localised showers

It was a day that started off badly. I was woken up at 5.20am to do work that should have been done a day before. I then slept one hour at a time (between work bits)  before ultimately throwing myself out of bed and into the pool. A boys' school group arrived and the first 5 minutes of bliss in a crystal pool became a spa pool of so many deodorant smells it was a sea of teenage angst. The guy who hit on me at the pool a few weeks back apologised at the scene of the crime - he had been about to abduct me back then - so it was kind of appropriate - we had a surprisingly reasonable conversation. 

Breakfast was at the usual suspect, diggies with a surprise friend. We chatted about all and sundry, including the medical dramas developing during the week, in the pleasant breeze of a perfect spring morning. I had a breakfast of bircher muesli mixed with with yoghurt, marinated strawberries & cranberries. I was surprised at how good the cranberries actually tasted. I'll order that again.

My breakfast buddy invited The Frenchman & myself to a tapas dinner back there in the evening with some of her friends after we'd mentally re-landscaped her garden. It was all over too soon and we were both off to work again. I arrived at the hospital, dropping my phone on getting out of my car to promptly step on it. Perfect.

With one patient I asked about how long she'd had the cancer affecting her liver to which her partner interjected (or should I say, lectured me) that she didn't know and until right now no-one had told her about it. He knew of course. There are so many things wrong with this scenario that I don't know where to begin. 

At gym after work I had an unexpected gym buddy. He was doing pretty much the same routine as me, running, then weights then abs then stretching. We'd chatted quite a few times there and at the pool - sexy man I might add, and it was great to actually spend some reasonable time chatting about life & loves in between the puffing and sweating. 

Dinner back at the regular was with my breakfast buddy, The Frenchman and 3 as yet unknown diners. We stayed until there was no-one else left at the restaurant, enjoying conversation that was sparking on all cylinders right to the end. I could easily do this regularly. I find out later that they in fact do do this every Friday - and we're welcome to join in the tradition. 

It wasn't such a bad day after all. 

Thursday Friday

Let's go back to Thursday, where I wake up and it's morning - I've not overslept on my morning off for a change. They predict 33 degrees today and I feel that they're going to be right. I want to take advantage of this weather and not sleep it away, so after about 6 hours rest I'm up, breakfasting, and getting ready to go to the beach. I'm not a big fan of the sun, but I love the water and the energy and at the same time the relaxed feel I have being somewhere without electronic communication. Reading things written on paper, listening to the waves in the dappled shade behind the beach. Life is good, and the men are getting cuter. I wonder how they'll be looking after 6 months of warmth and exercise. The future is looking good. I'm chilled out and a world away. 

Work in the afternoon at the surgery is a lot of fun, and I get fantastic feedback about my photos hanging there, though nobody has bought anything yet. At the hospital I arrive and within minutes am at the delivery of twin boys. Then there are a further 4 deliveries that follow where I am required. The dads faces expressing emotions from extreme excitement to shock and disbelief - I think one is about to cry or fall over or something, but he seems to remain in complete shock well after the baby's wrapped and given to him. I wonder if he knows how to change a nappy. He soon will.

The father of twins now has 5 kids. He looks like he knows how it all works. But he's still thrilled. 

Breakfast Friday at diggies and there is a new menu. I think I prefer the old menu, but they've brought back an old fave, so it's not all bad. The day is again superb, sunny, way too hot for spring and it gets to 39 degrees (102.2F) at various points in my travels. I really don't feel like working, and all the homes I visit with air-conditioning have it turned off, but it's a dry heat and they're a lot sicker than I am. They're saving the planet even if they are killing themselves to do it. 

My last house call is to a patient I've seen a few times now - relatively young and dying from melanoma. He and his wife are coming to terms with the whole process of dying, and it hits me harder than most patients I see because I relate to them more than most. At times during the consultation I wonder if I'm really any good at this job, but they surprise me by telling me at the end how many and varied sources have told them how good I am, and I'm quite frankly surprised. My eyes start to tear a little, just a little, and I know that I've actually helped them today by the time I leave. I spent about 30 min more than I had planned, but it was worth it, they needed it. The compliments are icing. The reward is in knowing they feel secure in what they're doing.

