SAS At This Moment

mmmmmmmmmmmmmmmmmmmmmmmmmmmpppppppppppppppphhhhhhhhhhhhhhhhhhh

After the stress of applying for jobs this August pivoted over the past two weeks, just getting the green light from my supervisor chillaxing in her home turf of Melbourne and then a well deserved break in Dundee over tea, muffins and cakes with Reem, I’ve been hanging out with the SAS in my spare time to gain a deeper appreciation of the vital community work done by these extra-ordinary people day in and day out that many just take for granted. I interact with them constantly but truth be told I still know little of the travails that face them in the front line of pre-hospital medical care so I figured…why not? I had previously hung out with SMUR and SAMU in Lille in the 90s and enjoyed the experience even though they were French (heh).

In the space of a shift, we had covered the run of the mill overdoses, domestic disputes, assaults and stab injuries, unconsciousness, fits, difficulty in breathing, falls with fractures, transfers, bleeding, rushed food and toilet breaks, police, drunk teenagers…it makes you wonder how some people live, if you can call it that.

The down to earth chaps were great to hang out with, the bum numbing bumpy rides in the dark and screaming flashing blue lights may get the pulse racing, but the most extracted from this experience was seeing patients in their own microcosms of existences that put their concerns and illnesses in perspective, the difficulties of caring and extracting confused, scared and sometimes violent people and seeing how we are all interconnected as team members to keep the veneer of civilisation from breaking down.

One notable patient I came across had Parkinson’s disease whose condition contributed to her fall resulting in a closed spiral peri-prosthetic fracture of the femur. It reminded me of the high profile publicity the condition got from the amazing Michael J Fox and this led me through a trip down memory lane when I was randomly surfing the Net…I couldn’t believe I found a particularly memorable episode of Family Ties ("hip parents, square kids"), one of the quintessential 80s sitcoms I grew up with, after something like 20 years. I remember having a crush on Justine Bateman and thinking Michael J Fox was oh-so-cool. Shit, can you imagine TV these days having such a cheese mush fest of an opening song? Isn’t it bloody brilliant?!?

I still recall this particular mushy yet poignant episode of “The Real Thing” as if it was literally yesterday and how massive the song “At This Moment” (by Billy Vera & The Beaters) was back in 1987…a song that I had slowed dance to *sigh*. Wow…I haven’t heard this song until like, uhm...just now…and all the synesthesia and emotional feelings it brought back was….*puppy dog noises*. It was one of the more memorable episodes in which the conservative Republican money-minded Alex .P Keaton met the sensitive insightful artist Ellen Reed, both actors (Fox and Pollan) later marrying in real life and are still together after all these years…which I guess is something akin to forever in Hollywood.

Still, the best two-part episode of Family Ties was and still is the Emmy winning “My name is Alex”…but I can’t seem to locate the whole damn thing yet. Surely the series must be on DVD by now??

Fluttering Kites and Shuddering Creeps

What a surprising joy to have seen this heart tugging film simply because it was better than I had expected despite the controversies, cultural inaccuracies, and cuts and alterations from the book, The Kite Runner by Khaled Hosseini. The entertainment value came principally from the commendable acting and chemistry from a pair of unknowns (especially the superb Ahmad Khan Mahmidzada playing the guileless and loyal young Hassan), beautiful score, panoramic scenery and a well-told story at a measured pace that pitched the mush factor at just the right level of lachrymosity.

It still has all the concentrated contrivances, convenient coincidences and correct clean lines that plague a neatly constructed novel but what the hell…I can see the film’s positive magic touching a lot of people and winning shit-loads of awards (I might cynically add, precisely the kind of stuff the Western world laps up in ladles and loves assembled, pre-packaged and gift wrapped with a neat bow tie about a culture and world still largely unknown to outsiders...and I may add even more cynically, the political climate is ripe for this).

I am also ploughing through my Heroes episodes and enjoying every bit of it even though word has it that the second season is not as good as the first. I can only shudder knowingly when I see Isaac Mendez painting the future when he has precognitive visions beyond his control.

