Internal Medicine

Dr Tabubil is doing internal medicine.

Her first patient of the day was an ancient, emaciated man - very ill.

            "How are you feeling today, sir?"

            "Shit!"

            Dr Tabubil, trying to hold back a laugh, ripped out a snort so loud that the drip line trembled.  She fled precipitously, while the consultant in charge sniggered.

            Her second patient was an equally ancient woman, suffering from advanced cancer.  The doctors would like to start chemo, but she weighs only 39 pounds, and they need to get her up to 42 before they start tearing her body apart again.  There is a miracle nutrient solution that "builds muscle on you, dear, won't you eat?"  But the bewildered old dear didn't understand, and Dr Tabubil was was treated to the sight of the consultant virtually sitting on the ancient woman's fragile ribs, shoving a bowl against her chest and a straw against her mouth and bellowing  "Eat! Open up!  Swallow!  Eat! Please!" while the bird-like old lady piped tremulously "but I'm not hungry, dear." and declined to open up.

            Dr Tabubil was asked to go back to the profane old man and perform an Arterial Blood Gas on him.  An ABG is like taking a blood sample, but it requires the needle to go into the radial artery in the wrist instead of the vein down in the forearm.

            "Does it fountain?"  I asked with interest.

            "Only if you do it wrong!"

            "Have you done it before?"

            "Once, and i got the sweetest Venous Blood Gas you ever saw.  Missed the artery completely.  But today I did it just GREAT."

            As she leaned forward to inject a local anesthetic before she took the ABG, the old man remarked conversationally to the consultant: "By God.  She's got nice breasts, hasn't she?"

            "Mr __________!"  The consultant cried, shocked.  "You're really not supposed to say that."

            "Yeah."  Dr Tabubil said, giving the old man an evil glare.  "I haven't given you the local yet, have I?"

            In a spirit of charity, she did give him the juice, and was then glad for it, because she spent 15 minutes poking into him and missing the vein every time.

            "I just hit the bone, over and over and over.  I kept imagining that I was going to chip the bone, and thinking that I was one poke away from breaking the needle and leaving it in there.  It was awful.  But eventually i got it, and it went sooo perfectly -  when I pulled out, I didn't even leave a blood blister, and even the consultant did that last time."

            She picked up her vials of blood, beat it out of the room, and the wall started swinging toward her and the next thing she knew, she was sitting in a chair in the nursing station, with the consultant leaning over her and looking concerned.

            "Are you okay, Dr Tabubil?"

            "Sure!"  She said brightly.  "Just fine!" 

            She jumped up and headed for the stairwell, and found herself hanging from the railing.  Instead of being sensible, she kept going, all the way down to the pathology lab, where she succumbed to a bad case of the shakes and fell over again.  And the consultant laughed and laughed and laughed.

Census Night, 2011.

Yesterday evening was Census Night in Australia. We are visiting with Dr Tabubil in Brisbane at the moment, so she had herself, one sister (currently unemployed by virtue of recently winding up her last job) and one brother-in-law (an engineer on his way to a new job in another country) to prod and poke and tally up for the public record. 

            A census turns into a thing - deep terminology, that. It's sort of amusing, and sort of embarrassing, sort of like getting undressed in front of a doctor and sort of like getting undressed in front of an auditorium.

            It's Very Important, so you feel full of Public Virtue, and even faintly Self-Important, because your little statistical data point can build hospitals and inspire public works initiatives like highways and bus routes (so the carpet-bombing pre-census advertising told us) but when you're a doctor working 16 hour shifts six days a week or a couple that has spent the last two weeks eating their way across the continent in the arms of wonderful and wonderfully hospitable relatives, some of the questions tend to come across a little uncomfortable, and put a nasty leak in your deeply inflated chests.

Examples:

"Have you provided any unpaid childcare for relatives in the past five days?"
Or:

"Have you performed any charitable activities in the last two weeks?"

And you begin to feel rather like Butterflies - or even Mayflies - and Parasites, and Pimples on the hard-working arse of society.  

So your answers start to get a little bit dippy.

"Occupation?"

"Doctor."

"Provide a comprehensive description of your job duties."

