unpredictable

I have read that poker("slot") machines are particularly addictive due to the unpredictable pattern of reward. People feel as though that next win might be just around the corner which makes it hard to stop.  Today I was talking with a patient whose father and partner are both alcoholic. It brought up memories of my own father who was an alcoholic though he stopped drinking when I was seven years old. Although he was often frightening to a small child, he was also unpredictably wonderful, all the more so after the negative times.

I wonder if we often find ourselves with a partner like our troubled parent because we become addicted to the capricious rewards of their behaviour as a child. We are aware of the risks but cannot resist the compulsion to play their game.

asleep at last

four a.m.. First day off after eleven days on call. Wife still in hospital, younger daughter has had ear pain and constant vomiting for more than twenty-four hours,so stayed home and took her to the doctor for various medications. It is a still hot sweaty night. One of my sons is calling out military orders from up the hall as he plays an online battle game. Downstairs my other son is laying down harmonies for another you tube song. Tiny black flying insects keep landing on my skin. Outside there is a constant echoing sound of crickets.

My daughter seems to be asleep at last.

dusk

eucalyptus ficifolia and agapanthus

orange

red

peach

white

pink

agapanthus

Grown from seed, the ficifolia colours cannot be chosen reliably. It is like having a baby and not knowing which sex it will be.

queasy

Some things make me feel queasy: heights, swimming over deep clear water, and weather coming from the east.

When I woke this morning I felt uneasy. The trees on the east side of the house were tossing noisily in the wind. I went to the window and saw low clouds rapidly passing over the house from east to west.

Now it is night and there is a sound from the restless trees like breaking surf, but I don't live near the beach.

rewards

Still thinking about the way we make life worthwhile by rewarding ourselves. We promise ourself some pleasure if we can achieve a goal.
What pleasure?  A cigarette. An alcoholic drink. Food. Sex. A holiday. An online game. A new book. The feeling that someone important to us would be impressed. A little less self-loathing. What makes the effort of living tolerable?
What goal can compensate for the depressing awareness of our personal mortality?  Nothing of itself can ever balance that sense of loss, but we can distract ourselves with rewards for success in our self-imposed tasks. A career. A relationship. Personal development. Acquisition of money or assets. Visible signs of success such as an expensive car or attractive partner. Children.
Children also provide a little consolation in that a part of us may continue past our own life span. And any of their own achievements can be claimed by our reward system.

But the real reward is only in our minds. We decide which behaviour or possession rewards us with pleasure. As we age some rewards no longer give so much satisfaction -
(I would like to say that our rewards probably become symbolic - if I achieve a certain goal I will give myself the pleasure that I once associated with a hug from my mother, an ice cream , an orgasm...this starts to resemble a Freudian-type system of ego and super-ego operating our minds but I don't want to go down that path. I want to know why we choose our rewards, our comfort, our thrills.) - 
they no longer represent our beliefs. A cigarette changes from a treat to a threat. An ice cream can damage our arteries. So what gratification do we choose to keep us going through life? What is the best choice, or, do we have a choice at all?  Perhaps our reward system is unchangeable - can a paedophile change their preferences and feel a reward in something else, or do they simply not wish to change? Is a borderline personality determined by choice or is it a biological sentence? Can I change my reward system by my own choosing and do better with my life? How do I know what is better anyway? Should we examine our motivations?


It might be interesting if we did.

back at work

Everyone is nice to me. People have worked to cover for my holiday. Now it is my turn.

I am too slow. No lunch again.

Called to theatre for a patient bleeding heavily after removal of retained placental tissue eight days after delivery, despite oxytocin, ergometrine, misoprostol and prostaglandin F 2 alpha. The uterus was too small for a Bakhri balloon after eight days so I injected another dose of ergometrine into the uterine muscle directly through the abdominal wall then inserted a double balloon cervical catheter usually used for induction of labour. A hundred ml in the uterine segment was all it took to stop the bleeding. It can be removed tomorrow.