Apparently precognitive dreams are fairly common and I honestly don’t know what to make of them as I have them from time to time (it’s always very vivid as opposed to run-of-the-mill dreams). Most of them are random shit I have no control over. Some related to me, and some seemingly never related to me. But I still remember the morning when my Dad rushed into my bedroom and told me the space shuttle Challenger had exploded – months after I had painted a picture of a space shuttle explosion (the painting was published in my school year book). Or the time my sister phoned me to tell me the Concorde had crashed…weeks after I told her of my hyper-realistic dream of seeing a Concorde (a plane until then that had never crashed) ploughing into a field right after take off near to a motorway and a row of houses. And then I see this in the news:

Most are probably coincidences and selective bias but these two still creeps me out to this day.

Happy Winterval

The German origin of the modern Christmas tree. The Germans had quite a religious feeling for their Weihnachtsbaum, which in turn stemmed from the pagan ancestral worship of the trees of the wood.

"Thus saith the LORD, Learn not the way of the heathen, and be not dismayed at the signs of heaven; for the heathen are dismayed at them.

For the customs of the people [are] vain: for [one] cutteth a tree out of the forest, the work of the hands of the workman, with the axe.

They deck it with silver and with gold; they fasten it with nails and with hammers, that it move not.

They [are] upright as the palm tree, but speak not: they must needs be borne, because they cannot go. Be not afraid of them; for they cannot do evil, neither also [is it] in them to do good."

^Yet another reminder against idolatry in Jeremiah 10:2-5 in the King James Version of the Bible. It was also the third Commandment if I remember correctly. But I believe it shouldn’t matter if you are a heathen.

It was a random quirk of my rota that I had a long period off over the Christmas season this year. So we had great moments simply spending time with loved ones and that was what mattered most. I was also most impressed to see the use of the Dyson airblade hand dryer at Gatwick airport and various London train station public toilets as I have been a long-term fan of the Dyson vacuum cleaner because it actually sucks.

But back on topic.

I have spent most of my life celebrating Christmas and I have many fond memories of them too. However I have stopped ritualising this hybrid pagan-Christian holiday years ago the moment I found out about its origins. I could not stand myself being a phoney so I stopped. It was really as simple as that and it’s no big deal. In fact I am more than happy to work over Christmas usually in shift swaps with colleagues as I know how much it means to many people.

I don’t mind at all if others celebrate it and I am not remotely offended so all this PC BS to ban religious symbols is nonsensical. It is often the Jews and Muslims who ask where have all the Christmas cheer gone? After all, you might be a pagan or a Christian (although a Christian should not celebrate Christmas and I know many Christians who don’t. Don’t kid yourselves about how much fun it is for it goes against many teachings of the Bible from the Old to the New Testaments). I find in fact that it is atheists, agnostics and those who are most uncomfortable with religion (and these include nominal Christians) that worship and celebrate the customs of Christmas with the most fervent zeal. When I kindly ask what exactly are they celebrating, it never ceases to amaze me how tongue-tied they become when such a blasphemous thought is introduced.

One has to be profoundly ignorant to be unaware of the numerous pagan customs shoe-horned into the supposed celebration of the ethnically Jewish Jesus’ (PBUH) birthday (why exactly do we give each other gifts if it is his birthday? Yes, it’s another pagan custom…go find out for yourself) or the mass crass commercialisation that has increasingly crept into it year on year. Okay, even if we accept it as a secular commercial holiday, it is still a deadweight loss under orthodox (ahem) microeconomic theory due to the massive surge in gift giving. And for the greenies out there, please consider the environmental impact of the clutter of waste, the millions of trees destroyed for the production of billions of cards and the purely pagan custom of setting up of a “Christmas tree”, the amount of electricity consumed by decorations bright enough to be seen from space or the carbon footprint from transportation of goods, people and junk. What I am saying is that there are greener ways to celebrate Christmas if you must.

Also, being fiscally responsible when you worship and sacrifice your moolah at the altar of the First High Church of Retail Therapy is a must. After all, you won’t be able to afford 72 virgins when you find yourself on the other side of existence called “spiralling debt”.

But surely when this does not amazingly happen (Christmas Day alone accounted for £84 million in online sales in the UK) is it appropriate and fair to place this under “Life & Style” sub-section “Women”? How sexist of the Times! Tsk. Tsk.

Other than that Christmas was great for me this year and I hope everyone else had a Merry Christmas and will have a happy and healthy 2008.

Cheers!

Izzy Boo

I spent the weekend with my 2 year-old niece who is getting to be quite the chatterbox. Amazing sentences like “I’ve got a wedgie!” or announcing proudly in a full train carriage, “I’ve done a big poo!” were run of the mill.

