The Leodisian Life...

[yeliab_cram]

Another boring days revision invariably lead to much time surfing the net and entering more medically related discussions. One topic which cropped up a number of times was dissection, and the importance of full body cadaveric dissection to medical training.

I vivily remember the day I stood above a wrinkled, aged, naked body; dead, smelly and with slightly too much stubble for comfort. You see they shave the faces, and scalps of the cadavers soon after death, but the hair continues to grow just a few teetering milimeteres, it is just ever so slightly chilling. There are two things that his me: 1) deer god this smells awful and 2) it doesnt look human, more like a defenceless animal, or handbag.

Anyway, such contemplations cannot put of the inevetable - bringing the fresh blade down straight into clean human flesh. I must admit, for the first time its not easy, somewhere a little man in your head is shouting, "noooo, what are you doing?? are you mad??" but you must prevail and slash!

In a rather anti-climactic way, and to misquote a Sheryl Crowe (Cat Stevens orginally ) song: the first cut was not deep enough. am afraid my surgical skills did not develop on the first day. Of course, the reason I was doing the cutting as opposed to anyone else, is that every one of my fellow disictees was too squeemish to go near, let alone use their scalpels to 'skin the thorax.'

Anyway, I soon got the hang of blunt dissection - but i have to confess, i much prefer utilising the scalpel to carefully trim through the fascial layers rather than ripping through with my index fingers (im well aware you can damage critical structures if you use the blade to much, but i found it produced a much neater result - less mangled muscle).

The two memories which push all others aside, are firstly the smell of formaldehyde, what was once noxious and forboding became almost welcoming. however it is notoriously difficult to get off your hands and cloths. It takes a few weeks to learn the most ancient tecnique of double gloving. And secondly the immense hunger that dissection provokes. Not just "i'm a bit peckish" but an absolute craving for meat. Which is kind-of ironic, seeing as you invariably eat a sandwhich down in 'Cafe7', and your hands invariably still smell of dead people - and i'm sure you can imagine the rather unpalatable result!

[yeliab_cram]

on further reflection of my reflecting i think my most memorable times dissecting were during the second year when we did upper and lower limbs and head and neck. I finally had at least one group mate who was similarly able to dissect and we produced some really nice work. Which of course, was subsequently slashed to pieces by the group sharing our body.

In Leeds each body is shared amongst two groups of 6 who dissect on different days of the week. Being a 'B' in the alphabet, i was invariably in the first group, and often, insead of sticking to our given side we just went for the one that looked best. This often resulted in the second group doing whatever the hell they wanted and destroying our painstakingly neat dissections of all the muscle groups - obviously, such groundbreaking anatomical work lost forever.

There may be "nothing quite like the smell of napalm in the morning;" but there is equally, nothing quite like the smell of formaldehyde late on a friday afternoon. I used to come home each week and deliberately hug anyone who was in to infect them with my recently acquired stench. Disgusting, of course, but thoroughly enjoyable - and hey its all part of house bonding isnt it!

Of course there is one dissection class famed above all others, as the most vile and deboucherous thing a man will ever have to do. I shall tell you this, the demonstration video at the start of the class described what we were to do as follows. "insert the glass rod provided into the urethra, then carefully cut along it with the scalpel, like so" And i was whitness, to the first and only time in three years that a large proportion of the studets let out a small yelp, as (the every so slightly camp, but we love him anyway) Dr Parsons plunged a glass rod into the cadaver's penis and sectioned it in two. It was something no man should have to do, but on the plus side i can now claim quite truthfully that i have sawn a man in half (even if it was only his pelvis) so it cant be all bad can it!

In such moments we rely on the calmness, maturity and overwhelming knowledge of the demonstrators to guide us through. The demonstrators range from surgical SHOs on a teaching rotation to BMS PhD students, some of whom have never done any hands on full body dissection. So whilst the surgical trainees are taking the piss out of our lack of knowledge and inability to insert our entire arm into the dark dank recesses of the abdominal cavity, the BMS PhD student is weilding something which closely resmbles one of those turkey basting pippettes, and sugesting we siphon off some fatty juice to he can show us how it should be done.

