Insignificance

Pale Blue Dot (Yoyager 1, 1990)

Look again at that dot. That’s here. That’s home. That’s us. On it everyone you love, everyone you know, everyone you ever heard of, every human being who ever was, lived out their lives. The aggregate of our joy and suffering, thousands of confident religions, ideologies, and economic doctrines, every hunter and forager, every hero and coward, every creator and destroyer of civilization, every king and peasant, every young couple in love, every mother and father, hopeful child, inventor and explorer, every teacher of morals, every corrupt politician, every “superstar,” every “supreme leader,” every saint and sinner in the history of our species lived there – on a mote of dust suspended in a sunbeam.

The Earth is a very small stage in a vast cosmic arena. Think of the rivers of blood spilled by all those generals and emperors so that, in glory and triumph, they could become the momentary masters of a fraction of a dot. Think of the endless cruelties visited by the inhabitants of one corner of this pixel on the scarcely distinguishable inhabitants of some other corner, how frequent their misunderstandings, how eager they are to kill one another, how fervent their hatreds.

Our posturings, our imagined self-importance, the delusion that we have some privileged position in the Universe, are challenged by this point of pale light. Our planet is a lonely speck in the great enveloping cosmic dark. In our obscurity, in all this vastness, there is no hint that help will come from elsewhere to save us from ourselves.

The Earth is the only world known so far to harbor life. There is nowhere else, at least in the near future, to which our species could migrate. Visit, yes. Settle, not yet. Like it or not, for the moment the Earth is where we make our stand.

It has been said that astronomy is a humbling and character-building experience. There is perhaps no better demonstration of the folly of human conceits than this distant image of our tiny world. (Carl Sagan)

Who’s side are you on?

A few days back, Ana asked…

Why now I have a whole double bed to myself do I still sleep on the same side I always have? (@Naasipop)

…And it got me thinking. Other than dragging up the obvious, which we’re going to blindly plow through here, my first thought was that I don’t. In my current bed, I sleep on the left (if you’re laying face up in the bed), whereas last time I shared a double bed I slept on the right. And thinking back through past beds, I switch around alot, even when with the same partner.

But even stranger, there’s a pattern to this. I always seem to sleep as close to the door as possible, and as far from the window as possible. Every bed I’ve ever slept in, I’ve kept to one side which is a combination of close to the door and far from  the window, even in single beds where I still curl up on one side.

There’s never any concious thought involved, I just feel more comfortable and naturally fall into that side. When I am forced to sleep on the other side, I have horribly disturbed sleep, and have to swap around for the next night.

So now I’m trying to work out which of those two factors is the dominant one? If the window and door were next to each other on one side of the room, where would I sleep? And what if they were at the foot and head of the bed? Would I just sleep in the dead centre? There’s got to be some sleep research centre somewhere to investigate this kind of thing!

So what factors effect where you sleep in the bed?

Oh… Kay…

cbtish is one of those blogs I often skim over but rarely comment on. I’m interested in the field of CBT from both a purely academic level but also from a personal level. I’ve tried a bit of home-brew CBT on myself to control my manic spending sprees (with not much success) and have friends and family who could certainly do with the stuff, if only the NHS could figure out mental health care (total cost of a few high cost events << total cost of a lifetime of low cost events, you goons).

Now this latest post, “OK“, got me thinking along some completely different lines. Just the introduction:

Saying “OK” at the start of a conversation is like a limp. It’s a compensating behaviour that makes something less painful. If you think about it you can work out where the pain is. The pain that is comforted by saying to yourself “there’s nothing to worry about” is the pain of anxiety.

The person who says “OK” [in the middle of a conversation] is asserting the right to be the judge of whether there’s anything to worry about. If you tell me something and I say “OK” it means, “There’s nothing to worry about and I am the one who makes that decision.” Saying “OK” to you puts me in control.

OK? Hell yeah she was...

It made me think of how often I do this in my everyday life, in particular when at work. How often do I use the word “OK”? As in “it’s going to be ok” – and is there any difference between when I mean it (reassuringly, or in annoyance) and when in fact I’m thinking “surely there’s a short cut to hospital, please someone take you off my hands before you die!”? Or do I use it in the above ways?

Yes, I do. One example that immediately springs to mind is the elderly rambling lady. I’m trying to question you about that bang to the head, and instead you’re giving me your life story. I’ll continually use the word “OK” to bring the conversation back on track – “OK, but can you remember falling over”, etc.

