front door at night

                       I always wanted to live in a house with stained glass around the front door.
                       I always wanted to live in a house with stairs.
                       I always wanted to live in a house in the country.
                       I always wanted to have a wife and children.
                       I always wanted to be an obstetrician.

I always wanted to write a book.

                                I always wanted to win Wimbledon.

I always wanted to rule the world...

Not really.I just wanted to live in a house with stained glass windows.

cat thinking

 hmm

 why am I down here

 when I want to

bite you!

children's rhyme

Tinker, Tailor, Soldier, Sailor,
Rich man, Poor man, Beggarman, Thief.


I had heard and read references to this counting rhyme for years but never knew the complete words. As with most of these types of verse there are a number of variations, as well as a deeper meaning to them.
I have just finished reading the book by John le Carre, "Tinker,Tailor,Soldier,Spy", despite my lifelong aversion to the genre. I'm not sure if this is a sign that I am changing but I had a craving to read it as soon as I saw it in the bookshop, and devoured it with satisfaction. However, I have no desire to read the rest of the series.
I think I felt an empathy with the character of George Smiley, retired at the beginning of the tale despite a lifetime of quiet mastery of his particular craft. He had a control of his professional skills which contrasted with the chaos of his personal life. That also rang a bell.
His work required care and persistence, interspersed with occasional though inevitable episodes of violence - which he handled calmly. He would have made a good obstetrician.
I don't think I would have been a good spy though. I find it too hard to tell a lie.

dessert

another film review

I saw "Take This Waltz" with my wife. She understood why Margo had to leave. I liked the naked ladies.

running man

He starts early.

He is doing his best.

But still he cannot escape.

tired

Tired.

full moon behind cloud

In labour ward for a delivery at ten thirty p.m. when a GP asked me to see his patient who had bled two litres after delivery. She had been given oxytocin, ergometrine and rectal misoprostol. An oxytocin infusion was running, blood was on its way, the uterus was contracted and the bleeding had settled.

She had stitches but I still checked the vagina for lacerations. I couldn't detect any abnormality, but said to notify me if the bleeding recommenced. There was no one in labour but I couldn't sleep.

The phone rang at one forty five a.m.. She had lost another 800ml. I organized the operating theatre and went back in.

To my surprise I found a large spontaneous laceration of the cervix extending well into the lower uterine segment which I was able to blindly oversew with great difficulty using a large curved needle. As soon as the apex was secured the bleeding stopped, but she had now lost at least four litres. She was given more blood and fresh frozen plasma, the bladder was endoscoped, showing two functional ureters, and the rectum was also undamaged. She was transferred to intensive care overnight and I drove home.As I arrived home the temperature had dropped  to freezing and a full moon lurked beneath the thin cloud. I would soon be warm in bed.

 The adrenaline has gradually worn off and now I am looking forward to the delicious sleep of the reprieved, the exhausted survivor.

 Let tomorrow do its worst.

my crimes - community service?

Finally catch up in clinic like a long distance runner forever behind the leading pack. A moment of joy then the sinking feeling of dread. Something is waiting for me. My come-uppance. I search my memory for clues.
Yes, I have been guilty of hubris. I should be more respectful to my wife in the neverending wrestle of marital life. I abandon my patients whenever I take a night or weekend off, let alone a holiday, and I don't see my post-op patients frequently enough. I nag and alienate my children, but I know this already. What is worrying me?
A difficult delivery takes shape from the formless disquiet of my unconscious mind. In the middle of the night. Second stage, abnormal foetal heart rate. All criteria present for a vaginal delivery. Cervix fully dilated, membranes ruptured, head fully in the pelvis, known position and good epidural pain relief. Applied forceps then the heart rate dropped to almost nothing. A tight squeeze for the baby but no time for any alternative. Eventually delivered the baby, stunned but recovered without likelihood of hypoxic brain injury. General relief but one arm not moving, likely an Erb's Palsy. They usually recover but this might not.
Recently the hospital notified me that her records had been requested under freedom of information laws. This is often the first step in a law suit. I can understand that. I would be bitterly disappointed if my child had only one good arm.
It is not pleasant to be sued but I can empathise with the parents. I just hope I can cope with my own self-doubt so I can continue to provide a service to the community.