We took her to the Shark Capital of Scotland at Deep Sea World at North Queensferry where she was fascinated by the piranhas, frogs and “ho, ho, ho”. It must have been the fourth Santa she had seen in two days and it’s not clear what she makes of him. She would stare at him timidly for minutes and then declare unanimously, “I want to go home!” Hmmmmmmmmmm. But it was the toys and stickers at the gift shop which would fascinate her more whilst I larked about with a hand held toy shark with movable jaws that bit her bottom making her laugh.

She absolutely loves playing hide-and-seek and we spent many fine minutes hiding in all the rooms, closets, curtains and cupboards at my place. She would loosely count to twenty and declare, “Ready or not, here I come!” accompanied by a devilishly cheeky face with narrowed eyes bent on mischief. She is so utterly adorable.

She thinks she is hidden. ROFL.

And wow, it snowed for the first time as soon as they got here!

She can negotiate. Eyeing and then grabbing a bag of Haribos, she would make her demands pretty clear, “Mommy, Daddy I want sweets!” Tantrums would be Plan B. Never fails. But then she is caring and readily shares the sweets with me freely without any prompting.

She loves to dance and every time a musical interlude she recognises is heard we would hold hands, do a little twirl and shake da booty.

She is very sharp and picks things up quickly after hearing or seeing things only once. She can sing some Christmas Carols in a semi-literate shy way with a huge smile on her face. And she LOVES reading books…or at least she pretends to since the only books at my place have words and no pictures. She would grab a whole pile off the shelves from my towering bookcases and ad lib stories to me in a delightful sing-song fashion.

At the Royal Museum of Scotland in Edinburgh, she would literally drag me by the hand to take me see the world that is full of delights and try the various hands on exhibits in the science section. And this is the age where everything is questioned with a plaintive “Why?”

She makes the ordinary extraordinary.



Children are essentially a blank cheque for hope. That’s what they are.

A Jew, Muslim, Christian, Atheist And A Vampyre…

…walked into a bar. Okay, okay…actually they are characters from the last few books I read. Well, along with tempting offers to the mind-numbing paradise that is digital satellite TV, I got yet another Official Warning in the post today from the TV Licensing Board threatening me that if I do not pay my annual TV Licence I could be slapped on the wrist, incarcerated with soap-dropping spotters or horror-of-horrors…forced to watch re-runs of TV reality shows ad nauseum.

Meh.

It’s been over 5 years 5 months since I’ve binned the dead metal. I refuse in principle to pay good money for being a passive consumer of commercial shit. Plus I don’t really have the time to watch shit (far more profitable to waste my time in front of the computer, of course). I’d rather see what I want, when I want (the internet and DVDs serve that purpose well enough for me). But I’ve also ended up reading more books, devouring at least one a week. Anyway…the last random few were…

Elizabeth Kostova’s “The Historian” (2005)

This book left me anaemic with horror. Horrified at how interminably boring it was.

First off, it’s pretty damn obvious that this is a labour of love for an author who adores history, genealogy, librarians and the legend of Dracula. I mean, that in theory should be a winning combination for me…especially when a character utters thus:

"It's my belief that the study of history should be our preparation for understanding the present, rather than escape from it." (p335)

Yup, pretty much the standard aphorism I do in fact utter but that was all the enjoyment I got I’m afraid because several things annoyed the hell out of me. The novel started off promisingly in a gothic way but vapidly descended in the most protracted way possible into a sappy love story between the standard atheistic dashing academic chap (why of course) and a beautiful atheistic intelligent jaded woman (you don’t say!) using a hybrid attempt of crosses and a touch of Islam to fight off the undead. C’MON! Maybe it's because I am a cynical bastard but there were a lot of suspiciously fortuitous happenstance and serendipity used to drive the narrative from point A to point B plus gratuitous doses of rose tinted idealism between the interactions of human characters that I found utterly unbelievable. They were also convenient walking-talking-encyclopaedias of history, furniture and what-have-you, to the point they all conversed in the same bland way…even Vlad Dracula himself, who just seemed so emasculated and wooden when we finally meet him (who incidentally is the titular “Historian”…to the in-joke of him actually having a copy of Bram Stoker’s Dracula in his own library…*winces*). Seriously, a trimming of the fat here and there and a stake through its heart would have made a more taut novel. Bite me.