"Hah."  Doctor Tabubil said.  Reinflating, she took up her pencil and  solemnly inscribed: "I SAVE LIVES."

Things got a little misty after that. From Mr Tabubil, the engineer who was last seen helping to re-line the blast furnace of a steel mill, I distinctly remember the words "contributing to the carbon load of the Australian atmosphere" being bandied about, and me - well, if we're determined to be pedantic, I've got no job at the moment and haven't actively sought a new one in the past four weeks, and that doesn't look like an example of productive public virtue any way you slice it. 

I do remember Mr Tabubil posing his sister-in-law the following question:
            "Have you performed any unpaid domestic work for your household in the last week?"

            "Oh yes."  She replied, relieved.  "Lots.  At least three hours." 

I'm sure that I hooted. 

            "Oh yeah?"  She said.  "And I suppose you've done any on your holiday?"

            "Yes."  I said smugly.  "I washed out our underwear and socks every night while we were traveling.  And I unpacked and repacked our suitcases every four days."

            "I'll put you down for under five hours then.  That's the lowest option.  And if you were washing the socks, then Mr Tabubil wasn't doing anything, was he?  Typical male.  You won't be shaking up any demographics here, will you?"

            "If you would care to recall" Mr Tabubil said with great dignity "I spent most of that holiday in various beds with a case of the flu."

Dr Tabubil made a rude noise and wrote something uncomplimentary in the comment box. 

            "Ahem." She said.  "Another question - are you willing to have your name, address and other personal information made available in the public archive after ninety-nine years?"

Mr Tabubil and I looked at each other and shrugged.  "Sure. "

            "Really? All public?"

            "Why not?"

            "Well I'm not sure that I want...I mean, that's pretty... Hah, wait a second! I'm the cool cat who saves people's lives!  Hell yeah!"

And with that, the party rather broke up.  Five years down the track, lets see if we can be in a permanent-enough situation to make us out to be rather more than mayflies and drains on the public purse.

Amen.

Chicks dig scars.

Yesterday while my sister was working in Casualty, a small boy came in with a small cut on his chin.  His parents were slightly over-concerned.

The child was barely pushing four years old, and the two-centimeter cut on the underside of his chin didn't even require stitches, but his father said anxiously "We have private insurance.  Can we please make an appointment with a plastic surgeon?"

The nurse and the consultant and Dr Tabubil and the resident, (the parents really were a wee bit over-concerned about the injury) looked at each other, but Dr Tabubil got the first word in.

            "Pssssh."  She said, and flapped a hand in unconcern.  "Chicks dig scars!"

            "I'm a little worried" she told me later, "that I'm getting a reputation as That Intern who has absolutely no filter between her mouth and her brain.  This morning I had to introduce myself to a consultant in the ER and you know how I did it? 

            I said 'Hi!  I'm Dr Tabubil, the resident!  Actually, I'm a first year intern, but saying that I'm a first year intern makes it sound as if I don't know anything, which is only sort of true because I've learned a lot this year so far and apparently I'm really good at suturing, and I want you to have confidence in me so that you'll show me the interesting things, so it's better if I call myself a resident!'  And at that point I managed to stop talking.  A bit too late, don't you think?

            But the consultant didn’t seem to mind.  He took me off to see a really cool shoulder dislocation and let me do all the pulling.  I can't actually move my own arms tonight after doing it, so I think he might have been trying to make a point.  What do you think?"

The Monkeys in the Zoo

Yesterday we went to the zoo.  We looked at the meerkats and the giraffes and the lemurs (perched on top of their heat lamps) and the siamang monkeys and the seahorses in the bio-education pavilion.  We visited the orangutang – she was sitting on the edge of her moat, watching the visitors and chewing grass.  When children stuck their arm out and mimed shaking hands, she would put out her own hand and solemnly mime shaking back.  When the idiot British tourist threw peanuts at her (his aim was extremely proficient) she gave him looks of calm disdain and let them bounce off and had absolutely zero interest in chasing them down in the grass.  So the twerp threw  more – in the feeble hope that she hadn’t gotten the message the first time, or possibly that she had the three second memory of a goldfish (although that’s in dispute now, isn’t it?) and would see every projectile as a brand new exciting opportunity.

