family and friends with you when you needed to seek emergency medical attention in the ER .

I admit that there have been a few occasions when I have had to phone a friend to fetch me from hospital ,after a night out with my good friends Johnny , Jack and Jim ,when I have found myself unexpectedly having to use crutches.

I suppose that I can understand why a teenager requesting the Morning-After-Pill would want a gaggle of her girlfriends with her if her greasy,pimply boyfriend didn't have the courage to keep her company when he had sobered up the following morning...and I understand that if you're playing a contact sport and get injured that your teammates will want to accompany you to provide moral support and to make sure that you don't cry...and to laugh at you if you do.

But why would you get your mummy and daddy to bring you to hospital if you're 25 and your girlfriend has just punched you in the face and broken your nose because she has found out that you are cheating on her?

Why would you insist that your 16 year old daughter stay with you when I am trying to take a history and examine you after your drunk abusive "boyfriend" has, -yet again-, beaten you?

*sigh*

And so...our waiting area is often packed to bursting,looking like a casting call for Britain's Got No Talent-Welcome to the Dole...and it used to be very disheartening until we realised that most of the people were simply supporters, and not actual patients.

Looking out into the waiting room on Sunday,I saw that a group of nine adults and four children had colonised one end of the room and appeared to be having a picnic...there were sandwiches,packets of crisps,bars of chocolate and bottles of Coke !

Now our waiting area is very clean and tastefully appointed with posters advertising the clap clinic and abortion services...but really...there is a park just around the corner and the beach is only a mile away...our Unit looks out onto a soulless concrete parking lot with a grave-yard across the road...its not as if they are going to see a herd of wildebeest sweeping majestically across some African Savannah...

The adults were in their late teens and early twenties...all of them had clearly shopped at the 'Cheap Chinese Clothes for Ugly People Sweat Shop' ...and they only possessed 27 teeth between the nine of them. At a guess...correct as it transpired...only one of them actually had a job...the rest were on benefits of one sort or another.

The first member of the group I saw was a pretty young woman,with a tight little vacant smile, who was accompanied by the ubiquitous loud-mouthed and opinionated single fat girl of the group,who was bulging out of her tiny (sweaty and grubby) tank top and shorts...

(shudder)

(Note to self: reconsider the whole vegetarian thing!)

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

The vacant girl looked at me and then at her friend.

The friend looked back at her.

Then they both just stared at me as if they were on a school field trip to the zoo and had just caught sight of a blue bottomed baboon for the first time in their life

No answer.

"I'm sorry...but do you speak English?"

Yer wot?

"What.Is.Wrong.With.You?"

Dunno

"Julian....JULIAN!!"

Julian stuck his head through the door...looked at the patient and her friend...looked at me and rolled his eyes...'Yes Lucien...what do you want now?'

"Well...you know that Language Line telephone interpreter service we have...can you please check if they translate 'stupid' ?"

'I'll be right back with a cup of tea and your tablets...alright?'

I looked at the friend..."Do you know why this lady has come here today?"

Its my ear...innit, the patient suddenly replied.It hurts...

"Right...how long has it been hurting you then?"

Two weeks I think...its wet and it smells and I've been sticking cotton wool in it but its not working...

"Uh huh...have you been swimming at all?"

No...

Yes you have , chimed in the friend. You was on holiday in Spain and you said you was swimming in the sea.

Oh...yes...I was swimming in the sea...but not in a swimming pool...just the sea...so that's cleaner isn't it?

She had a straightforward outer ear infection called an otitis externa and I dispensed the appropriate ear drops...

Is that all I'm getting?

"Pretty much...what else did you want?"

Well...its painful...that's why I came in...can't you give me any thing for the pain?

"Well ma'am...you could do with some ibuprofen...which you can get at any shop for about 50 pence...you don't need a prescription...

But I'm a single mum on benefits...and I've just spent all my money in Spain haven't I...how do you expect me to feed my baby?

"Well I'm not sure how much milk you can actually get for 50 pence...but here's an idea...try breastfeeding...or...let me think about this...I could phone the chaplain..."

Its all right for you isn't it...sitting there in your fancy chair....I know my rights...