The other extreme is the patient where you start every sentence with “OK”. These are invariably the ones who are about to die and you have no control over. “OK, so we’re going to….” was something I distinctly recall saying several times on a recent job that ended up in resus. Thinking about it, it is just like a safety blanket. Saying “OK” was almost a way of convincing those around me, and myself, that I was actually in control. And in this case I think it worked – I kept a cool head, and I even got to boss nurses (including a sister) around without any complaints, so I must have appeared to know what was going on when in reality it was brown trouser time.

Moments later, he was eaten by a shark

There’s no real point to this post, just an observation. Try it for yourself next time you’re communicating with someone, or even better, watching two others communicating. Look at where, when and why the word “OK” is used – I think you’ll find cbtish was spot on!

Still got it?

Recently, I’ve had a few jobs both on the road and on the ward that have really made me start doubting whether I am still as caring a person as I used to be, or at least think I was. I blogged about a couple here and here, but there have been plenty more from “big sick” patients that haven’t troubled me to welfare issues that I’m unfazed by, making me think whether I’m turning into a cold, callous and heartless bastard.

However, today I regained some faith in myself. We’ve got a patient in, about my age, with a severe allergic reaction. They’re atopic, suffering from allergies, eczema and asthma, with mental health conditions secondary to the above. And I really felt sorry for this patient.

The one issue I have here is, did I feel sorry for them because of the state they were in, or because, to be blunt, they reminded me of me (and I’m a horrible narcissist)? Do I care about them in the same way I care about any other patient, or do they get an extra portion of care and empathy from me because of the similarity of their condition to mine? I fear it might be the latter.

But still, an improvement on how I was feeling! Once upon a time, I got really emotionally involved with “patients” – be they people I came across through work, St John, or just people who needed my help in “normal” life be it friends or strangers. The homeless man I could do nothing for at Notting Hill Carnival, the suicidal friend, the recovering drug addict in the pharmacy. Through time, I’ve become more detached from all this. I wouldn’t say “learnt to become more detached” as I was about to – it’s more just developed through time without any concious effort. But I guess as Chapati kept saying, it’s not necessarily a bad thing. In some ways, it’s made me better medically, from being able to keep a clear head during the distressing situations to just not being taken for a ride by the homeless person after a bed for the night or the attention seaking addict trying to score some drugs. As long as I can keep hold of some humanity then if being detached means I’m able to better look after people then it is fine by me.

Update: Unfortunately, the kid never regained conciousness and died. Hearing that news upset me far more than any of the rest of the saga did, perhaps because I’d convinced myself that there was going to be a happy ending since I saw that sinus ECG rhythm in resus. Maybe I’ve watched too many episodes of Casualty. I guess that the fact I’d managed to convince myself they were going to be fine despite my head saying that there was a negligable chance of survival, given how long they were without oxygen, shows that I did care about the poor little thing after all, and it was just my all too effective psycological coping mechanisms cutting in at the time. Which is, as far as I’m concerned, a good thing.

Am I a caring person?

Something happened yesterday that made me really re-evaluate my opinion of myself as a caring person. At about two in the morning, the door to one of the bays on the ward opened, and I found myself face-to-face with an elderly gentleman who told me that I had to, “Stop playing this game”, and to let him out.

This is a common occurance here. “Confused” patients (often described as “pleasently confused” when we want to offload them – beware this phrase!) regularly present around midnight, and more often than not declare that:

• we are keeping them hostage
• this isn’t a hospital but a prison
• it isn’t actualy midnight because the sun is on outside (no dear, it’s the lights on the corridor)
• where’s my clothes?
• my wife was here a few minutes ago
• etc…

Almost always this can be attributed to a medical condition – pyrexia, hypoglycemia, UTI – which may be exacerbating already exsisting dementia or just causing the issues all by itself. In many cases this is reversable (a fan, some sugar) but we need to find out what the cause is first, and that is easier said than done.

This particular gentleman was insistent that we’d drugged him and dragged him from his home to what he believed to be a dodgy nursing home. Apparently, all the equipment we had was actually second hand, and our NHS ID badges were faked, with the aim of pretending to be the hospital. The other patients in his bay were in fact “heavies” who were pretending to be asleep, ready to beat him up if he misbehaved. His proof for this? I wouldn’t let him turn the lights on at three in the morning.

The joys of dealing with this chap went on and on, as he tried to leave the ward, break into female bays, repeatedly tried to wake the other people in his room, and make us phone his daughter at stupid o’clock am (yet more proof that we were in a conspiracy against him). How did we cope with this? Got him to sit at the nurses station with a cup of tea (“you’ve put something in it, haven’t you?”) and made fun of him.