(For the record, my favourite Vampyre novel of all time, besides Bram Stoker’s "Dracula" (1897), is the much under-rated Joseph Sheridan Le Fanu’s "Carmilla" (1872). The 19th century Irish seriously knew how to wield the gothic pen.

For the study of Vampyre lore in literature, Christopher Frayling’s “Vampyres: Lord Byron to Count Dracula” (1992) comes highly recommended by moi.)

Sam Bourne’s “The Last Testament” (2007)

Another Da Vinci Code wannabe that actually has a good McGuffin looted from the Iraqi National Museum during the war in 2003 that may change the Middle East conflict between the Israelis and Palestinians. It’s the same formulaic religious history thriller in bite sized chapters ending with useless non-suspenseful mini-cliff-hangers, a hot intelligent ballsy lapsed-Catholic babe© and a handsome macho yet sensitive Jewish man© (yes, they do bang each other) in a race against time to locate…well, read it to find out what it is.

But having found out what it is, any Tom, Dick and Ahmed can guess the uncontroversial pedestrian ending. It’s undemanding pulp fiction full of clichéd cardboard characters for people who know jack-shit about the Israeli-Palestinian conflict and Abrahamic religions. Which means it should sell.

Justin Cartwright’s “The Song Before It Is Sung” (2007)

This is a moving well-crafted piece of work that is elegant, morally and intellectually engaging and poetically elegiac. I would rate Cartwright amongst the best of contemporary British writers and this book was simply a delightful find. By the use of differently named characters, it’s essentially a fictionalised historical story of the relationship between Isaiah Berlin, the Jewish Oxford philosopher, and Adam von Trott, the German aristocrat who had been a Rhodes scholar in Oxford, and a token card carrying Nazi but true German patriot who plotted to assassinate Adolf Hitler at the “Wolf’s Lair” in 1944. The book’s narrator, a dreamy Conrad Senior, having been bequeathed various personal documents, becomes obsessed about finding out the past (and the location of the only surviving film of the German patriot’s eventual execution ironically filmed by a Jewish cameraman still living in present day Berlin) to the detriment of his relationship with an emotionally frigid unsympathetic lover who cheats on him.

The history is essentially iffy but ignoring that one stain, the novel’s delving into the larger questions of fate, friendship, and the contrast between talk and action as exemplified by the two main characters was masterful.

Shimon Ballas’ “Outcast” (English translation from Hebrew 2007)

This is a rare little gem from a contemporary Israeli writer originally from Iraq. Admittedly this review was what got me interested:

" . . . reveals more about modern Iraq than nearly all Americans put together know, and Ballas creates one of the most relevant, most important characters in contemporary fiction." – Booklist, Starred Review

Ouch. That was a bit harsh hyperbole heaped on the Americans (even though it might be true…heh). It’s a fictionalised historical memoir of Haroun Sassoon (based on the real figure of Ahmad Nissim Soussa), an Arab Iraqi Jew who embraced Islam in the 1930s and his personal interactions with family and friends set against the tumultuous background of Iraqi politics. Now talk about a Pandora’s box of issues.

I loved the insights the narrator made on himself, people, religion and politics. The depressing narrative sometimes rambles a bit and goes off into seemingly unpromising tangents but it does tap into issues of identity, loyalty and family dynamics as it does so…a scene where the narrator stands in front of the cross of the grave of his wife with his Jewish son and Muslim daughter pretty much sums up the poignancy of his life. This book could probably benefit with a timeline of Iraqi history for the general reader since even with my paltry knowledge I felt it was hard to follow.

Take Turns

This is the popular right brain vs left brain test

Look at the picture. If you see the dancer turning clockwise, you use more of the right side of your brain. If you see the dancer turning anti-clockwise, you use more of the left side of your brain.

Most of us would see the dancer turning anti-clockwise and if you focus you can also change direction of the dancer.

LEFT BRAIN FUNCTIONS

uses logic
detail oriented
facts rule
words and language
present and past
math and science
can comprehend
knowing
acknowledges
order/pattern perception
knows object name
reality based
forms strategies
practical
safe

RIGHT BRAIN FUNCTIONS

uses feeling
"big picture" oriented
imagination rules
symbols and images
present and future
philosophy & religion
can "get it" (i.e. meaning)
believes
appreciates
spatial perception
knows object function
fantasy based
presents possibilities
impetuous
risk taking


What do I see?

I find this is yet more proof my brain is not like 99% of the population.