[yeliab_cram]

so, a discussion about having to take your clothes of during some anatomy classes and clinical teaching inevetably got onto the topic of breasts. It got me thinking... if you want similar inspiration here's the link:

Random Striping in Practicals Discussion

The first time breasts become an issue in medical school [except during fresher's week of course ], is when you learn to examine the chest. You will be acutely aware that every volunteer teachers pick or every patient a doctor shows you will be male. There is absolutely no avoiding breasts in the real world (belive me ) but in the sheltered life of a young medic on the wards they try their very best. Even in the OSCE you are garenteed not to have to worry about which way to push or pull any breasts whilst you are tying to examine a patient... except of course for the breast examination station!

However once you get away from bedside clinical teaching or teaching in a classroom and you are loose on your own patients you quickly realise that a) most patients are far too hapy to show you their breasts and b) you need to learn how to deal with them very quickly. You see the laws of psysics dictate that the breasts will get in the way, and to perform an adequate chest examination you have to move them. The problem is this: there is a fine line between shifting and fondling, as doctors we must stay clearly on the side of proffesionalism. This has lead to all sorts of interesting advice; i have been told you must lift the breast with the back of the had rather than cupping; and you have to make sure you keep your fingers shut when doing this with old ladies otherwise the fatty breast tissue will simply ooze through your fingers like thick custard... niiiice. However once you get over your initial nervousness you realise that the patients, for the most part, weren't nervous in the first place and you just get on with it.

That is, of course, until you wind up on a breast firm. Breast surgery is synonamous with breast clinics; on a busy surgical ward, medical students are annoying and considering just how many breast clinics there are, it makes sense to ship them off there. The thing with a breast clinic is, you're not merely trying to move the things out of the way, you going to sit and chat about them and then have a jolly good poke aroud. By the end of my first clinic, i felt very bad that a) i didnt have breasts and b) that may non-existant breasts were perfectly healthy!

My first true hands-on [excuse the pun] experince was when in clinic with one of the SHOs (who was thoroughly lovely!) and when the first patient came in (a 16 year old girl with her mother, who had found a breast lump) she told me to "go have a feel." oh dear: 16 year old girl, breasts, feel, moter - oh no i feel a law suit coming on. Its very hard to know what to say to the patient whilst you are examining her breasts', and even harder to know where to look. But these things come with time. Of course time was not something i had, and after identifying a small mobile lumb at 3 o'clock in the left breast it was onto the next patient. It was obviously not my day, 21 year old student, blonde, (luckily i didnt know her) and she was a looker, and again i was told to examine. What can i say, it was an awkward few minutes. However umpteen breast clinics later i soon got over the awkwardness of my baptism of fire.

It is very interesting to note how the surgeons talk about and deal with breast cancer. They have definately not been watching those Cancer Research adverts on TV. When it turns out one of their patients has breast cancer, there is no big fuss, no feeling of impending doom, just a simple, "dont worry, we'll chop that out next week, give you a bit of chemo, then put in an implant and you'll lokk as good as you do now. You'll be fine." I was astounded at the efficiency and the calm manner with which it was all conducted, and generally thoroughly impressed with the entire management process. From the breast clinics, where you get your 'triple assessment' and results within 24hours, to the quick surgery and most excellent support provided by the specialist nurses.