I head back to the pool after work. It's too hot to go running, and I swim so fast it's like I've actually had a proper sleep and haven't worked all day. I'm happy about this. And then just to go for complete exhaustion I go to gym, and before I know it, it's the weekend, and I'm hungry. 

Body Parts

Do you know where your prostate is? or if you're that way inclined, your cervix? Know what it looks like? what it does? 

Today I was chatting with friends about various anatomical and physiological bits & pieces and was quite surprised with the lack of knowledge about their own bodies.

Having studied medicine and practised in the field for some years I've become very familiar with both the anatomical and pathological versions of people's bodies. I guess to me it's second nature to know what's happening and where. And while my knowledge is expected, it still astounds me the lack of knowledge most people have about their anatomy. People usually know where their heart is, though not always, but ask about the prostate, epididymis, cervix, liver... and wide eyes are often the response. 

Surely, I think to myself, people will have an interest in parts of their bodies, especially parts intimately involved in things like sexual activity. But it seems I'm wrong about that one too. Though, I think knowledge in this area is certainly a sexual advantage. 

With the world at our fingertips it's so easy to find out what everything is and does - for example if you type "epididymis" in google and click ' I'm feeling lucky ' this is what you will find. Easy. A few minutes later you'll know about a part of you you probably didn't even know existed, though you've probably felt it a thousand times. 

Perhaps as kids we should be taught not just "point to your nose... now point to your lips..." but also "point to your liver, your kidneys... now point to your prostate, your spleen...." it might look a bit odd, but what an enlightened new generation we might have. Who knows, it might even make my job easier.

Raw Emotion

There's this image embedded in my brain. It's incredibly emotive. There is a couple, on the left sits the wife, early 60's, a few missing teeth and overweight, slumped forward in a plain lounge chair, her husband embracing her from her left side.  They're both lit by a radiant heater at the far left of the image - which warmly highlights their emotions and the tears embarrassingly rolling down her cheeks. 

The wife is dying from an acute form of leukaemia. She's tough and jovial, but the intensity of the discussion has broken her. And the tears flow. It seems like a classic theatre production, but it's real. I have asked the questions, initiated the discussion that has lead to this breakdown. It's entirely appropriate that she's crying. And as I sit there watching, I feel an intruder into a world that is not mine. The questions needed to be asked, the situation discussed, and a plan for her ongoing care constructed. And so I sit there, this poignant image burning silently and deeply into my retinas, and I say nothing. There is nothing to be said. It's sad, but it's beautiful. Life is beautiful even when it seems the complete opposite. 

'This is not a drill' Friday.

By the time I have breakfasted at diggies with friends - it's already been a busy work day. But there's a whole new day ahead, and I'm certainly not expecting what comes next.

A short time later as I'm walking out the door of the hospital where I'm based, to go do a series of home visits, a whole movie scene plays out literally at my feet.

There's a car pulling up urgently in front of the hospital. As it stops two men drag this limp body from the car towards me. Through the automatic doors they deliver a man with a congested blue face to my feet. He's unresponsive. They're yelling urgently,' he's been blue for a few minutes', 'he's overdosed on heroin', 'he needs narcan' as they slap him about the face and yell his name, hitting him again as if it might reverse his drug induced coma. 'Do something!' they yell as I stand in a vacant entry corridor in a hospital with no emergency department. There's no alarm to press, no equipment to speak of and not a lot of people around, just a lot of wind that has also just blown in from the west.

I put my briefcase and files on the floor and go through the routine resuscitation steps,  he is breathing but hardly and ineffectually, he has a strong pulse still, thank god, but he needs a working airway and the narcan (which rapidly reverses the effect of the heroin) as his fellow junkies have said. Still, despite much yelling and sending off of staff who have wandered by, no cardiac arrest team has arrived and we have no equipment, no oxygen, and he's still blue. 

Ultimately equipment arrives and with an ad-hoc team he is brought back to life. [Think airways, Oxygen, IV cannulas, and the revered Narcan.]