At first glance, I’m thinking….heyyyyyyyy hot heavenly honey. Okay, seriously. On second glance, I see the nubile nymphet nipples turning clockwise (hmmmmmmm imaginative fantasy based right brain for me then). But I can also make the pretty pirouetting princess pivot anti-clockwise. In fact I can literally make the lithe lap-dancing lassie loop any way I want instantly. I can force the fetching fit filly flip-flop back and forth by fluctuating the graceful glamorous girl clockwise and anti-clockwise alternately at Will without the captivating contoured chick ever circumvolve a full 360 degrees.

That to me is out-right proof that one can alter their perception at Will – but only if one wants to.

Lions For Lambs

The film was more intellectually engaging than say, The Kingdom or Rendition (but that is not saying much) yet still came across as trite…but then again Redford was deft enough to realize not to delve too deeply on the issues regarding what motivates us as individuals and on the “War on Terror”, vast topics that tends to polarise (or…paralyse) people, lest it might just alienate the movie going American public whose Friday night entertainment peaks at the level of Bee Movie…or whose general knowledge seemingly regresses to primary school level as one gets older…

The tryptich plot, if you can call it that, does not actually visually intersect but is made to intertwine like a braid by the audience’s mental participation of digesting and assimilating the staccato questions and conundrums thrown out like pretzels to the movie-goers (now…don’t choke on ‘em).

Charming Senator Irving (played by everyone’s favourite alien, Tom Cruise) announces exclusively a “new strategy” on the “War on Terror” to the veteran but seemingly naive reporter Janine Roth (Meryl Streep) as a favour, delivering neo-con sound-bites without offering any evidence and blithely admitting “past mistakes” but then goes on repeating more new ones.

Two model soldiers (played by Michael Peña and Derek Luke) who fought the much tougher war of gettin’ outta the ghetto and into higher education are shown to be lionised examples of American patriotism, honour and conviction by having volunteered to fight the war implemented by baa-aaa-ad lambs but end up just being cannon fodder.

Then you have the privileged slacker but very bright student (Andrew Garfield) being given a one-on-one sanctimonious dressing down by a Californian Professor of Political Science (Redford) in order to motivate him to…translate his apathy into action that…THIS WAR IS A TRAGIC WASTE OF HUMAN LIFE. Oh shit…I just gave away the entire plot and message.

It’s sneakily anti-Bush but plays out fairly balanced no matter what side of the political divide you happen to be in…if your whole idea of politics is from a Western centric POV. All we see are American faces. We (might) care for the American faces. We (maybe) cheer for the American faces. We (I sincerely doubt) cry for the American faces. The Afghans are reduced to mere mutterings in the snow and moving black dots on a screen…to be blown to bits by American military hardware like the hapless dime-a-dozen commie bastard Vietcong in Rambo First Blood Part II. I mean who cares on how the policies of the “War on Terror” impacts on others because as Senator Cruise explicitly states, it is the USA that has been attacked! And oh yeah, this film is hardly going to be a box-office draw in Kabul or Tehran.

‘Liberal’ has somehow become a dirty word in American politics and I doubt Redford’s friends see much capital gain from this lite-film (check out the Celebrity Liberal (or Celiberal) Whine Rack and List!) but to be fair, as director and actor, he has done a reasonable job of avoiding the highly tempting route of providing answers but chooses instead to simply rehash the questions that many are now openly asking and is thus a useful catalyst for stoking the fires of debate and discourse before we all return to our comfortable cloistered existence.

It Is Impossible

Damn. I am still riding on adrenaline.

Just shy of midnight, 50 year-old Mr X walked in complaining of central burning chest pain for the past hour and a half rather than attend work as a taxi-driver on the night shift. I was at the fag end of seeing another patient documenting the notes and wanting some nourishment but had this chap’s ECG placed in front of my I-want-to-go-to-the-loo face for a quick opinion. The nurses are great at their job. Hmmmmm…1 mm ST elevation on V1 and an indeterminate rise on V2 with a very mild ST depression on the lateral leads. Riiiiiiight…I said he needed to be urgently seen next.