Yup, you read that correctly. We made fun of the patient. Not made fun of him in an overly obvious way (throwing custard pies at him or using him as a makeshift drip stand), but in a more subtle way, amusing ourselves by the way we spoke to him and laughing at his responses to our questioning and actions, even those completely unrelated to him.

At seven, we relented to his constant requests for a phone call, and let the gent call his wife and daughter. At first, he didn’t believe them either (“they‘ve got to you too, haven’t they“), but after about half and hour of phone calls the message got through. And that’s when I began to feel awful. He started crying.

The chap grabbed my hand and shook it, and asked “Still friends?”. He apologised profusely as we walked him back to his bed, for swearing and at one point hitting us with a walking stick. He seemed absolutely mortified by the way he behaved, and so embaressed at his misunderstanding of the situation. He was still crying and saying sorry as I tucked him into bed.

And what had I done to help him? I’d laughed at him. I, and the other people working with me, had treated him like a game. Ooo, what’s that crazy old man going to do next? Oh look, he thinks we’re going to drug him, isn’t that a giggle? It was hard to hold on to the fact that he was actually ill, and needed our medical attention, and it upset me greatly that instead of just helping him I treated him as the source of a few cheap laughs. Sheesh, I’m even making fun of him now in my tone of writing about the incident!

Now, we do this a lot. Patients are a constant source of amusement to us. Should they be? I don’t know. As long as we provide the care they need to the best of our ability, is it ok to laugh? We did for this chap, did everything we could to protect him, and the other patients who he wanted to disturb. But was it right of us to treat him the way we did as a person?

In some respects, you’ve got to laugh, or else you’ll cry. It’s sad to see someone in that state, and even worse when you think, “that’ll be me in fifty years”. Laughing about it numbs the pain. And then, it’s our job. People in an office will laugh at their clients (they certainly did when I was temping), so should we be able to laugh at ours? But would I want the staff laughing at my grandad in the same state? Or my dad? Or me?

I want a nice conclusion to this post, but I don’t have one. I feel like I let the patient down, and although I can’t speak for the actions of the people with me, I let myself down. I’m trying today to be extra nice to the patient, though is this making it up to him or is it for me, to make me feel better about being nasty as I’m putting in hard work now? The important question is, was I a good carer, and I can’t answer that.

On another note, I’m determined that when (if?) I reach eighty-odd and if I still have my mental capacities intact, I’m still going to wander all over the place, make inane requests at night, and maybe even shit on the floor if the mood takes me. Because I have to deal with it in my job, I’m going to make certain the next generation has to too!

Quoth the crow, ‘It’s my frigging nut!’

I’ve just spent a rather entertaining fifteen minutes stood in the rain watching a crow try to eat an acorn. Yes, I’m that sad

The weather’s rubbish. My project is rubbish (Yeah, it’s probably not. But that’s how I feel right now). My cooking is rubbish. Everything’s just a bit rubbish. So I do what any sensible person would do, and go for a walk to buy beans and bread for that traditional pick-me-up, beans on toast. Co-op don’t have bread – rubbish. The Shell garage doesn’t have bread or beans – also rubbish. So I have to walk all the way to Waitrose for extortionate bread and gold plated (hopefully, for the price) beans – extra rubbish. However I did run in to a new orange flavour Relentless (“the energy drink with a health warning”) which tastes slightly less artificial than the original and now has me buzzed up.

On the way back, I came across a crow hopping around in the middle of the road. It had an acorn in it’s mouth, so having nothing to do but get out of the rain, get changed out of my greens (Was supposed to be covering a rugby thing. Didn’t happen because of rain. Didn’t find out until I got there. Rubbish.) , warm up, eat beans on toast, do project, etc, etc, I decided to stop and watch.

Obviously, once I stopped and stood still, I became less of a threat and the crow started going about his business. Which was trying to break open the acorn. His plan was simple:

1. Place acorn in a puddle. Tap it with beak.
2. ???
3. Profit

This seemed to be particularly unsuccessful. However many times the crow picked up his acorn, walked across the road to the next puddle, dropped it in the puddle and pecked at it, the acorn didn’t appear to open. One of the major problems may have been all the people and cars and other scary things that were about – each time something moved nearby that was bigger than the bird, it would place the acorn in the dead centre of the puddle and retreat to the far side, dancing around the edge always keeping the car/oldfolk/kid-in-pushchair on the other side of the puddle, safely away on the far side of the vast expanse of water.

