An Epiphany In King's College Chapel (a.k.a. OMG I Met A Celebrity OMG!)

King's College Chapel. The most famous icon of Cambridge and one of the world's most recognisable landmarks, it costs the college £1000 a day to operate and is home to one of the country's most famous choirs, King's Voices, which sings regularly for the BBC. It is also a haven for the devout, no matter what religion they come from or if they believe in God at all, to rest, pray and quietly reflect under its soaring arches and grand windows.

And, today, also a place for one gushing medic with a bad case of starstruck-itis.

I was leading a group of people through King's College Chapel when I bumped into Margaret Mountford, Sir Alan Sugar's aide on the British version of The Apprentice (the equivalent of Carolyn and now Ivanka Trump on the American version).


*GIGGLY SCHOOLGIRL WARNING*

Oh. My. Gawd. I gushed and I gushed. I don't know what I did, but somewhere in between I managed to shake her hand, grabbed a picture, and had this exchange:

Margaret: So what do you read here at Cambridge?

Me: OMG OMG OMG uhm like you know like medicine.

She looked at me, gave me this sympathetic look, and disappeared into the crowd.

OMG OMG I JUST MET MARGARET MOUNTFORD!

*end Giggly Schoolgirl Warning*

Back in my room, in between rubbing ointment on my forehead for the bruises caused by repeatedly smashing my head into my table for not being more composed and asking her some coherent questions (like "What career advice do you have for a young medic?" or "Tell me I'm fired! TELL ME I'M FIRED!"), I couldn't help but think that maybe meeting her in King's College Chapel was some sort of sign. But of what? That my future lies in television? That I should take the lessons I learnt from The Apprentice and apply them to medicine? That I should get a sex-change operation and go make really good friends with Alan Sugar's or Donald Trump's children?

I feel another post coming up.

Sigh. I bet many of you have met celebrities, perhaps just last weekend at the Spider-Man 3 premiere in London. (Yes, Little Medic, I know you've seen Stephen Hawking and I haven't. Yay.) I also bet you didn't react as stupidly as I have. Drop me a line if you want to gush. (Unless you've met Donald Trump. In which case, I will hunt you down and kill you out of jealousy.)

God Vs The Angry Medic, Round 1

Cantsay Specific Airlines

Those of you who have been reading regularly will know that God, Almighty Ruler of the Universe, has it in for me. Every once in a while He looks down from His heavenly throne and picks a mortal to have some fun with and to amuse Himself and mankind with. And this, folks, is almost always me.

I boarded the Cathay Pacific flight at Heathrow Airport looking forward to a smooth flight home. Half an hour later the pilot's voice comes over the PA system, apologising for an "unknown error" which will take at most 30 minutes to repair. Cathay Pacific thanks you for your patience.

An hour later, the pilot finally announces we're ready to take off! I love takeoffs. The thrill of the plane speeding up gives me an adrenaline rush like no other. So we all strap into our seats, the cabin crew are seated, and the plane taxies on to the runway of Heathrow Airport, one of the busiest airports in the world, where you have 90 seconds to get your plane's ass off the runway before another plane's ass slams into it.

And we wait.

And we wait some more.

Ten minutes later, the pilot's voice comes on again, and tells us the same error from before has mysteriously recurred, and takeoff will be delayed whilst engineers fix the problem. Shouldn't take more than an hour or so, he says.

Six hours later, we're sweating it out on the plane, this Spanish woman is in hysterics screaming at airport personnel because she'll miss her connecting flight, and the air stewardesses (who all look like they've been hothoused in some Hong Kong military academy) are barking orders all round. Then the pilot (whose voice by now sounds strangely beaten-up) announces that the error can't be rectified, and that we will all be transferred to another plane, thank you for your patience.

Cathay Pacific Air Stewardess

But first, of course, we have to wait for the plane to ARRIVE. Then, when it finally takes off, and I'm busy looking outside the window as Britain falls away under me, a steady stream of cold water drips onto my leg from the roof of the plane.

Brilliant. Not many people can claim to have been urinated on by an airplane.

Hong Kong is a funny place. It smacks of efficiency and impersonality. You expect to be barked at by airport personnel and hustled along by ground staff simply for walking too slow. Them giving me my boarding pass a minute before the gate opened (on the other side of the airport, naturally) fit right in with this hypothesis. But then you look up and see posters like these:


An underwear expo, complete with models. You'd expect something like this in Japan. But hey, whatever keeps the visitors coming to your airport.

Days later, I'm sitting at my laptop, finally ready to update my blog, when all of a sudden an electrical storm comes out of nowhere, and lightning fries my broadband modem. Right when over a hundred people are screaming for a newsletter I'm trying to send out.