It's a very irregular start to my day in palliative care. I wander off as he sits up and starts vomiting. He's breathing, he's alert again with the general hospital staff now looking after him. I'm a little shocked, and a little pissed off at the people who so carelessly come close to death on a daily basis.

my gym

The patient I am going to see doesn't answer when I knock on his door; despite me prearranging the visit. I call his mobile and he's shopping at the supermarket. I'm exhausted and I really haven't started. Eventually I finish work and get to the gym where I run for 35 min and gruel through weights, abs and stretching which actually replenishes my energy levels. On my way out of the mostly straight gym I am propositioned by a cute guy who's also just finished there. I smile. 

Oh, what a day of contrasts.

Do Cry...

I had a patient cry during a consultation yesterday. A blokey Australian guy - in his early 60's.  It wasn't the usual scenario: life falling apart, depressed, relationship on the rocks, crying experience. They were tears of joy. He'd started to make the lifestyle changes I'd suggested, in fact he was doing it with much gusto. He was cycling and walking and pushing himself hard, eating sensibly. He'd also quit drinking alcohol(which had been to dangerous levels) and after some weeks of doing this was feeling out of his skin, so much energy, so much drive and able to do so much more than he ever could before. It was like he was given a new lease of life. He was empowered in more ways than one and felt fantastic. It was awesome to see. Also great to have been some kind of stimulus in this life changing experience which was ultimately the result of his own effort. 

These are the kind of experiences that make all my constant harping to patients so worthwhile. In fact it made my day.

Who would have thought?

"This won't hurt a bit"

So I go for a blood test today, not too worried—figure it’ll be over quickly at least… I have big veins! But by the time they even call me in I’ve already guessed what everyone in the room is having blood tests for.
The nurse seems pleasant enough.
“Does it hurt?” she asks, needle already embedded into my flesh.
Somehow she’s managed to miss my HUGE VEINS.
“It’s fine,” I lie.
I forgo complaints as there's still a needle in my arm - and no blood in the tube. I don't want another needle I just want to be out of here. I think I'm going pale. She loosens the tourniquet and somehow manages to get blood without it - I told you I had big veins - but it still takes her forever .
I make the mistake of watching. I wish she didn't know I was a doctor - I'm sure it psyched her out.
Why is this taking so long? The needle is STILL in my arm.
“Really it doesn’t hurt,” I keep telling her, only by now it hurts to say it.

FINALLY she removes the needle and I dive for the examination couch, it's that or the ground.

She realises how pale and clammy I've become as she presses the cotton wool into my arm.

I wait for it all to go away.

She guiltily gives me a box of juice and I'm on my way. 

Then in the evening I pour my soul out and send the story of my blood test to my friend. She mutilates it. "I hope you don't mind."
"Oh no, It's wonderful, really, I like it lots"
And I'm right back where I started.

Wild Health Wednesday no. 2

Last week it was time for your physical check up. But while we do the physical things quite well, we often forget the rest, and it has come to my attention recently how many people are suffering in silence with depression, anxiety, panic... Often putting on a brave face for the outside world but absolutely freaking out inside. It can affect anyone and often does, with gay men more afflicted than most. One such patient just recently told me how he has been feeling severely depressed for literally decades, but has been trying to keep a brave face for the people around him. The bottom line is there's a lot that can be done and in Australia at least with medicare you have a lot of options that won't cost you a fortune.

So rather than freak out - take it to your doctor and talk about it.

I've re-posted an article I wrote for 1234Men below for further detailed information. I hope it's useful but please feel free to ask me more either in the comments below or via email.

Be wild and talk about what's really happening with you. It's a Wednesday thing...

Deep deep down...

Feeling a bit blue? Not really feeling sociable? Keeping away from friends and activities that you used to really love? Bored with the idea of sex? Losing your self confidence? Maybe this describes you or someone close to you. If it’s been more than just a few weeks, then it might well need treatment.

I’ve diagnosed so many people with depression in the past few weeks in my clinical practice that I figured a post here on the subject is in order.