I rushed into the cubicle. He looked comfortable sitting on the trolley chatting away and his vital signs were all normal. I introduced myself. Tell me all about it I said. He had been on a proton pump inhibitor for years. He thought it was indigestion and had self-medicated with Rennies with some improvement in symptoms. The pain was almost completely gone. Well so far so good I thought. But closer probing with my rapid fire questioning in the next minute revealed that the pain had involved his left arm associated with very slight dyspnoea and brief sweatiness. Uh oh. That sounded cardiac rather than dyspepsia. And he was a known hypertensive. And a heavy smoker. And his father died in his 40s with a myocardial infarction. As far as I am concerned, that was good enough for me. We needed to get him out of the examination cubicle and move him to the resuscitation bay now.

Cardiac monitor lines were immediately unplugged. Trolley and patient rolled into Resus Bay 1. He looked absolutely fine, non-plussed and slightly amused at the fuss. Oxygen. IV access. Bloods. Sats monitor. Chests leads, BP, pulse, temp and BM. Aspirin and clopidrogrel stat. IV morphine and metoclopramide and GTN. The pain was completely gone now. Wahayy! Can we have a repeat ECG? Yes. It was completely normal. Straight-forward. So it was unstable angina +/- dyspepsia. Whatever. He needed to come in for a M.I. screen. I even weighed him myself to calculate the correct dalteparin dose. You MUST stop smoking I said. I’ve tried and I can’t – it’s impossible he said. Uhhhhhm, sure.

Instead of the regular on-call medical team, I instinctively called the on-call coronary care unit doc…that happened to be at another hospital. God knows why for it was purely a visceral instinct. They had one bed left in reserve only for a thrombolysable MI but another bed for assessment. Sure, he said, we can probably take him but could I fax the ECGs over first? He will call me back and let me know with a final answer. Sure. The ECGs were faxed over. Then the chest pain came back with a vengeance. I gave another IV bolus of morphine. The pain settled completely within minutes. Cool. Can we have another repeat ECG? Yes.

This time there was >2mm ST elevation on leads V1 and V2. Shite…this was a frank MI. I quickly checked that he had no contra-indication to thrombolysis. The call from CCU came back…I interrupted and said we now have a thrombolysable MI so you guys can actually take him. Despite being pain free, the morphine was likely masking the pain. We both agreed that he should be thrombolysed tout de suite.

And then he started gurgling and went into cardiac arrest right in front of me as I was on the phone.

“Uhmmmm…he’s just gone off so I’ll call you back okay?” I put the phone down. The crash team was called. Everyone and their dog ran to the resus bay. WTF. It was ventricular fibrillation. The first shock was delivered after I tried to hop, skip and untangle myself from all the bloody wires. His body convulsed violently with the shock. His face turned a ghastly blue. Chest compressions and bag mask ventilation was resumed. A second shock was delivered at the second cycle. Then the rhythm changed…yaaaaargh. Still no palpable cardiac output. Probable pulseless electrical activity or low cardiac output. Continue CPR and IV adrenaline. Then the rhythm changed to VF. Right…charge, clear, check and shock! Whump…his body convulsed violently. CPR was resumed and intubation attempted. And then a sinus rhythm appeared and he was self-ventilating. Bloody hell. Poised with the prepared tenecteplase in her hand the medical team member asked Was there a contra-indication to thrombolysis? No, I said. He had the green light for it. And the IV bolus was given.

And then he went into VF and a fourth shock was delivered. CPR was resumed. Then he suddenly struggled, sat bolt upright and spat out the Guedel airway. Everyone around him took a step back, with him and us looking at each other collectively with a massive WTF-is-going-on on all our faces.

He wondered out loud if someone could please contact his workplace.

Errrrrrrr. We all looked at each other and collectively spontaneously laughed as the intense tension of the last few minutes just vapourised. Phew.

Repeat ECG showed a massive antero-lateral MI across all chest leads. Arterial blood gas showed only a very mild acidosis. He needed a CCU but should he undertake the long journey to the regional specialist hospital where rescue angioplasty was available should the tenecteplase not achieve reperfusion? After a phone call with the cardiac specialist it was settled that the ECG should be repeated at 90 minutes post thrombolysis. If no improvement occurred by then, then IV tirofiban should be commenced and the patient transferred for emergency coronary angioplasty. Everyone and their dog dispersed to their usual work places.

Mr X was sat upright talking, comfortable, pain free and he was…alive. His concerned work mate came in to chat and joke with him. I went away and resumed whatever I was originally doing after the documentation was completed.

Then the crash team alarm bell was activated. Bloody hell. Whaaaaat now? Reperfusion arrhythmia?