What have I learnt from all this?

HELL IS DIAL-UP MODEMS.

BWAHAHAHAHAHAHAHAHA!!

Not all is bad, though. I've got some exciting news regarding taking my blogging to a new level coming up soon. (No, it's not Google AdSense. I rather like having a soul, you know. --Editor) Watch this space.

Let's Make Some Grand Rounds, Shall We?

Every Tuesday, Grand Rounds is an accumulation of the best posts from medical blogs all over the Internet. Its original intent was to be written with the non-medical blogger in mind (this means you). After all, who isn't interested in medical topics?

What kind of stuff will you find? Just about anything! It can be stories about patient interactions. It can be commentary on the latest medical news. It can be explanations of clinical disease processes. Or it can be rants on just how ridiculous medical school is as seen through the eyes of a jaded and possibly slightly insane medical student. (Not that I'd know anything about that, of course).

This week's Grand Rounds is up over at The Rumours Were True! Surprisingly enough, webmaster Topher has elected to include a sample of my terrible writing in the collection this week. (At least now my readership will increase from the usual three people. I hope. --Editor)

Time to call a MEDIC! The Angry Medic of Cambridge isn’t seeing as much gore as he’d like from his textbook prison and decides to take his education to the pitch where he receives a ball to the face, dips blood into his antiseptic and consoles the players that a large bandage will not effect “the number of female spectators yelling their names from the sidelines.” You could say he Comes of Age.

Grand Rounds is a weekly collection of the blogosphere's best medical writing. In the past there has been concern over the falling standards of Grand Rounds, but this edition is a step in the right direction, as Topher has obviously exercised stringent quality control (I should know. He was very generous with his feedback and got me to edit my submission twice before including it. Quality control is good, even if it doesn't do my carpal tunnel syndrome any good *wince* --Ed).

Go over and poke around. There's something for everyone, whether you're in the medical profession (you have my sympathies. --Ed) or not (you lucky bastard. --Ed). You might even find your Holy Grail.

And once you have, don't forget to pop over to Doctor Anonymous next week for Grand Rounds 3.09.

As God commandeth in a certain very famous film,

"GET ON WITH IT!"

(first two paragraphs adapted from Doctor Anonymous. I was lazy.)

Doctors vs Nurses: Medicine's Oldest Battle Reaches The Blogosphere

One of the most ancient battles in the medical profession has been that between doctors and nurses. Each wants the other to just hunker down and do their damn jobs, but inevitably doctors develop a superiority complex and start lording their superior selves all over the hospital whilst still running whimpering to the nearest nurse whenever anything goes wrong, whilst nurses tire of the superiority (and the arse-wiping and the bedpan-cleaning) and try to tell doctors what to do. Then people get pissed off, the kid gloves come off and things can sometimes get nasty. (Especially when you're an inexperienced medic in the maternity ward's delivery room doing your best not to rip a newborn baby's head off, and the only help available is from huge bitchy nurses long on experience but short on temper. Not that I'd know anything about that, of course.)

Well today, the floodgates did indeed open, and the Doctor vs Nurse debate broke out in the blogosphere. It all started with an angry nurse who posted a rather inflammatory comment about a patient being unnecessarily sent to A&E. She diagnosed the patient as having Quinsy, but showed little sympathy for him hollering for the paramedics after a little inflammation:

"Excuse me sir - could I have a look at your throat? What's that I see? Inflammation? Things with pus in clinging to other red swollen things?Ever had tonsillitis? Oh you have ? And it was just like this except this is worse?"

Quinsy is indeed an emergency, but to be unable to have even done the most basic of examinations before getting all excited and calling the blue light boys....well.

(this Nurse Ratchet is not to be confused with the nice Nurse Ratched in my links, who thankfully keeps her diagnoses to herself.)

Not only that, but in a previous post she makes very clear her opinion of doctors:

For too long now Nurse Ratchet has been reading blogs by erstwhile members of the Medical profession; and while the views and observations on the whole are to be commended, there runs a theme throughout of "Nurseism", or "Nurseogynism" - or even "Nurse-o-phobia". These self-satisfied, pompous, narcissistic fellows (I assume they are fellows?) take great pleasure in patronising nurses who have the temerity, nay the bare faced cheek to aspire to something greater than lovingly wiping an arse, mopping a piss soaked floor…

Now, anyone who knows me (and watches enough Russell Peters) will know that I have a theory that once in a while, just for the fun of it, God looks down upon the Earth from His throne in High Heaven, and in all His infinite wisdom picks a random person on the street, and BOOM. All hell breaks loose, with hilarious results. Now usually that person is me, but today as luck (or rather, God) would have it, this little nurse gets lucky. And along comes none other than Dr John Crippen of NHS Blog Doctor, who reads the post, and decides to add a doctorly riposte:

Oh dear me, nursey, you have, to coin a phrase, just crapped all over yourself by demonstrating the classic nursey intellectual inability to have a "DIFFERENTIAL" diagnosis. You do not have the mental card-index of diseases that all experienced doctors flip through their mind as they are assessing a patient. You can think of two diagnoses. A doctor can think of twenty.