Then back to the patients in clinic who ask if everything is now ok. I recall the blood all over the patient, the sheets and the floor, the anxious staff and the very pale patient and say, "No problems".

beach holiday

                                     packed

cat is staying home

on the road

first glimpse of the sea

holiday apartments

home for a week

centre of town

surf beach - flat on this day but good waves every other day 

 dvds

refreshment

local restaurant - entree

duck with grilled fig

steak

lavender pannacotta and apple gelati - a little ambitious

on the wall

another restaurant - Japanese

walking home at night in the town centre




The holiday is over. I don't want to go back to work tomorrow. Ever.


I am like this every year but this is the worst.


I feel frozen with fear.


 Condemned.

first sighting

                                          Easter products on the eighth of January.

                                           An interesting combination of the most solemn Christian feast, paganism and vulgar opportunistic commercialism. Pretty colours.

atheist religion

Thinking of starting a new religion without any religious beliefs. It could replace the current models  while retaining the community spirit. People could still gather for  regular  moral encouragement perhaps.

 I think we have lost the concept of sacrifice, and people are less happy as a result. When we are required to do something inconvenient we no longer have any consolation. We just feel aggrieved at our seeming loss. There is no pride in taking second place, putting the needs of others before our own.We are searching for happiness through selfishness but it is not working. We have never had so much depression, obesity, marriage breakdown as today. There is a shortage of helpers for children's sport, childcare and care of the elderly and disabled, while we have never been so individually wealthy in terms of possessions.

A society has core beliefs about itself, myths often related to its foundation by tough pioneers or warlike invaders. The soft, obese and self-indulgent modern masses imagine themselves to be empowered by the essence of these rugged and brave heroes, usually weathered by their outdoor efforts. And yet we seem to huddle together in ever larger urban centres, accumulating possessions and looking for ever more pleasant personal experiences which still fail to satisfy. There have been some successes - a new school curriculum has created an ecologically aware younger generation, while racial and cultural tolerance is part of the  new politeness - but it takes much time and effort to change social behaviour.

Sir Richard Doll first reported that cigarette smoking caused lung cancer in 1950, confirmed by a much larger study published in 1954. It was later shown to cause heart disease and many other diseases but it is only in quite recent years that rates of smoking have reduced significantly. Society is slow to change even when the need is obvious. We are currently confronting obesity with the same slow initial progress. Our whole society is like a single individual who has given up smoking and is then overeating to replace the craving, even though most of the obese do not smoke at all.However, as a group, we had something pleasant to punctuate our day which we lost. We replaced it with something else that was pleasant but that has also proven to be unhealthy. Perhaps this time we could replace the unhealthy behaviour with a different kind of satisfaction, like the ex-smoker who has lost weight and now gets pleasure from regular exercise. Perhaps exercise itself could be part of a new response, certainly exercise for the young though this can cause social divisions if overly competitive and ultimately alienate those who might benefit.

If we are not vigilant there will be another world-wide replacement for food indulgence which is just as bad as smoking. Perhaps it is time to manipulate society again to create opportunities for participation in an increasing number of useful projects that are easy to enter and allow flexible hours of involvement - cross-cultural, across religion, age and sex: something to offer a sense of satisfaction to those who take part. Religion has traditionally provided such a structure but has been shown to have problems with intolerance, fanaticism and social conflict. However religion has proven to be the most capable vehicle for rapid social change as the mass conversions of Christian and Islamic history demonstrate, not always to  the immediate benefit of the converted. Somehow, we need to take the best parts of religion, the community spirit and altruism, the ability to provide deep personal fulfillment, and insert them into our lives, not to change our political system, not to give power to the ambitious, but as a form of mass conversion to the concept of gaining pleasure by putting others first, by giving ourselves a massive social heart transplant.

Now who will volunteer to start this thing?