Then the crow hit on something. One car came a bit too close, to the crow grabbed his (I say his, might well have been a lady crow, I’ve no idea how to tell the difference) acorn and flew for the nearest high grown, a bus stop-signifying post that was recently bent out of shape by a council rubbish collecting lorry. Car safely away, and he jumped back off his post and swooped down towards the nearest puddle to continue his futile dunking and pecking routine. Then disaster! He lost his grip on the nut.

You could almost imagine what was going through the bird’s mind as he sat next to the acorn and looked quizzically at it. “Dang, dropped it. Hang on a tick! Hmm, looks a bit bent. Maybe this will do the trick?” Having tried in the puddle again for a couple of minutes, he went for another go at the throwing the thing at the ground trick.

Success! The crow swooped down upon his prize, and pecked away at those sweet, sweet innards. And I went home, strangely full of renewed vigour and hope for the future. Take a lesson from the crow. “Never give up, never surrender”

A long weekend, with added life-changing realisations

Realisation 1: It is impossible to work in the sun

Working while the sun is shining is all but impossible. You’d think that having bright sun would encourage you to be happy and hence productive, but no. Instead, you’re sat inside watching everyone else outside having an awesome time, and wishing that you didn’t have to do this damned degree and instead could spend all your time on the Backs drinking alcoholic beverages and eating fruit. You get angry, the people around you get angry, and no-one gets anything done.

The solution was simple – take a day off and go enjoy the sun! Exams are over 5 weeks away. That’s ages. So instead of sitting and trying to work I cycled out to Granchester with Ana and had a picnic, including the important fight with the local widelife (this time with a swan who decided he wanted my food, the bastard).

Realisation 2: Drunk people know when you have to be up early

Drunk people only ever annoy me when I’m trying to sleep when I have to be up early in the morning. Take Saturday night for example. I had to be up at 6am on Sunday. I went to bed early. I didn’t drink anything. Yet I got such little sleep I almost passed out on the bus home from London at 1700 because I was woken up twice by (I assume) two different groups of sinking drunkards – once at 0130 (pub kicking out time?), and again at 0300 (clubs kicking out time). So a staggering 3 hours of sleep was had. Yet when I don’t have to be up at any particular time, the drunks are never out in force. Perhaps beer gives people psychic ability in addition to a desire to annoy people? But whenever I’ve been drunk enough to acquire this psychic power, I’ve been too drunk to remember it later?

Realisation 3: St John cadets do have uses

The reason I was up at 6 was to go and Johnnie it up at the London Marathon. This was a mixed bag as to how I feel about it – the atmosphere was great, the weather was nice (perhaps even too nice) and the people I actually hung around with were cool (although this may be because I already new them all because we were all Cambridge LINKS). The negative side was the station we were on – badly organised, poorly staffed (skills wise), just generally quite poor. Though as mentioned above, I have come to realise that cadets do have their uses:

1. Handing out Vaseline. It’s a nasty job, but someone’s gotta do it. So it might as well be given to those that everyone can pick on
2. Acting as runners. The radios didn’t work, the mobiles didn’t work, and the crowds were too big to shout. So send a cadet! If only we had a catapult…
3. Getting in the way. Either that, or being too lazy to do anything
4. Fucking up. Need I say more? (probably, but I’m not going to)

Realisation 4: Two years is a long time

Warning, soppy romantic bits ahead! Yeah, me and Ana have been together two years yesterday. And this time round I actually did something to celebrate it. Shame it was the only day of shit weather for the last week, but it didn’t effect what a great day it was

Realisation 5: Assassins screws you up

When I was off bowling with Ana yesterday, I ran into a guy at the bar. I thought I recognised his face, so asked if he was who I thought he was. He was. I remembered his face, his (quite distinctive) clothing style, his name, his subject, his college and his year. I “killed” him nearly two years ago. We had a nice chat.

Then I realised that I couldn’t remember anything about my ?spinal casualty from Wednesday aside from his first name. Ok, I remember his face… ish (quite pale ). I remember his clothes… ish (they were standard clothes that someone attending a metal concert would wear). But despite asking him all the questions, filling in a Patient Report Form (PRF) with all his details on, and being around him for c.20mins, I couldn’t remember jack about him.

Why is this? I guess as an assassin you get a bit geeky about stalking someone, whereas when treating someone you’re not concentrating on their every detail, just what is wrong with them and trying to ship them off somewhere else to get them better treatment. And I’ve treated far more people than I’ve killed playing assassins. But still, I’m a bit disappointed that I can’t remember more about the poor lad.

Realisation 6: There’s always something to make you giggle on the internet