(Fancy chair??)

(Take me now Lord)

Yes dear reader...I gave her the ibuprofen...it was that or face a long and complex interview with a policeman

About an hour later I saw a young man of 21 with an obviously broken right hand,swollen almost to twice the size of his left hand,with marked bruising...and his ring finger was in an unnaturally bent position.

He was polite and co-operative,and self employed as a window cleaner.He told me that he had been on holiday in Spain and that last Sunday...a week ago...in the bar...that he had tried his hand on a punch-bag machine but that he was so drunk that he missed the bag and hit the metal machine casing instead...his girlfriend didn't think that it was broken...he did...but he couldn't afford to go to hospital because he hadn't taken out any insurance.

And a previous girlfriend had stolen his European Health card...

And of course he hadn't come directly to hospital when he got home because he was scared.

Oh...and his girlfriend didn't think that it was broken.

I duly x-rayed his hand and he had a nasty angluated and displaced fracture of his 4th meta-carpal...he was also unable to straighten his ring finger having clearly damaged the extensor tendon.

I emailed the x-rays to St Vulvas where a tired and defeated-sounding hand surgeon agreed to see him later that same evening.

"Right then Sir...my colleague Julian is just going to strap your fingers together,pop you in a sling and we will send you up to St Vulvas where the hand guys will look at you and probably operate tonight or tomorrow morning."

Operate...? Operate...? What do you mean?

"Well...that's a bad fracture...its a week old...you've damaged the tendon and its your dominant hand...so you need to get it sorted out asap..."

So when will I be able to go back to work?

"I'm not sure...but probably not for a week or two at the earliest...it depends on what the surgeons do...you'll need to talk to them...I'm sorry."

Can I bring my partner in...can you tell her as well?

"Sure"

Two minutes later he returned accompanied by his partner...otitis externa girl!!!

She looked at me...I looked at her...

"Here's some free advice Sir...don't buy any lottery tickets."

D-Day + 65 years

Harbingers

Frail, old men with weathered hands stand,
Alone, lost on the wide sandy beaches,
Each turning back his rusty mind clock
Piercing the veil of memories
When they were young, anxious and terrified,
Boy-soldiers in battle fighting for their lives,
Experiencing the gamut of fear and death
Watching friends died horribly,
Scarring their young minds forever.

Blue beaches murmur waves
Splashing old, rusted war remnants.
A sea bird flaps wet beaches
Where the sea swells and crashes gently on wet sand,
Retreating back erasing all footprints.
The men stare the distance,
At blurred memories through tears.
Trickling down their cheeks dripping softly,
To merge with the sea like before.

They came to say good-bye to their friends,
To a confused past which has no answers.
The graveyard crosses watch in stony silence,
Stoically from tree shadows on soft meadows,
In eternal military formation fronted by small, flags,
Wind-shivering in the hush of silence.
Marching the stillness in quiet precision
Protecting the young soldiers buried there,
Frozen in time and death
The old veterans stand awkward, unsure with the dead.
Experiencing those familiar, dreaded, sick feelings
Of remorse, regret, blame, and fault for what happened
To their generation who gave so much for their country.

They have gathered one final time
To share history, blame and guilt for all eternity
Banding together as one, they embrace the moment,
Experiencing once more, this terrible place of memories.
And the same salt sea air, still blows up from the beach
Once inhaled in panic by all the young fighting men
Mired in the beach mud conducting the senseless slaughter of children,
Trapped forever in the obscenity and vulgarity of war,
The pain returns for a moment, overwhelming them,
It hangs suspended, as real as yesterday, then drifts away and mellows away.
Now time, history, and denial blessedly blur the horror and inhumanity
Of what they did; of what was done to them.

Curtis D. Bennett

Where did I leave that body?