Now usually Dr Crippen is quite civil in his lambasting of the NHS, but in this one he seems to have gone over the top a little. Unfortunately for poor Nurse Ratchet (but very fortunately for God's amusement) his is the first post, and sets the tone for about 50 other commenters who promptly materialise and proceed to take turns gang-raping the nurse and making very clear their opinions of her intellect:

Was he ill? Yep.
Was it serious? Yep.
Did he need to be in hospital? Yep.
Quickly as possible? Yep.
Could I have harmed him by delaying? Yep.
Let me guess, Nursey. You haven't been on the course yet.

Render under Caesar that which is Caesar and leave to the physician that which he knows namely the art of differential diagnosis which passeth the understanding of the ignorant.

Nurse Ratchet - we don't interfere in your job, why don't you lot stop interfering in ours and stop all the nay-saying and bitching from the side lines. If you want to diagnose, manage and treat patients - go to medical school. In the meantime, stick to the bedpans.

Then Dr Crippen decides this shows a dangerous lack of medical knowledge and respect on the part of nurses, and decides to make Nurse Ratchet the focus of a whole post on his blog.

(This is also about the time when God decides to go into Ultra-Gag-Mode.)

And so the shit truly hitteth the fan. DOCTORS.NET picks up the article and has their say, while visitors to Dr Crippen's well-known blog take potshots at Nurse Ratchet on both her blog and Dr Crippen's. Even Singapore's Angry Doctor picks up a pitchfork and joins the fray. At this time, of course, I (having a perpetual death wish) try calling for diplomacy. Strangely enough, I do not get fragged, and instead Dr Crippen backtracks and agrees with me that the debate has descended into vulgarity:

I tend to agree with you, Angry Medic. It is getting a bit vulgar and out of hand over on Nurse Ratchet's site.

Her article has been picked up by DOCTORS.NET and battalions of angry doctors have mobilised and are on the attack.

I suspect Nurse Ratchet is writing with a little bit of tongue in cheek. As was I in the first comment I made under her article.

He then very cleverly diverts the argument to the real problem, that of what he calls the "dumbing down of the NHS", including (as I mentioned in a previous post) the endless reorganisations, the target-setting, and general nonsense that the NHS has taken from prophet of doom Patricia Hewitt. And thus the real villains of the story are revealed.

The midwives.

*dum dum DUMMM*

Okay maybe not. But Dr Crippen, in his reply to me, pointed out that the line between doctor and nurse is a fine one, particularly nowadays that Patricia Dimwitt is trying to replace doctors in A&E with nurse-practitioners and community matrons.

It is fascinating to look at the job requirements to be a "community matron"
• take a comprehensive patient history
• carry out physical examinations
• use their expert knowledge and clinical judgement to identify the potential diagnosis
• refer patients for investigations where appropriate
• make a final diagnosis
• decide on and carry out treatment, including the prescribing medicines, or refer patients to an appropriate specialist

As far as I can see, that is EXACTLY what I achieved after 5 years at medical school and three or four years as a junior hospital doctor.

Spot on. The NHS is messed up, but that's not what I'm getting at here. Nurses take a lot of crap, sometimes more than doctors do, and I've worked with enough nurses to know that they can make or break a doctor, especially in his junior years. They also have a far greater impact than doctors do on the quality of a patients' stay in hospital, and the work they do cannot be undervalued. However, the hospital is sometimes a jungle, and as I saw on a National Geographic documentary so long ago, the "key to survival is respect". If we all just respect each other, let each other do their jobs, and stay the hell out of each others' way, the hospital will be a much better place.

Thank God I'm still in med school.

Monkeys And Peanut Butter

Inevitably someone will ask me why this post is titled the way it is, so let me state from the beginning that I was walking down the street with a box of peanut butter I bought from Sainsbury's when a huge furry monkey leapt down from a third floor window and ran off with my peanut butter*. Told you my life was miserable enough to be entertaining.