Everyone and their dog ran to the resus bay. Mr. X looked fine and dandy. Mr. X’s concerned work mate lay collapsed on the floor like a star fish. Apparently he gurgled, went pale, unconscious and fell backwards off from the stool he was sitting on…but was now awake whilst a nurse held his legs up. It looked like a vasovagal syncope…a simple faint. A formal examination and check ECG supported that.

Mr. X’s family arrived and came round, chatted and joked with him. At 90 minutes the repeat ECG showed complete resolution of the MI for him. Absolutely amazing. I told him if he had originally chosen to go to work he would have definitely died tonight.

Transfer arrangements were formalized with the ambulance crew and receiving CCU. He thanked me as he realised how close to death he was.

"Look, you MUST stop smoking okay?"

“I already gave up an hour and a half ago!” he said.

Strange Meeting

"I am the enemy you killed, my friend.

I knew you in this dark; for so you frowned

Yesterday through me as you jabbed and killed.

I parried; but my hands were loath and cold.

Let us sleep now . . ."

- Wilfred Edward Salter Owen 1918

Depeche Mode - Enjoy The Silence

The whole synthesizer approach sounds horribly dated yet it gives Enjoy the Silence that undeniable charm as the best example of its genre with its beautiful melodies and concise lyrics that never tires my ears no matter how many times I listen.

Simply one of the best songs ever written by a British group

Words like violence

Break the silence

Come crashing in

Into my little world

Painful to me

Pierce right through me

Can't you understand

Oh my little girl

All I ever wanted

All I ever needed is here in my arms

Words are very unnecessary

They can only do harm

Vows are spoken

To be Broken

Feelings are intense

Words are trivial

Pleasures remain

So does the pain

Words are meaningless

And forgettable

All I ever wanted

All I ever needed is here in my arms

Words are very unnecessary

They can only do harm

All I ever wanted

All I ever needed is here in my arms

Words are very unnecessary

They can only do harm

All I ever wanted

All I ever needed is here in my arms

Words are very unnecessary

They can only do harm

Enjoy the silence

Down In Dundee And Dad

I just got back from Dundee…it tends to be a place I usually rapidly pass by but I liked it at first impressions from up close…it has a noticeably high student population with its two large universities, a rich cultural and scientific patina which I have yet to imbibe, and the city is negotiable on foot with a pedestrianised city centre and the usual shopping trappings to cater to the most essential needs of the inane modern lifestyle. It also seems to be randomly peppered with cemeteries but I think the city just gradually grew around them over time, rather than have the burial places erased away for development.

I worked briefly at Ninewells Hospital the last few days in my time off, more as a fact-finding mission for myself to see how another place operates. It’s not the largest hospital I’ve been to but with it’s expansive multi-storey layout, the place felt like an interior of an aircraft carrier when trying to negotiate my way through the labyrinthine corners, stairs and long corridors, nimbly dodging staff, students, trolleys and vehicles in a hive of industrious activity. I was amazed at the number of people whom I randomly bumped into who have seen me or think they’ve met me or know people who know me (!) I didn’t have time to meet up with Reem but she promised to cook me some food the next time I drop by…plus she’s tempting me further with green tea. How can I refuse an offer like that???

Halloween at Edinburgh tonight was awash with randy Roman centurions, not-so-little Red Riding Hoods, pasty pirates, card-board cowboys, naughty nurses, dastardly doctors and other similar ghoulies and ghosties. And twats, you may be dressed like that guy with a big “S” on his chest and tanked up with alcohol, but please look carefully both ways before crossing the busy road or you’ll end up in Scotland’s busiest A+E department covered in a different type of red and blue.

I’m not feeling too good atm. With my lack of internet access at times for days and my mobile being off when at work, I only just literally got news my Dad has been hospitalised with massive bleeding. It doesn’t help that I know the differential diagnosis inside out. And I was due to see him next month. It’s eerie that for some inexplicable reason at the same time I couldn’t sleep last night and I lost my house keys – something that has never happened to me.

