Three

Hail, apologies for the long absence.

The following post is rated G: for readers accustomed to Gore. Sorry.

Much has gone on, including some nightshift, and I am trying to write this before our tutorial session. We have three hours of weekly tutorials which are interesting, educational and money for jam, but I am struggling against the temptation to stay home and write instead.

What's been going on?

Well, Dr Iskandar, who was there when we saved the Snow Maiden back in April, is resigning. I went in after his last night shift and saw him writing his resignation letter - I believe he only paused to wonder if "shithousedness" was a word. I suspect for Iskandaar "Things had Suddenly become Very Clear", a feeling which means you've worked something important out or you're sliding into psychosis. He will be sorely missed.

So that leaves three - the pleasant, cautious and capable Dr Longstocking, me and Dr Maad.

And I'm not that sure about Maad.

Dr Maad is from Saudi Arabia. One of the nurses worked in Saudi Arabia for ten years, he says it is an unusual place. He did some shifts on what he called the Ward of the Living Dead. He says in Islam, the person is considered alive until the heart stops beating. This means that if someone suffers massive braininjury (due to stroke, motor vehicle accident, etc.) the doctors resuscitate them (get tehir heart pumping and their blood oxygenated, like we do here) and then go and try and explain the situation to the family.

Often this is exceedingly difficult for everyone. In Suadi, especially if the family is very religious, they may not be able to advise the doctro to turn off the machine, because the orthodox religious position is that that is murder, and who can do that?

So you have an entire ward of people who are dead but are kept alive by artificial means. The drugs keep the heart beating for weeks at a time. One of the ways they do this is by shutting down the peripheral circulation (the blood frlow to the skin and fingers and toes, etc.) and increasing the central (to the heart, etc.). Without blood the extremities die. So he would spend hours working on the ward. In the morning he'd come around and removed the body parts that had dropped off (the fingers, toes, and noses), the doctor would check the doses, and that would be that.

Anyway. Dr Maad originally had some problems. He is knowledgeable, efficient, competent, assertive and eloquent, but he did have what one person called issues with the nursing staff. I don't know who started what, but he started one sentence with "The problem with you Australian women..." and things have gone downhill from there. Alienating and entire country and an entire gender in six words - I told you he was efficient. Apparently, and again, this is hearsay, one nurse fetched him a bag of hypotonic saline instead of hypertonic saline, and he growled "Western Dog!" and hurled it across the room.

I don't know if this is true. Registrars are in short supply, they tend not to double us up on shifts, I have hardly worked with him at all. I can imagine it is difficult for all concerned.

Anyway, tutorial calling.

Mr Baluch, by the way, is still alive. He may turn out to be as difficult to shift from the ICU at the Royal as he was from the Florey ED. And I tell you now, if anyone I've met is going to sue, it's him. As soon as he can move his arm independently, he's going to dial for a lawyer. We shall see. Something to look forward to.

Thanks for listening,

John.