The Winter Shunt

Hail,
And that oddly poetic sounding name, evoking perhaps someone standing at a train station, some time in the nineteenth century, watching steam locomotives bullying carriages back and forth, refers not to that but to a particular operation to cure the dangerous condition of priapism, or a painful, long-lasting erection.

There you go. I write to you today from deep in the glomerulus, that rococo structure of tubules and cells in the kidney that turns blood into urine. Doesn’t seem quite as miraculous, for some reason, as the breast, which turns blood into milk, or the brain, which I suppose turns blood into thoughts, but still, it’s impressive. If we didn’t have kidneys, we’d all still be lounging in the primal sea.

Renal (means kidneys) medicine is something I never really got my head around last time, but this time it is seeming to come together a bit better. A lot of it is so simple you think there must be some kind of trick to it. Kidneys are basically a tea-strainer with a long tube behind it, plus a couple of little pump things on the tube, adding a touch of this and subtracting a touch of that. Urine is basically blood with all the stuff we don’t want to throw away becasue we might need them later taken out, and some stuff we reckon we won’t need anymore chucked in.

In their spare time, kidneys make hormones (sounds like someone crocheting football scarves, doesn’t it?), make sure you don't suffer the embarrassment of running out of red blood cells and look after your blood pressure. Proponents of Intelligent Design, by the way, might like to explain to me why when you get high blood pressure one of the first things to go is your kidneys. But once your kidneys are damaged they can’t really control your blood pressure anymore, so that goes up further, which further damages your kidneys… so the only thing that could stop the situation is one of the first things to go. As well designed as a wax fire-truck, or a chocolate teapot.

Penguins, by the way, never get cystitis, what is commonly known as a bladder infection. This is because, being birds, they don’t have bladders (not urinary bladders, anyway). Amazing fact for the day.

By the by, in an effort to lift my spirits I have been reading fiction. Unfortunately – and the reasons behind this are pretty clear to me – I have chosen not-extremely-uplifting books - Primo Levi and Kafka, who, by the way, wrote a lot of crap among the brilliant stuff. Levi's book details the rise of Fascism in Italy – apparently when he was awarded his chemistry degree, it specified below his name that he was “of the Jewish race”.

Being genetically German Jewish, I will now tell two of the very few jokes I know – my German one and my Jewish one. They are even less funny when I tell them. I don’t believe in “national characters”, but one of these is about a political situation and the other could be about a variety of groups of people – it makes more sense as a “doctor” joke, or even a “me” joke.

The first my father (he whose uncle was a rabbi) told me. A television reporter arrives in the Holy Land and is looking around for a story. One of her compatriots suggests that she interview the “the old Jewish guy”: an elderly man who has been coming to pray at the Wailing Wall three times a day for more than fifty years. So she does so.

“So, how long have you been coming here to pray?” she asks.

“Fifty years” he says. “Three times a day for fifty years.”

“That’s amazing piety. And what do you pray for?”

“I pray for the end of hostilities. I pray that one day there will no longer be the sound of gunfire in this land. I pray that the children of Israel and the children of Palestine can come together in peace, love, mutual understanding and respect.”

“That’s truly beautiful. And how do you feel, after fifty years of praying for this?”

“Like I’ve been talking to a fucking wall”

The next joke I read somewhere and told Sarah and she said it was about me. A busload of Germans/doctors/whatevers arrives in heaven. There is a big sign pointing to the left and to the right. To the left the sign says “Heaven”. To the right the sign says “Lectures and examinations and workshops about Heaven.”

So all the Germans/doctors/whatevers go off to the right.

Sad but true. Obviously it’s not about all doctors, it’s about a particular temperament, a particular way of looking at things, an attempt to displace something or cleanse something or hold something at bay by learning, studying, controlling. You see it in medicine, in law, in the more hardcore gyms and in the cleaner homes.

Nietsche – who, let it be said, also said a lot of crap amongst the brilliant stuff - said there are two ways of looking at things – Apollonian and Dionysian. Apollonians – and no-one is one type, it’s more an approach to things – Apollonians have the ripped abs and the tidy desks and the sensible financial strategies, but the Dionysian gives you Buddy Guy and sex in the outdoors. Beauty versus ecstasy.

I think I, like most people, would like to think that I am at heart a Dionysian in an Apollonian world. From what I understand of what Nietsche said, it's not that simple. I think what you sometimes see in doctors is that sometimes the only way to approach some of the stuff that happens in medicine, some of what would otherwise tear deep holes in you, is to channel and subsume the emotional stuff into numbers, lines on a cardiac monitor, protocols.

I don't know. I write instead.

Anyway. Sarah is in Tasmania - hence these odd, meandering thoughts - and I have now to go and feed the multitudes of cats. It's weird the way they come up to the door of the run and squall at you, and when you raise the lantern their eyes glow. You can tell, apparently, two different breeds of white cat by the colour of their tapetum - the membrane at the back of the eye that reflects the light. And then I have to go to bed, because due to the instrasigence of Virgin Airlines, I have to get up at three in the morning and drive five cats to the airport.

Anyhow, thanks for listening,
John

One last thing - about comments. I feel maybe part of the reason I am so crap at replying to them is that if they are complimentary I get embarrassed. I do appreciate well-wishings and so on, but sometimes I don't know what to say - "You're right, I am fantastic" doesn't seem appropriate. I don't want to sound like a galah, but there are other people out there who write more regularly and coherently and interestingly and just overall better than me and live more interesting lives - I would feel more comfortable handballing any positive comments off to them. Go and read their blogs, follow the links on the side.

And I do enjoy getting the comments, I just never know what to say in response.

By the way, I have to update my links but I don't know how.

Thanks for listening,
John

*One of the non-crap things he said: There are some who, from obtuseness or lack of experience, turn away from such phenomena as from "folk-diseases," with contempt of pity born of consciousness of their own "healthy-mindedness." But of course such poor wretches have no idea how corpselike and ghostly their so-called "healthy-mindedness" looks when the glowing life of the Dionysian revelers roars past them