The consultant I was with for most of these clinics (including the 7:00am tuesday morning clinic - argh had to be up at 5:30 --> i mean i didnt even know 5:30 existed) was Mr Turton, thoroughly nice bloke, young consultant, bit old school, and best of all he enjoyed playing with the medical studnets. Unfortunately there were only three of us, two girls and me, and the girls could always get away with looking at the floor, like they were about to cry and keeping shtum. Hence it was left to me to do the intellectual medico-sugical jousting. It became somewhat of a theme - he always had me in clinic with him, and put the girls in with the new SpR. And everyday he pummelled me; in true surgical style, he pushed me until he found the outer reaches of my knowledge, carefully teetered on the border and then rammed me straight through it. Made me feel like shit he did. But as the weeks went on, i began to get better (or he got more lenient, one or the other) and i started to get how to answer his questions and give myself time to think. I shall never forget, one day i was actually in the zone, was with him the whole 9 yards answered everything, and i smacked each follow up question far into left field - it was a good feeling, not often to be repeated!

each week on the 'grand ward round' he always selected 2-3 students to present cases, and each week he picked on me, without fail. And no matter how good or bad my history was he pumelled me with questions. He never commented on other students apart from the odd 'good' even when they were complete tripe.

anyway, by the last week, i understood his little games a lot more, and quite enjoyed the daily challenge, it was better than being ignored all day! we started to have little chats and i learnt he was a very wise man. On this particular day, in the early-morning clinic a middle aged woman came in with her 'life partner.' She was diagnosed with invasive breast ca (i forget which type) and instead of going along with the surgeons calm attitude towards it, she erupted. It WAS the scene out of the Cancer Research ad this time, she played her part beautifully. She was hysterical, she thought she was oing to die, what about her kids etc etc etc. The surgeon kept on telling her that she was not going to die, her cancer was very treatable, they would cut it out and she would be FINE. then her 'life partner' started up with "but she doesnt want her breast off!!!" it was all quite shocking - i mean of course she wasnt having a mastectomy, there had been absolutely no mention of it, he was just jumping to conclusions (maybe im too judgemental, but i cant help thinking he was worried he wouldnt have anything left to fondle with-he was like that) it was just mad. Anyway after 20mins or so they calmed down, after the consultant, the nurse and even I had tried to explain, and they left.

TURTON: So, Marc, do you think they understand the situation?
ME: erm... no!
TURTON: hehe, was mad wasn't he! What the hell is a life partner anyway?

anyway when he filled in my end of firm evaluation thingy, he gave me a really excellent report, and he wrote me a message on the back. He said "good firm, with a bit more reading, you will go far in life, good luck with your sutgical career" which put all his 'bullying' into place.

I liked that firm, and kept a copy of the form for when i feel like im useless.

[yeliab_cram]

"Should old acquaintance be forgot, And never brought to mind..."

Ladies and gentlemen: HAPPY NEW YEAR! May I wish you all a happy and healthy 2006.

So we have completed yet another rotation around our sun, and are once again all being expected to go out and gut DFS, comet and currys whilst simultaneously getting new windows and doors for our house (with the upstairs free of course) all without paying until 2007. Which is a bit of a bitch really, because if you are the type of sucker who falls for such adverts, you will not only be bankrupt due to you overspending befrore xmas and in the post-xmas highstreet sales, but the leather sofa you bought last year now needs paying for - oh dear!

At the start of a new year, i think its nice to take 10mins out and think about what has actually happened over the last year. I find the older i get the more the years seem to blur together into one brown-coloured skid mark!

2005 marked by transition from partial to full time teaching on the wards, and hence my entrance to the medical student big boys club (membership is gained once you start prancing around campus in your shirt and tie). I obviously wont go over again my highs and lows of clinical medical life, as they are what i constantly recall and remenisce about when im bored! However i have been privalaged to meet a few great people who shall remain with me as mentors and role models, most probably for the rest of my life. Almost one year ago, in Jan 2005, i lost my grandfather; now i dont mean i took him shopping and he ran away (although this was not unheard of in his later years as he developed Alzhiemers' thus marking the third of my four grandparents to die whilst demented) he died just after i returned to uni, which im sure you can imagine caused no end of headaches. But the older i get, the more i realise just how fragile life is - i think spending so long in hospital teaches you that. You meet far too many good people struck down by disease. It always seems to be the nice ones who suffer post-op complications. i remeber this lovely old bloke who i had enrolled in my vascular confusion study and chatted to just before he went up for his AAA repair. I needed to follow him up two days later and was quite upset to find him still unconcious in ICU, and to be told he had already been back to theatre once and was going back again in an hour. I popped to see him a few more times, but he didnt wake up during my time with the firm. I wonder what happened to him?