We were leaning over the rail, peacefully contemplating a pleasant Sunday afternoon, and a woman arrived with a toddler and a baby in a stroller.

            “LOOK at the MONKEY.”  She boomed.  “LOOK at him sitting on his bottom.  LAZY boy!”

            “Yah-” attempted the child.  Mother cut him off in mid-voice.

            “DO you see the LAZY BOY there?  WHAT a lazy BOY!  He’s not doing anything at ALL!  Tell me, do YOU think he’s Lazy?”

            “Ya-”

            “WHAT A LAZY man you ARE!  Sitting on your BOTTOM in the sun instead of being a USEFUL person.  NAUGHTY Boy!”

            “Ya-”

The long suffering orangutan grunted and knuckled to her feet and turned her back on her audience.  Giving us one hopeless look over her shoulder, she hid behind a stand of grass and say down again.

            “LOOK at him!  SHOCKING!  He’s not going to do ANYTHING today but sit around!?  What do you think of THAT, you LAZY Man!  I’m WATCHING YOU!”

Not all of the monkeys were on the INSIDE of the cage.

An early morning phone call. Or, Why it might be inadvisable to flirt with policemen at three in the morning.

Dr Tabubil has finished with Obs and Gobs and is working the ER.

            She doesn't much like Saturday nights.  They live  up to all the chaotic, drunken reputations they've earned on daytime television dramas.  And at about 3 am, things start to get slightly surreal.
            Later, around 8 am, my telephone rings:

            "Hey Tabubilgirl."

            "Hey Dr Tabubil."

            "Talk about puppies to me for five minutes will you?  I need to hear something nice."

            "What happened?"

            She sighs. "So.  It's about three in the morning and I'm stitching up a girl who's been glassed by her own mother -"

            "Did you call child services?"

            I can hear her shrug  "She was over 18.  What was I supposed to do?  You should have seen what she did to her mother.  Anyway - I'm stitching up this girl and a cop comes in with a drunk in handcuffs that he needs to have sewn up where he fell into a mailbox. 

            And I'm really tired.  And the cop is really, really cute.  He's wearing leather gloves so I can't tell if he's wearing a wedding ring or not, but he smiles at me, this totally gorgeous smile - and have I mentioned that I'm really really tired?  And that I haven't eaten for about ten hours because it's been too busy for me to sit down long enough to even eat a biscuit?  So maybe my reasoning abilities aren't quite at their best, okay - so do you know what I do?

            I look at him, and I say in my very best throaty flirty voice:  Is that a taser in your pocket?"

            "Or are you just happy to see me?!?"  I snickered.

            "Oh my God, no!  I wasn’t that far gone.  But he looked at me and smiled again - this really long, slow, sexy smile, and stood just a little bit taller and said 'Why yes.  Yes it is.'

            And then I said - oh my god, I purred - and I think I even fluttered my eyelashes a bit - I said - 'You know.  There's something I've always wanted to know.  Is it true that when you policemen learn how to use tasers, you have to practice on each other?'

            And he smiled even wider and cocked his eyebrows at me and said 'And I always volunteer.'

And -BAM.  Just like that.  My crush was gone.  I mean, the policeman was nuts. So I turned back to my drunk and finished stitching up his head.  And then I went and found a biscuit."

            "Do you think maybe you could carry biscuits around the ward with you in your pocket?  You know, to stop you getting into emergency situations like that?"

            A sigh.  "Could you just talk to me about puppies for about five minutes,  before I go to bed?  And then I'm going to sleep and I'm not going to talk to another policeman for at least a month. And male cops shouldn't be allowed to wear gloves. It's all his fault. If he'd been married and I'd been able to see a wedding ring, this would never have happened in the first place."

Giraffes

G'bye.

So we're off.  Bags checked, hand-luggage shell games played in the airport terminal, boarding passes in hand - Goodbye.  It's been a hell of a ride.  Thank You.

We're off to Melbourne.  And Perth.  And Darwin, and Brisbane, and Vancouver, and Toronto, and then, eventually - Santiago, Chile.