Youth Is Wasted On The Young

I need to find me one of these for Halloween

I’m currently sipping my astringent jasmine green tea all warm and cuddled as the winter season starts to settle in. I’ve found meself a clinically neat tea-house to feed my green tea addiction even though the prices are twice that of Aberdeen (bah!). It’s becoming a seasonal habit of mine…dark winter nights means an emo-leaning towards moody classical music and warm pots of green tea...sound and taste being the two senses strongly associated with memory for me (my sense of smell is not as powerful as the other two)…after all, winter time in the UK can get fucking boring when soulful reflection can surprisingly be a major activity, as waking up and coming back from work means hardly being greeted by the DNA destroying rays from our friendly yellow ball of gas in the sky.

Ahhhhh, green tea and no sun – just some of the secrets to my disarmingly youthful appearance. Yes, I genuinely confound people. First, after having long ago shaved my oh-so-cool moustache (on the advice of a girl…err, I concede she was actually right) people now think I am much younger than I am actually…from, “Soooo….what are you studying now?” (uhmmm, I’m waaayyyyy past post-graduate)…to the classic…“Can I see some I.D. please?” (uhmm, not only do I not drink, I often treat these drunk and/or assaulted fuckers much younger than I, thank-you-very-much)…to the extraordinary…“Are you old enough to watch this DVD?” (paying for a copy of “Léon” at the till – one of my all time favourite films I can near quote verbatim)…to being flirted by teenage girls young enough to be my daughters. It’s so Nabokovian. I don’t mind though as people younger than me collapse with acute myocardial infarction and it’s me ending up treating them.

And then I open my mouth and from a few choice words they rapidly realise I’m not fresh out of kindergarten...“Sorry, what does that mean?” (NB to self: desist enunciating archaic iambic pentameters)…

…but then I get the second confounding classic, “…that accent…it’s not Scottish…where do you come from…which part of England…it’s so region-less”…to the improbable but already occurring several times, “South Africa? Australia?” (NB to self: WTF??!?).

Nobody guesses correctly I’m from Hong Kong. Not even people from Hong Kong. Not even when I am in Hong Kong. And then their mandibles plunge when this “gweilo” reply in Cantonese. And eyeballs extrude, expand and explode when they hear me colourfully swear in Cantonese.

Then thirdly, the inevitable…“What are you?”…and some inexplicably, for lack of an imagination, settle on something that may just cover it:… ie. ----> “Are you…American?” (Oh the ignominy)

Well, I’m Eurasian if you must know, the next stage in human evolution…


So seriously, how does one go someway in maximising their chances of staying youthful and healthy? Of course where you live and other environmental factors can have a huge impact – poverty, pollution, poor sanitation, crime, ignorance, gamma radiation and inane reality TV shows can really be harmful. But reflecting on my habits the following Ten Commandments is what I actually do and may go some way to explain my Peter Pan appearance:

1) Do NOT smoke.

2) Do NOT consume alcohol.

3) Enjoy life but don’t purposefully spend unnecessary amounts of excessive time in the sun.

4) Plenty of water. Or green tea (heh).

5) Eat plenty of fresh fruits and vegetables – there are onions, garlic, tomatoes, carrots, ginger, pulses, cereals, apples, bananas and EXTRA virgin (heh) olive oil and vinegar somewhere in my diet everyday. Oh yes, I eat rice everyday too – potatoes can do as well (I neeeeeed my fuel). Consume lean meat and oily fish. Limit amount of red meat. I allow myself copious amounts of chocolate (gotta treat yourself every once in awhile) but other than that I generally avoid junk food.

(This is not for everyone since for some their genetic make up can’t handle it but I drink lots of whole fat milk (never with green tea) and consume cheeses every bloody day and it’s the high calcium intake that is one of the reasons that keeps me thin. I also eat chillies everyday but that is just a “me” thing of loving spicy food – it’s not for everyone)

6) Hygiene – brush your bloody teeth at least twice a day, wash yourself etc. It’s bloody common sense.

7) Exercise and stretch regularly. Some yoga it or tai-chi it or martial arts it. Whatever works for you. I just walk briskly (I’m %^&*£)£ late for work) at least one hour every day. Occasionally I'm even known to jog. As a bonus, performing salah five times a day, every day actually exercises every joint in the body.

8) Get enough sleep.

9) Be spiritually content (that is totally different and separate from being happy but if you are happy too, then lucky you). Have at least one passion in life (not just mere interest although that is a start!). Exercise, challenge and stimulate the mind mentally with cerebral gymnastics. Be interested in family and people. Love and be loved. Where possible, avoid negative souls who tend to bring out the worst in people. Basically, try to %^&*£)£ minimise stress.

10) The rest is random genetic lottery.