Monday, November 27, 2006


First day back after almost a month of absence. This last episode has used up all my sick leave and fair amount of my holidays, and cost myself and my family two and a half thousand dollars... plus untold emotional damage. But I am back at work and doing stuff. We are still in the mire but at now at least we are digging upwards.

Everything was going okay... well, as far as could be expected.

I don't know. Things aren't back to normal. Things tire me out that shouldn't tire me out, I am still a little more labile than I would like to have been, patient's stories affect me. I don't sleep without low-dose antipsychotics on top of everything else - or I sleep until three or four in the morning, then I wake up. Unless I stop myself I gorge myself. I am still susceptible to panic. When I am alone, or stressed, I still get those dull, churning thoughts, the steady mechanical thud and clunk of self-loathing and suicidal ideation, fainter but still there.

But I don't have the hopelessness, the helplessness, that cold agitated desperate emptiness that marked the last few weeks before my admission. I am nothing like that sick now. And I am a long way from decisions and plans and preparations.

Anyway. I saw a patient today, a busy, energetic man, looking much younger than his thirty years, working as a carpenter up near Darwin. He was tall and thin with blond stubble-cut hair, too busy to get his Hep C checked out but also too busy to get on the smack, and he spent half the time telling me the new projects he was working on - a new extension to the Royal, some hotels out in Uluru, work for the Royal Flying Doctor Service.

"We get all the medical jobs" he said.

"Might see you at Florey" I said.

"You probably will" I said.

And he told me about the events of the last three months, which included his wife's brother's suicide, and then those of the last year, which included two other suicides (both of his cousins).

Two hangings and a shotgun, a family hit three times in a year, bodies found and funerals attended.

"And the thing is, the brother in law, I saw him the day before. Told him I could get him some tickets for the Ashes."

I nodded.

"Didn't seem any different. Couldn't have told" he said.

"No-one can" I said. "Doctors, family, friends. No-one can see it coming."

And I was able to listen to this as well as I normally do, asking all the right questions, his moods, his sleeping, any unpleasant thoughts (no to all the above, never been depressed, could't understand suicide) and I marked him down as one of those people at considerable risk in the long term, a stoic man whose any requests for an urgent appointment should be met, but maybe not someone at risk now. And we discussed warning signs and who to call.

"Anyway," he said, "better get on with it. Meant to be on the flight at two."

"It'd be getting hot in Darwin" I said. "Thirty degrees easy"

"Thirty four today*" he said, (not pronouncing the asterisk). "Only thing wrong with the work is the heat. I love the cold, Iused to live up in the hills, close to freezing all winter. Mist every morning, owls and possums in the trees, ice on the ground or dew on the grass until lunchtime. That was back when I was on the smack."

I nodded. He spoke more quietly, reminiscing.

"Crazy days. I was staying up there with four hookers, stayed about a year. Two sisters and two others. One of the sisters was a pretty good friend of mine. The landlord, he had a forest, like a real forest on the property, twelve acres, he was breeding deer. There used to be one male, a buck, and about eight, ten females."

He paused for a moment. "I just used to - you know, you get up late in the morning, they'd all get up late, and we'd have bacon and eggs and then we'd hit up and me and the girl would just sit out on the verandah, watch the deer. That one guy, that one stag, going at it like thirty times a day, every single opportunity, in the forest, out by the dam, up near the fences. Wearing himself out, and we'd be watching him. So damn cold his breath was like mist and still be going at it. Back in the day"

"Back in the day," he said again. He stopped, and for a moment I imagined I could see his pupils change, diminish, that "looking-at-a-bright-light" look of the heroin fix. Back in the day.

"Anyhow" he said, picking up his script from the desk. "Thanks for that. Hope to see you next time. Three months?"

"Three months" I said. "See you earlier if you need it."

So there it was, my first patient back. I don't know how to put it into words, but all that life and death crammed into half an hour. And I have gone back over what I did, and there were no mistakes that I can see, no jots or tittles, no wrong doses.

Anyhow. In half an hour we have the first of today's pregnant buprenorphine clients. In the interim I will leave you with an email I found among the literally hundreds ("Urgent: the small blue stapler has gone missing from the Port Innsmouth Office...") in my inbox that have accrued in my one month of sick leave. It was marked Highest Priority. I reproduce it in full below:

Please be advised that a step-ladder has been left against the sliding door and wall in the staff dining room. One staff member has been injured from walking into the room and colliding with the ladder. I have now put up orange cones and a notice in the dinning room. I have been advised by Property Manager Ian Dolent that the ladder is property of Kray security who are putting up a security camera in Inpatients. As the CNC of Inpatients is not onsite today I have requested via inpatient staff that the Coordinator requests the security person when they come back to store the ladder is a safer place. I will advise Ian Dolent later today if the ladder is still onsite.
In the interim I can only suggest that all staff walk slowly into the dining room.
bye for now,
Pedro Antic
Occupational Health and Safety Officer

I defy anyone to read this and tell me why the writer (dead set, more than six foot tall and shoulders like an ox)
a) couldn't move the bloody ladder himself, or ask someone to, and
b) what we are supposed to do about people so stupid they walk into a ladder standing in front of them and then bitch to occ health and safety about it.

This is why it's the twenty first century and we still haven't reached the stars.

Thanks for listening,

* That's ninety three in America, and humidity above fifty percent. Plus crocodiles. Every month I get people writing to me asking me to come work there. I'd love to.


Blogger Juanita J. Sanchez said...

Oh John. How incredibly difficult, and how generous. To be able to help others when you're still hurting. Don't overdo it if you can help it, BJ. I'm thinking of you.

1:25 AM  
Blogger Juanita J. Sanchez said...

P.S. Thanks for the American translation. That's hot for sure. It's about 65 here and raining, not bad at all.

1:27 AM  
Blogger Prom said...

Welcome back John

4:47 AM  
Blogger Benedict 16th said...

testing testing 1-2-3...
BJ is having some problems posting so I thought I would chuck this in as a test


9:34 PM  

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