Thursday 31 May 2012

Romeo and Juliet

Trying to help my daughter write an essay about this timeless story. There were at least four published versions before Shakespeare's play although he based the story more on a popular poem.
It is a romance.
It is a tragedy.
There is a Greek chorus.
Character flaws.Impatience. Anger.
Death.
Sad death. Heartbreaking unnecessary death.
Sex. Bawdy sex. Pure love. Eternal love.
Love equals hate equals death.
Beautiful people. Beautiful words.
In one day from bare puberty to first kiss, proposal, marriage and murder.
That sneaky sword.
That lost message. Oh no.
Well they did warn us.

Despite the ending, my daughter thinks it was all worthwhile. For love.
I think I'm going to have to watch her.

textures









From paintings on the clinic wall.

morning, nearly winter









The wistful days of late autumn. Work goes on.

Wednesday 23 May 2012

turtles all the way down

Today is World Turtle Day, created to help people celebrate and protect turtles and tortoises and their disappearing habitats.

Stephen Hawking tells the story in A Brief History of Time of a scientist who was giving a public lecture on the orbit of the earth when a "little old lady" told him he was talking rubbish - that the world is really a flat plate supported on the back of a giant tortoise: The scientist gave a superior smile before replying, "What is the tortoise standing on?" "You're very clever, young man, very clever," said the old lady. "But it's turtles all the way down!"      This has become a popular reference for the infinite regression problem of the ultimate origins of existence.

rescued mouse


                                                              Wants his pet back.




                                                                     The survivor.

Monday 21 May 2012

the farmer's market



                                                      Ornamental cabbage or kale.
















Friday 18 May 2012

amanita muscaria

One day these Fly Agaric mushrooms appeared in the driveway.



Next day they had grown.




Next day they were gone. The lawn mower man doesn't care for their magic.

roast beef dinner for two


with warm olive, onion and tomato salsa

Thursday 17 May 2012

heavenly creatures

So yesterday, there was a twenty four week pregnant inpatient with fever, loin pain and haematuria, suggestive of pyelonephritis - a kidney infection - although no organism was detected on urine testing, possibly due to the GP starting oral antibiotics before the test. Her pain and fever initially improved with intravenous antibiotics, but then started to return. This was especially worrying since she only has one kidney. Her renal specialist wanted to admit her to the big city hospital but only if she was under the primary care of the obstetric department. The obstetric department would not admit her unless she had an obstetric problem. Neither would budge. My registrar spent a couple of hours on the phone, keeping me updated. They said that I would need to speak with the obstetric consultant although I am not usually allowed direct contact with one of these sacred creatures. I gathered the information and asked to be put in contact with the consultant on call at which point we were allowed to transfer the patient. It was clearly of most importance that the consultant be spared from contamination by the outside world.


Meanwhile.... another patient had come in for assessment with irritable contraction-like discomfort and reduced foetal movements. She was an obese poorly-controlled insulin-dependent gestational diabetic with incidental obstetric cholestasis with severe itch, polyhydramnios and macrosomia( big baby and lots of fluid). The foetal heart rate monitor appeared to be showing a potentially lethal sinusoidal pattern yet the labour ward scanner showed active foetal movements. A contradiction. Perhaps the pattern was only pseudo-sinusoidal, not the real thing. On the other hand, she was a very high-risk patient, so we called the foetal diagnostic unit at the same big city hospital and sent them copies of all the tests. They thought it was pseudo-sinusoidal because it had improved a little, but she was now on oxygen. By this time she had been assessed in our ultrasound department - there was good umbilical artery blood flow and active limb movements but no breathing movements. After further consideration we were advised to deliver at once despite the prematurity. At Caesarean Section there was a true knot in a tightly tethered cord, completely unrelated to her history and potentially fatal, but there was one more twist in the tale: after delivery the baby appeared pale and was found to be severely anaemic. It was suffering from foeto-maternal transfusion. The baby had bled into the mother's circulation. I had ordered the Kleihauer test which detects this at the time of her presentation but we had been unable to get a rapid result. The report arrived today showing evidence of a massive transfer of foetal blood to the mother. The baby is now in the city hospital on a ventilator but should survive.


Meanwhile.... I raced back to finish my clinic before doing another Caesar for a failed trial of labour after two previous surgical deliveries. No lunch, no dinner, phone calls, babies in danger - obstetric heaven. On a day like this it was no surprise to be called back to labour ward for a drastic drop in foetal heart rate in late first stage. Prepared for instrumental delivery, pushed back an anterior lip and applied the vacuum to a posterior position. Managed to rotate eventually but slow descent due to an epidural and reduced maternal power. Heart rate dropped precipitously, feeling pressure, called in theatre, wished they were already there. Changed to forceps and completed the delivery, only to find the shoulders would not descend, and heart barely beating. Reached up into the uterine cavity and pulled down a shoulder, then delivered the baby, anxiously watching for a response. Then a little cry, then more crying. Sewed up a partial third degree tear and left the mother breastfeeding her perfect little angel, not feeling so exalted any more.

Saturday 12 May 2012

cat math

Maths is certainly one of my interests. Equations are fun, although I am not so much a fan of statistics. A two-tailed t test is just unnatural! I always keep a close count on the people in the house. If there is only one left I keep them under observation to ensure they don't become zero. Apparently zero is an even number because it is a multiple of two (2x0) and has an odd number on either side of it. I think, however, that it is a little bit cute to say that it is evenly divisible by two, or that a set of zero objects can be split into two equal sets. If you look in my scrotum you can divide it into as many sets as you like and there are still no testicles. Try that with any other even number. And, incidentally, that is another very good reason to keep a close eye on the people in this house.

Wednesday 2 May 2012

family film project

My oldest child suggested that every member of the family nominate their favorite film and the whole family view it together. We watched my film first and I am happy with my choice.



Perhaps later we can do a family book project.

holding the line

- holding the line waiting for diabetes test results -


 "We will be with you as soon as possible,"


"We are experiencing higher levels of calls than usual,"


........the sounds of Spanish guitar......


......the sound of impatience in the waiting room...


meanwhile, back at work


Autumn is here.