Anyway, 2005 also saw some major world events: not least the 7/7 London bombings, which had a few personal links for me. Firstly a number of my friends were working in central london at the time, so i had to do the round of "so, you dead?" calls - which was slightly perturbing as i saw it all unravel on BBC News24. Perhaps more disturbing was the revellation that the bombers had their bomb factory in Leeds. But not just any old bit of Leeds, no, the bomb making factory is a mere 100metres as the crow flies from my student house in Leeds. There is nothing stranger than seeing you local area beseiged by newsreporters, and all the landmarks familiar to you being shown on national TV. It was all a little too close to home.

2005 also saw a particularly enjoaybe time for me inter-railing around europe: We travelled from Denmark, through Germany, Czech Republic, Austria, Hungary and Croatia and saw some wonderful and very special things which again i will remember always. especially on grey Ledoisian/Mancunian days! I also took a 4 day trip to Rome with my housemate and another friend - a last minute deal which turned out to be another memorable holiday. This brings me to another thing which has bloomed in 2005: my interest in photography, which has been growing over the last few years and was really kicked into overdrive during my tim in Europe over the summer. If you are bored and would like to check out some of my pretty pictures, check out my online gallery, any comments are gratefully received via PM

Marc's BetterPhoto.com GALLERY

So on that note i will shut up, and look forward to an even better 2006. The main concern of course is that we are begnning to get worryingly close to the date of expiration of my student card, and hence QUALIFICATION - Jun 2008!

[yeliab_cram]

As i like my films, i thought it would be fun to look back at the films i have seen this year and give you my top and bottom 5 films of 2005. (IMDB proved very helpful for jogging my memory, so i thought i'd provide links for all of them so u can check them out.)

MY TOP5 OF 2005:

1) Crash
2) Sin City
3) Broken Flowers
4) The Constant Gardener
5)* Me, You and Everyone We Know
5)* Wallace & Gromit in The Curse of the Were-Rabbit

Its been a fairly bleak year in terms of 'classic' films, in fact, i think a lot of this top5 arent actually that good. There is a tie for 5th poistion because i simply couldnt leave out Wallace and Gromit, which was an absolute delight! but as a result had to leave out Ray, which probably does deserve a place as well! Me, You and Everyone We Know, is a low-budget independent film which I saw at the Hyde Park picture house, a small art cinema in Leeds; its a beautifully crafted contemporary take on life, and is well worth a look. The Constant Gardener, whilst a good solid film, did not live upto the expectations it set for itself. Although it was a descent watch, it felt like it could have been so much better. however the production and acting were first rate. Broken Flowers is a wonderfully ironic, and very Bill Murray-esque film, again perfect to watch in a small art-house cinema, and one i would definately watch again. however dont expect it to go anywhere in particular - much like lost in transplation.

Onto the top two, and these are definately worthy of going into the DVD collection. Sin City is a wonderful film noir adaptation of a comic book. for once the amalgamation of characters does not spiral together but skillfully whisltle past each other as their stories almost, but dont exactly cross. Its only downfall is that in Sin city, everyone seems to be either a killer or a prostitue - interesting place! The number one spot goes to a film out some time ago, Crash, another film which intertwines the stories of many people in the same town, but it is beutifully done and has a harsh underlying theme of judging those around you without truly knowing them. It is very powerful and a definate must-see.

MY BOTTOM5 OF 2005:

5) Elizabethtown
4) War of the Worlds
3) Revolver
2) The Corpse Bride
1) The Dukes of Hazzard

It causes me great pain to have to put a Cameron Crowe film in the bottom 5, but elizabethtown really was that bad; the last 20 mins were almost its saving grace, but were not enough to cure it of what came before. If only it could have been like his other films - shame. War of the Wrolds was eagerly anticipated, one of the most expensive films ever made, and as a result the plot got completely lost in the effects, Tom Cruise was awful, oh well. It also pains me to put a Guy Ritchie film so low, but Revolver was an unfortunate fall from grace; he should stick with what he's good at and not get carried away with trying to find deep meaning where there is none. It really has been a year of dissapointments!