Men are typically brought up to hide any negative emotion, ‘tears are for girls’, ‘be a brave boy, don’t cry’ … you know the drill. Acknowledging you have depression can be a serious step outside of what society considers normal manly activity. When we have these feelings, we can feel it’s a weakness, a flaw, and so we typically hide them from the outside world. We get angry and moody and behave irrationally. Sometimes it will make us withdraw into our corners and hide from the outside world. It may make us scared to go into public places, or contribute to anxiety problems and panic attacks. Sometimes we want to withdraw from life completely – end it all, ‘life’s just not worth living…’ But invariably the feeling of hopelessness is there, it’s like you’re in a submarine, and the world is happening right above you – you can see it – but you’re just can’t get to the surface, you’re on your own, deep deep down, and it can feel like you’re sinking fast.

But you’re not on your own… Depression is incredibly common. Around one in five people experience it at some point in their lives. This also means that most of us will have someone close to us experiencing it at some point, if not ourselves.

People will do all kinds of things to get around depression. Sometimes the odd drink might seem like a good idea, but being a depressant itself, alcohol will in fact just make it worse; similarly party drugs can give a transient high, but often return to a deeper low.

There are a number of things that can in fact help to resolve depression. Simple things like regular exercise will improve it (aim for 30 minutes per day of whatever exercise you enjoy that keeps your heart pumping at least a little faster than normal), talking to a confidante as a regular thing can help get through down times (and strengthen relationships too), just talking out loud with someone can significantly improve our feelings. Professional counselling with a trained psychologist working with Cognitive Behavioural Therapy is very helpful, and this may be combined with prescribed antidepressant medication for optimal effect. St John’s Wort is a natural remedy which has mild antidepressant effect and useful on it's own for milder forms of depression. Certainly there are a lot of antidepressant medications on the market which are extremely effective at treating depression, and the right one can be prescribed according to individual needs (if one doesn’t feel right – there is another sure to work for you). In Australia the cost for these treatments is quite low, and recent changes to medicare mean that you can get rebates for the cost of referred psychologist treatment.

Your GP is the first point of call in order to fully assess depression and anxiety issues, and it’s important that you have a GP you’re comfortable with. There are also other counselling and support services detailed at the end of this post.

Suicide in gay men and youth is much more common than in the general population. Depression is commonly connected with this, and a society that is not welcoming, tolerant nor supportive will only exacerbate this. Feeling suicidal is a very scary and alien thing. It's important that you see someone if you feel this way as it IS something that will pass, but you may well need help to get past it.

We need to recognise depression in the people around us and to make an effort to support them. We need to continue to press for law reforms to recognise gay relationships and support them. We also need to become more visible, to provide positive role models for the youth and indeed young adults around us who need something to aspire to that they can identify with. It is easy to be complacent with what we have, but in Australia we still don’t have equality which is itself depressing. Changing these things may seem insignificant but can be enormously powerful for the mental health of all gay men.

The bottom line is Depression is common, it is treatable, but it can have huge effects on our lives and the lives of people around us. Recognise it, treat it and help prevent it, and your world is going to be a better place.

For more information see the links below.

Australia
Beyond Blue (Australian National Depression Initiative – highly recommended)
Gay and Lesbian Counselling and Community Services of Australia

USA
The Trevor Project (no not me) an organisation in the USA which operates a 24/7 suicide & crisis prevention helpline for gay and questioning youth.

Do you have useful links from your country / state not included here? Please email or post a comment with details.

Friday

Reading the paper at diggies, my Morning Smoothie at my side, waiting for Jamie to arrive, enjoying just being there, just absorbing the energy of the day and the truly stunning day around me. I used to feel uncomfortable sitting in cafes on my own , but these days I don't give a damn. The ocean in front of me - waves folding onto the beach warming air and clear rays from the rising sun. I could stay suspended there all day. Jamie arrives and we both decide on smoked salmon eggs benedict. And it's the perfect breakfast today, our last Friday breakfast together for some months now as he's off training the Chilean Olympic team... and he won't be back until after the Olympics. Damn it. I'm gonna miss him. I'm late to work because we're talking non-stop and there are so many things to discuss before he leaves, and also in no rush to leave the beach.