People have been asking me just what the heck I'm doing back in Cambridge so early, two weeks before term starts. After coming up with about a hundred different reasons, some designed to evoke sympathy and maybe get me a date ("They messed up my ticket scheduling...*sniff*") some so utterly far-fetched that people actually laugh at my face ("Why, because I'm hardworking, of course!"), I decided that the whole sorry tale is indeed entertaining and insightful enough to put in a blog post. So gather close, children, for 'tis a tale of Ministers and Awards Days, of vengeful publisher dads and black-hijab'd banshees, of Donald Trump and foxy air stewardesses, of flight ticketing agents and oh you get the idea.

The exam season of 2006 was a tough period for all of us. Sure, some medics never left their rooms for fear that 10 minutes apart from their books would cause them to bleed from the nose and lose their first classes, and others showed up for lectures with bruises on their foreheads from where they had been slamming their textbooks against their heads the whole night hoping the information would go in wholesale (after removing their thick-as-mathematics-textbooks glasses, of course), but I was never one of those. Sure, I was always seen as a capable medic, and because I never hung out with the other medics everyone always assumed I was studying and was a genius. (Fools! Bwahahahahaha!) I, of course, was busy either watching House or Grey's Anatomy or, heaven forbid, Desperate Housewives (hey, I got desperate sometimes. Ooh, a pun!) and was busy playing two-bit minor characters on stage under bitchy directors who looked like Drew Carey after a milkshake binge. So it was that in early June I walked into the exam hall, sat down in my seat, and proceeded to get the faecal matter kicked out of me. Not one of my better showings. I always slunk out of the exam hall right after the papers were collected, with the obligatory oh-it-went-fine smile plastered on my face, and shot back to Jesus faster than a civil servant on lunch break.

But hey, I had something to look forward to. My sister's Awards Day, her graduation from the same A-Levels college I attended, was the week after my exams, and I had already booked a flight ticket. But no sooner did I bound back happily from the travel agent than I ran into a wall of red tape. Apparently I was intending to fly out 2 hours (yes, TWO HOURS) before the official end of term, so I had to get "written permission from all the relevant authorities", or so said the bushy-eyebrowed porter with the thick Scottish accent. So I went to war with the combined forces of the Bureaucracy of Jesus College. After e-mailing and personally seeing and/or calling my Director of Studies, the Senior Tutor, the Senior Tutor's Secretary, the Senior Tutor's cat, the Head Porter, the Housekeeper, the Accommodation Officer, my mother, your mother, and my bedmaker, I finally got permission to get out of college early. The Awards Day was intended to be on a Friday, and I, being the man of prudence that I am (as well as being used to bad luck, bad weather and bad timing) booked a flight on Wednesday, leaving me one whole day's margin of error before the event. So I packed my bags, bought my souvenirs, and prepared to play the magnanimous returning-champion gentleman ex-student by surprising my little sister (and maybe a few other selected females) back in college.

As fate would have it, though, the Minister of Higher Education was asked to be the VIP for the event, and graciously agreed. At that moment, however, God was watching The Apprentice reruns, and got a bit jealous of this Mark Burnett fellow and his success with dramatic television, so He switches channels (with his Universal Remote. geddit?), and gets Boston Legal, and now He's really pissed. So He decides to outdo both Mark Burnett and David E. Kelley, and looks down from His mighty throne upon the Earth, and the first person He sees is this happy handsome drama-free medic bouncing out of Jesus College, and He thinks to Himself, "Aha! I'm gonna make this person's life a reality TV show no one'll forget. Take that Jeff Probst!"

And so it is that the Minister of Higher Education realises that Friday isn't good for him, calls the college and gets Awards Day brought forward. To WEDNESDAY. The day of my friggin flight.

Yay.

To top it all off, my ticket back to Malaysia is only worth 3 months, and so here I am, exactly 90 days later, sitting in an empty house becoming a testing-ground for all the germs in Cambridge before they go all-out on the incoming freshers. (Cough cough sneeze.)

So there ya go. Actually God got a lot more creative, and it was a lot more dramatic, involving a vengeful publisher dad, his equally vengeful daughter, and my best friend, but kids read this blog, as do my parents (hi Mom!), so here's the watered-down version. Besides, I wouldn't want to get sued or put on the front page by any rich publisher dads, or get bitched about in a book, so I'll keep my rants to myself this time. Not like any of you don't know anyway. Thank God for good friends and baby sisters to cling on to. Everyone needs their rocks to cling on to when God hits you with the plot twists and life flips 180 degrees and trusted people turn on you. And when I sit and pray to Mark Burnett God tonight, I'm going to pray that everyone out there has some rocks in their life. Cheesy, I know. But for some reason, the longer you stay in medicine, the cheesier your prayers become.

*okay maybe not. Thanks go to Haz though for suggesting this post title!