I have ---'d on the --- of giants
First of all, thanks a lot for the comments, will attempt to reply later today. People have said stuff I am quite keen to respond to, and as soon as it calms down here, I will. I do find this whole issue an incredibly complex topic - each time I try write about it I get ten paragraphs of unfinished sentences. The topic itself is that horrible mixture of the private and the public.
I remember reading somewhere that the obese are unusual in that their sin is impossible to conceal and impossible to excuse. If you cripple the economies of small African countries you get lauded, if you spend every waking hour downloading hot Flemish porn you can at least lead a normal life, but if you really love pasta, you're marked out in a crowd. Obesity is hard to isolate one thing to talk about - every medical "fact" has social implications, emotional connotations, political connections.
But it's interesting. And six mornings a week I am getting up to struggle and blunder and lunge on one of those stepper machines, and each morning I am eating my low GI breakfasts and each night not having second helpings of anything non-carrotty, and all that. And it's working - incrementally, and it's early days yet, but it is working, and I do feel better.
Additionally, as part of a bargain with Sarah - she's a smart woman, but she has some really weird ideas, like "life should be enjoyable" and that "pleasure is not wrong" - I am cooking exciting stuff for us to eat, and doling it out with pathetic demands for oohs, aahs and fanfare. Anyone with any recipes that were too hard to get into "Really good exotic looking cooking for dummies" can send them hereabouts.
And it has been pointed out to me that measuring weight when you are concerned about adiposity (sounds like one of those mediaeval religio-legal terms, doesn't it? "In 1140, following the publication of his summa gastronomica, Bearneard of Cleauerviuaux was convicted of adiposity") isn't the most accurate way of doing things. So adjustments are going to have to be made, some kind of criteria which take into account body fat and physical measurements and so on. I might get one of those electrical scale things where they measure your body fat by sending an electric current through your feet. The good thing about those kind of scales is if my mood gets too bad, I can just strap a couple of them to my head and turn the voltage up.
Anyhow. We shall see. I was going to write something about boundaries - there have been a couple of patients who have sortof blurred the boundaries lately, patients where I have felt that things have slipped out of my hands, ended up in unknown territory - but I am at Central today, and the police have already been called to drag one of my patients away, and I am unlikely to be able to concentrate on something like that.
Instead, some ephemera. Here is a fragment of recent dialogue between me and one of our new patients:
Me: When you picked up the clean needle pack, there's this bit where you're meant to write down what you inject...
Him (defiant): Yeah?
Me: You wrote the letter "M"...
Him (incredulous at my stupidity): For emphetamines!
Additionally, I have in front of me a printout of blood alcohol results that show a 44 year old man presented to Florey last year with a blood alcohol of... 0.77.
That's not 0.07, that's almost ten times the old drink-driving cut-off. It's .15 g/dl higher than anyone else I've ever heard of. If this reading was not an artefact - the most likely thing I could think of is someone used an alcohol swipe to wipe his skin with and that somehow contaminated things - and if this was the Cirrhosis Olympics, this guy's Martin Phelps or whoever. Theoretically, 0.5 would kill most alcohol naïve people. I am trying to work out how much of this guy's blood you would have to drink to become drunk.
And as another aside, here is a fragment of conversation I had with two of my nurses. If anyone can explain where "first nurse" got her idea from, I will be very grateful. I cannot begin to make the connection.
Me (walking past): Jumpin' jack flash, it's a gas gas gas, do do, do do dooo do do dooo do do do...
Nurse: No, he's a porn star.
Other nurse: Bullshit. Ask John.
Me: What? Who? Why? Why me?
Nurse: Isaac Newton, he's a porn star, isn't he?
Me: Isaac Newton?
Nurse: Sir Isaac Newton. Big porn star. In porn movies.
Me: I've heard of a scientist Isaac Newton...
Nurse: What'd he do?
Me: Gravity. Optics. He was the guy who sat under an apple tree, apple fell on his head. First one to get a ray of white light, shine it on a prism, split it into colours.
Social Worker: Didn't he invent calculus?
Me: I reckon. Him and Leibniz, wasn't it?
Social worker: Horrible man.
Second nurse, triumphant: Nothing to do with pornography then?
First nurse: You're both full of crap. Sir Isaac Newton. He's a really big porn star. He's really famous.
Second nurse: What, so he got knighted for services to pornography?
First nurse: Go look it up. And then come back to me and tell me how right I was.
Speak soon, and thanks for listening,