When I arrive at the hospital it seems I have nothing to stress about as the day is relatively quiet (though the office staff under much stress for operational reasons). I get to spend time with patients I've seen before who need review, and need the time to explore various aspects of their terminal illnesses. They're all strong characters today in their own ways, which makes it a lot more fun and we're all joking despite the seriousness of it all. I end the work day feeling good and full of energy.

Then I go to gym where I do... gym stuff because well, does anyone really want to know what gym workout I do? But it's a light session today because this weekend we're back in Byron bay for our annual ocean swim, and I don't need muscle fatigue in the race. I decide against take away for dinner as I've got too much energy left after my sub-maximal gym, and so I shop and cook a stir fry of fish, choy sum, snow peas, slivered almonds, oyster mushrooms and flat rice noodles. I've not cooked this with fish before - but it works and I'll do it again.

The week has been filled with so many awesome things, life is progressing in ways I would never have expected 6 months ago, and I still have so many more things that I want to do... I still need more hours in the day.

The weekend is here. Another long weekend for us as we're staying on in Byron bay for 4 days all up.

Perfect.

Have a great weekend. If I'm not too busy chilling out I may post updates along the way.

Wild Health Check Wednesday

The last time I saw my own GP (family doctor) was nearing 2 years ago. Dentist? A bit more than that... While nothing's falling apart, yet, I think it's time to get reacquainted with my health care providers. How well do you know yours? It's not exactly a wild thing to do but it can be a bit scary, people sticking things in all kinds of places, but then, I'm sure you've done worse... We men are too often complacent about our health (I see it every day) and if you haven't been checked out for a while, today's the day to make that appointment to see whoever needs to poke and prod you a little to ensure you've got no major servicing required. Go on, make the call. If you're sexually active with a number of different partners you should make it a regular event for just the STI component alone. Being a GP myself it almost feels decadent to see my own GP, time for some indulgence I say!

click here for info on oral sexual health that I wrote last year for 1234men...

talkfest

A patient of mine tells me today that she saw coverage from the 2020 Summit in Canberra , on TV on the weekend, and that if she knew it was on she'd have gone to take part in it. She'd tell them how they need to fix up workcover health insurance because she has (legitimate) grievances about it, and a handful of other things that she'd clean up.

I sit there wondering if she realises that the rest of Australia knew an age ago this was happening, and that you needed to be a leader in your field of expertise to get a foot in, so her turning up on the door on Friday for the weekend at Parliament House would have been akin to walking up to Buckingham palace unannounced and asking to spend the weekend with the Queen, please. Mind you if she did get in - I don't know that anything else would have happened all weekend, because she's kinda like a didgeridoo... you never know when they take breaths but the sound keeps on coming ...

Meanwhile I'm sitting there, not making much of a difference to her particular small yet significant problem, let alone the greater world, thinking that at least she shows some enthusiasm for it all, which I did when I first heard about it all those weeks ago, quickly realising that I would qualify as readily as my patient for a participatory role and instead my biggest problem for the day is getting home before 9.30pm because I have let too many people speak for way too long today.

Medical Advice

So I'm at work and the hundred and second person, upon hearing my darth vader voice and chronic smoker's cough, suggests I see a doctor. I smile politely, tell them I don't know any good ones, and ask what their problem/illness/ raison d'être is today...

I've had people suggest how I should treat myself, including specifics of what to take, where to find it, and how to prevent getting ill in the first place... Isn't that MY job?
I'm just glad I don't have a surname like 'Carver' or 'Paine' or 'Hacker', the days could be very long...

Gay Genes Discovered

Finally someone got the science worked out!

It appears being gay is linked to a number of genes which, when present in the right combination, lead to the expression of homosexuality. It appears the most powerful genes, GMBT2 and AFDJ9, when both present increase the probability of homosexual orientation to around 72%. The probability increases if there are other associated genes also expressed in combination with one or both of these, though it seems there is quite a range of associated genes that can act in combination with various relative 'strengths' (ie the more genes you have - the more likely you're going to be gay).