A reader left a comment earlier this week that got me thinking...

i just got back from a jo-burg flight too. when on the flight they asked for a doctor. NO one stood up. so then they asked for a nurse. NO One stood up. eventually i detached the baby from the nipple and handed it to a priest sitting next to me and went off to see a VERY dead body in the galley at the back of the plane. THANKFULLY an orthopaedic surgeon also was there so i returned to my screaming baby and continued to suckle. PLEASE ADVISE ME NOW: what happens to dead bodies on planes. how do you keep it flat? is there a special storage space or is keeping is flat not a problem. we always try and keep them flat in hospital. maybe you just ask someone to move out of business class? maybe the priest would have been happy to sit next to it? i was scared hey.....imagine if i had had to do mouth to mouth or something


I did my actual 'Flight Medical Assistant' course at the Jo'burg gen in 1987 and was deployed on
the (then) 'Flight for Life' helicopter service as the Paediatric Flight nurse.

I had,prior to that,-in the early 1980's-,worked for DeVries Ambulance in a role that included that of a fixed-wing flight nurse.This was a lot of fun and included flying in a Lear jet...whee!!

As the Paeds nurse,most of the calls I flew on were inter-hospital transfers of really very ill newborn babies.These were 'nice' calls,where basically the helo took experience and expertise and equipment to a remote hospital,often resuscitated a moribund baby and then took them to a centre of excellence for definitive intensive care.

That all changed for me on Saturday 30 July 1988. Someone...in fact the ANC later took responsibility for the incident, - (and three "cadres" appeared before the TRC)-,
detonated a bomb in the Wimpy in Benoni.

Apparently it was a few yards from the Security Police office and so was considered to be a 'legitimate' target;additionally,that day was the 67th anniversary of the SA Communist Party.

*sigh*

It killed one person and injured a further 60 people,mostly black South Africans,including a number of children,one of whom lost a leg.I remember flying in that Saturday to extract her.
The (then) Boksburg Benoni Hospital had a bizarre and really tight LZ,surrounded by trees...because-as I remember it-the Hospital secretary didn't really want a helicopter pad and didn't want to spoil his view either

Anyway...basically the pilot had to locate the LZ...stop...hover...and set the helo straight down.Landing wasn't too bad in fact...it was the takeoff that turned us all into Christians!!

I flew a lot more trauma calls after that!!

This is all part of a long explanation of why...when the dreaded call goes out at 30,000 feet and invariably at 0200...I am always happy to lend a hand.And to be honest,its always been very lucrative...and as yet...touch wood...no one has died on me.

In the past five years I have responded to perhaps eight calls for medical help...and have thus far received some 250,000 air miles that have directly funded three free transatlantic flights;have scored a £50 duty free voucher that got me my noise-cancelling headphones (sweet!!) ;got to sit at the bar and chat with the rich and famous;and of course have been given several bottles of Moet and wine.

I've also scored any number of First Class sleep suits and amenity kits...just love that Kiehl lip balm...(and they make great presents for the kids in your life); and the Xmas before last,flying back from Jo'burg on 23 December, I got upgraded because the Purser remembered me from helping an old lady,- (who was scared because she was 76 and had never flown before...and who had indigestion...well....I hope it was indigestion...anyway she responded to the alka seltzer I gave her and settled down whilst I her held her hand, and we didn't need to return to Boston...big relief)-,on a previous flight with her.

In truth there is little that you can do unless you have some basic kit and the willingness to make an idiot of yourself,although more mature readers might recall the cardio-thoraic surgeon in 1976,on a flight from Hong Kong,who inserted a makeshift underwater drain into a patient who had had a spontaneous pneumothroax with tracheal shift.

Mainly its about reassuring the passenger and providing some moral support to the crew.
I understand that bodies are placed in the toilets ; in the bunks in the crew rest area in the tail:
and that some are merely left in their seats and covered with a blanket. BA apparently have about ten deaths a year out of some 36 million passengers!!

Singapore Airlines apparently has a special corpse stowage area!!

But sometimes it all just goes wrong:-

A BRITISH Airways passenger travelling first class has described how he woke up on a long-haul flight to find that cabin crew had placed a corpse in his row.

The body of a woman in her seventies, who died after the plane left Delhi for Heathrow, was carried by cabin staff from economy to first class, where there was more space.
Her body was propped up in a seat, using pillows.The woman’s daughter spent the rest of the journey wailing in grief.