Environmental exposures, including chemical and hormonal influences can cause both genetic mutations and alterations in the genetic expression of genes already present, influencing the probability of homosexual orientation.

Following from this there looms the possibility of antenatal genetic screening tests, estimating the 'probability of orientation' but with environmental influences ongoing in-utero it seems these would be loosely indicative and not be as accurate as testing after birth. Post-birth testing may then become available with genetic manipulations to 'cure' homosexual orientation, and while no such treatment is available, its possibility is expected to cause significant social and ethical issues.

Full article soon to be published in the journal 'Nature'.

You heard it here first.

All about Friday

To a rainy Friday morning I awake - again a call from a nurse brings the new day to my attention, someone needs me more than my bed does, and so my day begins. Problem sorted, or at least navigated, and I'm on my way to the beach, a group of swimmers on the beach in the rain staring at the surf. I love swimming in the rain - there's something about the silence of it all, the closeness with the elements (and the lack of crowds) that makes it special. Coachless today we make our way through some serious swimming - and some serious fun. I'm not the dedicated triathlete like these guys are, and sometimes it feels odd to be out there training with them. But it makes me faster, and it gives them target practice of sorts. Today I feel fast as we race from the surf, bodysurfing the waves to the shore and running to an impromptu finish line on the beach. I pant and laugh at once and contemplate doing it all day. Instead I prepare to go back to work, as the others prepare to go for an 80minute run. Maybe one day I'll join them - but not today.

I meet with patients in all manner of life circumstances, all of them dying, but in completely different ways, and it feels good to be able to give them some hope and control in what is happening in their day to day deteriorations. Each one of them moves me in different ways, and it feels good to be alive. It's nice to be able to laugh and joke with them all, and I see in them a sense of security when I leave, which make me feel I've done my job.

I head to gym after work and do an interrupted run - all up 40 minutes or so - and I'm wet, it's like I'm raining now. The gym is increasingly busy, and I can't get to all the things I want to use, but manage most of what I want to do today. Starving we head out for Thai with friends we've not seen all year. It's nice to catch up, and the food is great (or was I just really hungry?) .

Home and I catch up with Lynnette from Tasmania online (who has posted some awesome photos of her recent trip) and a friend we're dining with Saturday, then check on some blogs I've not seen in a while, watch an episode of the last season of The West Wing and contemplate what to write about in this post, but don't really come up with anything. I do decide to add the following photo (as requested unofficially by Vancouver Geoff) both to appease him and further perpetuate unobtainable aesthetic ideals to which we all aspire - if momentarily. Because that's what I do. This time with facial hair.

And then I go to bed.

Multi-tasking Mania

From the time I was doing my higher school certificate, I learnt to do a thousand things at once. At university, studying medicine, it was just expected that you had to be able to multi-task. 9 exams in 4 days? - sure I can do that. My parents instilled the practice in me, and it seems I've exponentially increased the activity. I'm not sure there aren't many minutes in my day that don't have something planned for them. Even then I'll usually add more things to do in the time I have. Mostly I'll get it done. At work it can be a challenge though to keep up the pace given that people do need time to absorb things; you can't always rush a discussion about a terminal illness for example, but you can make it the most holistic event in a patient's life, and so I try to encompass everything conceivably possible and beneficial into the time I have, at the same time ensuring I'm not rushing them. Its the whole thing of making something complex seem effortless. The busier I am, the more efficient I get, and it seems the easier it is to do the things I want to do. 

It means that at the end of the day - I sleep very well.
And tonight I will sleep very well indeed.

Friday

I wake up at the hospital and the day is overcast but warm. I have slept 5 hours but feel exhausted and as I plunge into the pool for my morning laps I feel as energetic as a cat fallen off a skyscraper balcony for the 10th time... But I manage to swim up and back a few times and feel more awake by the time I sit down at diggies for breakfast by the beach with my good friend Janet.

While there's not a lot of direct sunlight there is a hell of a lot of sparkle coming from the ring glued to her finger. The cluster of pink and white diamonds announcing She's Engaged!! (Note, I never really take notice of these things and she probably waved it around for hours and had to actually point it out before I noticed it - the classic gay best friend it would seem I am not...). Despite my slow uptake I'm quite thrilled. She's a real catch and why it's taken this long for the straight men in this world to notice I simply don't understand. Finally I've also moved to second place in her mum's books which a whole lot healthier place for me to be. While I'm there not noticing the ring, I am noticing the incredibly hunky guy wandering around dressed just in a towel and surfboard, he has a chest and back to die for and the rest ain't so bad either, so in those few minutes I think we must have been discussing wedding plans - because I don't recall any.

Then I head to work for the day where the most remarkable experience is standing in a hospital room for a palliative care consultation while an entire family piles into the room, surrounding me. There must have been a dozen people entering the small room. Why some of them didn't pass out I'm not sure, but I felt like it myself at one point as I didn't really feel for euthanasia talks right there and then, but such is life, and death. And everyone seemed happy in the end. If you really can in such circumstances.

So after work I head back to the pool and gym. I'm still feeling like that cat in the pool from this morning, so get out early and take my weary body to the gym. I remember to take the ipod which has become my gym buddy and it energises me with a random selection it chooses perfectly. I lose count of how many abdominal exercises I do and feel happy moving about the gym as if in another world, oblivious to everyone around me. Somehow this makes me feel mysterious and interesting, even though right now I'm neither mysterious nor interesting. I'm introduced to a cute guy called 'Hussein' and all I can think of is how I really shouldn't say anything related to his name as it would be inappropriate, but he has the cutest smile and still I have Saddam and Iraq and 'The War on Terror' going through my head and say nothing much because I can't think of anything else right now and I'm so fatigued and it really doesn't matter - this is the gym and I'm being mysterious anyway.

And so on my way home I realise I've left my work shoes at the pool, my head somewhere in the clouds, and tomorrow morning (yes Saturday) I have to work again...

Monday

Monday morning, I wake up to alarm 2. It's not looking good. I feel so completely lacking in energy I want to ignore the alarm - but sensibly it's placed away from bed so I have to get up to turn it off, and it's not nearly as pleasant as alarm 1 which is the Kylie cd which has now stopped. (I snooze to Kylie every morning - I've tried a host of different cd's but she's consistently the best wake up music for me so far... not that she actually makes me get out of the bed) . The damn beeping one wins and I'm on autopilot to the shower. Shaving next stop, a bowl of cereal and fruit eaten in front of my pc with the latest news and blog updates. London Preppy has usually posted by now and I laugh myself awake, look at the time and rush to finish the cereal I'm eating because invariably I'm running late. The garage door closes remotely and I'm testing the supercharger my German engineering has installed to delight and propel me. I wonder as to whether I should accelerate so heavily as an environmentally responsible citizen, then I look at the time and my mind moves on, to the tempo of Bob Sinclair's Love Generation. My staff smile and welcome me in, they will have told my patients that I'll be there about now, and the day is underway. I have a mix of people to see, from the superhunk blonde 25 year old with muscles that need no more defining to the middle aged woman with a work injury that she doesn't seem to want to get better, to the kids pointing at the jelly bean container that I have mixed feelings about in the glassed in cabinet.

I escape into my seriously shortened lunchtime, after spending 50 minutes removing an implanted rod from a woman's arm that is not nearly as easy at they say in the promotional material, into a scorching day. Despite my sense of reason I go running in the heat and saturate my t-shirt with a sixpack-seeking sweat, then dive into the pool with 2 minutes of my lunch time left (lunch is still back at the surgery). Work continues evenly yet intensely for the afternoon. There was one patient where think I lost count at 6 yawns - but my post prandial somnolence thankfully doesn't last too long. They were in another world anyway - so I get away with it. And for the first time in weeks I finish on time.

The supermarket is filled with my patients, one of whom is the 25 year old I'd seen earlier in the day, this time with his girlfriend - it was quite funny given the personal nature of the consultation to cross paths at almost every aisle and then again at the checkout. But I'm not complaining.