Trinder was catching up on sleep when he was woken by a commotion and opened his eyes to see staff manoeuvring the body into a seat.
“I didn’t have a clue what was going on. The stewards just plonked the body down without saying a thing. I remember looking at this frail, sparrow-like woman and thinking she was very ill,” said Trinder.
“She kept slipping under the seat belt and moving about with the motion of the plane. When I asked what was going on I was shocked to hear she was dead.”


More Moet anyone?

Once,twice,three times a lady...

It was just a horrible , horrible weekend at work...very hot in the building and very busy and short of staff...since there was such glorious weather I think all the patients assumed that everybody else would be at the beach...unfortunately everybody else thought the same thing...and so we were seeing old injures and spurious illnesses, only leaving the Unit at 2230 on Saturday and 2315 on Sunday...having started work at 0800 on both days.

Admittedly I did add a "very-rare-specimen-patient" to my collection...a charming and chatty lady of 76 who had no medical problems of any sort;who was not on any medications of any description;who had no allergies;who didn't smoke;who was fit and well in mind,body,spirit and soul...and who still worked part-time in a charity shop...she came in having sustained a shin-flap injury whilst working in her garden.

Very rare to find any patient over 50 in England who isn't on at least one medication...so quite excited by that...!!

(Note to self: get a life!!)

So after a sleep-in that in fact lasted until 1500 on Monday afternoon,I decided to drive out into the countryside with a friend for an early dinner and visit a once favourite country pub...just really liked the idea of sitting in the twilight in an English country garden setting,sipping a long cold drink...several long cold drinks...quite literally stopping to smell the roses.

I had not been back to the pub since an unfortunate internet date 2 years ago...but since I've shaved my beard off and lost some weight I was hoping that I wouldn't be recognised.

Like most modern single people I've tried finding the love of my life online...and generally been unsuccessful to be honest...and so I met Jane on one of the more edgy dating sites...

She had her own business,didn't have children,was 10 years younger,and her emails were witty and hopeful.
She looked very attractive in her online photographs...

And by 'attractive' I naturally mean that she had significant mammary hyperplasia...big boobies!!

And so after exchanging emails for a few weeks we decided to meet for drinks and dinner one evening...we arranged that she would meet me at St Vulvas ,and go to the pub together in her car.

As she drove I noticed that she had very large hands and had a strong sure grip on the steering wheel of her Ford Explorer 4x4...
I wondered idly if she had Marfan's syndrome*...

But what a magnificent chest!!

As we chatted in the dusk I became aware that she had a deep voice and quite a square jawline...
But what a magnificent chest!!

Eventually we came to this charming little pub...she easily parallel-parked and got out of the car.

In fact her boobs got out first and she followed them about 45 seconds later...
And I did notice that she was quite tall...but hey...I like a challenge!!

And...did I mention her magnificent chest?

As we walked into the dining room the convivial buzz gradually fell silent as everybody turned to look at her....and then me...and then back to her.

A bepimpled teenager stammeringly asked us if we would like a table and then took us to a table in a corner...over the next 10 minutes we got bread rolls,butter,more rolls,free drinks,and even a little amuse-bouche of pork scratchings and pickled eggs...I think everybody who worked there came to look at us.

Eventually we were left alone...Jane had a steak,I had a prawn salad

So...have you been married before?

"Yes",I replied."I was married for about 14 years and have been single now for about 10 years"

Not met anyone nice then?

"No...not really..."
Well...in fairness...you can only keep people chained up in the basement for so long before the fuzz come knocking on the door.

"And you...have you been married?"

Yes...I was married for seven years and then my partner had an affair so we got divorced...and I moved to Germany and got married on the rebound I suppose...so that didn't work and we got divorced after about six months...

"Ummhh..."

And then I went to Thailand and had the operation...

"Oh...right....what operation was that then?"

My male-to-female sex change operation...

*sigh*

Ah...so the magnificent chest was shop bought rather than organic...

*sigh*

So...no opportunity to practice my T.U.B.E.^ technique there then...

So much for that cunning plan !!

And yes...of course they recognised me!!

*Marfan's syndrome is a genetic condition in which the connective tissue of the body, which is an important structural component in all organs, is abnormally weak and elastic

^TUBE=Totally Unnecessary Breast Examination