Home with the wind in my hair - a balmy evening - & collapse onto the couch with Norah Jones playing - The Frenchman spontaneously vomits on hearing her, so with him still on his way home, I'm safe - and I know I can sleep to her. A candle is lit for atmosphere, but completely wasted given I'm snoozing. The Frenchman arrives home and we prepare a dinner of roasted fish and salad and discuss the day with a volley of text messages interspersed to various third parties following up things from the weekend, and a selection of news programs dissecting the current election campaign. We were given some home baked choc chip cookies today and a third of them survive the night.

I read Single in the City and wonder why I didn't add him to my list of blogs before, then watch a man showering on Aussielicious but wonder why, and ponder what to post today - something different and innovative - because I like to be different an innovative, but I end up with a web log of my day, which is I guess what this is supposed to be in the first place. And then it's finished and I go to bed.

I have played, I don't know how many, Norah Jones songs on my ipod today because I slept through most of them.

What your doctor REALLY wants to say....

No you're not big framed, you're FAT.

Of course sticking a needle into you is going to hurt and especially so if you don’t stop moving about like a boxer.

Since when does ‘no contact sport’ allow for wrestling?

Sure I can give you antibiotics, I can also give you steroids, anti-inflammatories, benzodiazepines, antiarrhythmics and tricyclic antidepressants, but none of them are going to cure your cold.

You don't want to go to hospital huh? Can you make out a new will with me as beneficiary then? The odds are looking pretty good.

Yes it really IS possible for you to be pregnant.

I’m putting this IV in to HELP you, not because I like inflicting pain. I do have things I’d much rather be doing that coming here to defy Darwin’s theories. Sure it may hurt a bit, but it’s certainly not intentional. So if you threaten again to punch me if it hurts you, I’ll show you how a really bad doctor puts one in.

I know you've never been that weight since you were playing competition football aged 18. It's time you got off your fat arse and started exercising again!

Here's your medical certificate. It says "Adam is not fit to work, or suffer from any gainful employment, especially on sunny days or when the surf's up, because he has an incurable case of slackarssitis".

Sure you can go out drinking again on the weekend. Shall I book you in on Monday for that other broken leg?

If you had listened to me and actually taken my advice over the past 10 years, I wouldn't need to be calling for an ambulance while applying oxygen, anginine, aspirin and being unrealistically reassuring right now. This is your heart kicking you back. Oh and today you're paying the full fee.

No, its not that you're unlucky, you just make really really bad choices.

You've got to be kidding, you think I'm using you as a guinea pig? If I wanted to experiment with prescribed drugs on someone, it certainly wouldn't be you!

underwater musing

This is what you get when you submerse your camera (suspended on a very small float that really should be called a sink...) press record and try to swim in front of the lens...

The two almost evident people in the video are The Frenchman and myself.

I really should just call it something more like "study # 3", install it in a gallery of modern art projected onto a 30m wide screen, and hold lectures discussing it... but perhaps I'm being just a little bit cynical.

It's a long weekend here - and I want to be a little creative. Of course - it's when I am feeling most creative that I'm committed to other things, and when I have the time , I have not the inspiration.

Today was a hellish day at work - I'm not one to ever lose my cool - but I found myself telling a patient's relative off today. I'm tired of people who just don't listen - but are very ready to complain that they're not getting what they want (which, if they listened, they'd realise they were actually going to be getting exactly that) - I felt like changing my mind after their complaining. Last night I also had a nurse calling me for advice about a patient - and when I didn't answer my mobile, phoned back 3 minutes later to complain (to my voicemail again as I still didn't answer her) that I hadn't called back and that as I was on call I had to be tied to the other end of the phone waiting for her to call. Of course, I was in the shower at the time, and called her 5 minutes after her initial call. This time she didnt answer, so I called again and again for 10 minutes eventually getting her , explaining I was in the shower and not getting any kind of apology from her (she expected one from me and yes I was too kind and gave one as soon as I returned the call.)

Why are people so impatient and so unkind?