Some people love Tim Burton and the Corpse Bride, I could not stand it, maybe if i was female and 14 i would like it better? And finally, The Dukes of Hazzard - an embarrasing remake of a 70s classic, and it really was cringing, i have no idea why i allowed myself to be dragged to see it!

the year also had space for some other notable averages; Be Cool was a dissapointing sequal to Get Shorty; and more recently I felt that neither King Kong or Narnia lived up to expectation, although neither were particularly terrible. Batman begins was also suprisingly good, but not quite good enough for my top 5! Similarly, finally the fruition of Douglas Adams' dream to see hitchikers guide get to the big screen was ruined by a) his untimely demise and b) the fact that it doesnt quite do justace to his fantastic series of books despite being a fairly good way to spend a couple of hours.

So i hope you enjoyed my end of year film review, i promise to talk about something more interesting very soon

[yeliab_cram]

I am beginning to reach the outer reaches of my sanity - there is a large dark tattered sign stating "abandon hope all ye who enter here" it is not good. I'll tell you what did it, the straw that broke the donkey's back. It was MS Word; more specifically it was the autocorrect feature. It insists that amygdala is not a word, i assure you it is, but no, it prefers to correct it each and every time to amygdale.

As you can imagine, this became annoying, so i looked up what 'amygdale' means, that is so much more important that my anatomical structure. And you will never guess what it said... I shit you not:

"AMYGDALE: An Amygdule."

Can you now understand why I am losing the will to live????

I think i should start from the beginning; well not quite the beginning because we have already been there and there is no point retreading old ground. You will recall, if you are an avid reader, that my reasons for my Anatomy BSc were twofold 1) to improve my anatomy and 2) to help me along the way to a surgical career. So far it is failing me on both counts! I feel a rant approaching...

I was sold the degree by the tutors under the impression that it would be of great use in my career. they assured me there was a specially selected choice of modules, specifically tailored to the needs of a medical studnet with an interest in anatomy and surgery: Bollox! The School of Biomedical Sciences, of which i am now an inmate, has a stupendous module choice for level 3 students (such as myself) however being a medic, i have specially selected modules to chose from (because im special you see, just like my mother always told me).

On superficial inspection the modules appeared to be vaguely relevant, however only after they were chosen and they began did we all begin to realise that they were far from the detailed anatomy we had expected, they were mainly neuroscience. this struck me as odd, as i specifically didnt chose to do a neuroscience degree because i hate neuroscience, and naively assumed that the 'specially selected' modules about the brain would have their grounding in anatomy: wrong.

So i now find myself truding through pathways and molecules, GABAergic, glutamitergic and dopaminergic neurons projecting in all manner of wonderfully named pathways which do all sorts of wiered and wonderful things. I mean its great, only, i couldnt give a toss! i chose anatomy, you know point at things and ill tell you what they are in Latin!

I can DO anatomy; after 3 years of practice ive got the knack, i just need to refine it a wee bit. I mean its not all bad, i do get to do a whole 10credits of anatomy, which I and all the other medics blitz through, but its not enough to balence out the hard core neuroscience which doesnt really interest me.

But that is not what really gets me, no, what truly grinds my gears is the fact that there is a BMS level 3 module entitled 'Clinical Anatomy Topics' and do you know what you do? you dissect, pick a clinical topic and write a report on it and get marked on both, there is no exam. I dunno, maybe im a bit ****ed up in the head, but to me, that seems intrinsically linked to my degree: full title - Anatomy in Relation to Medicine. But you know what, we are not allowed to do it!!!

The reason we dont get to do it, is instead of doing a lab project for our dissertation we are doing some dissections and producing an e-learning package. However it is now Jan 2006 and we still know absolutely nothing about it, we have not been designated projects or told what we have to produce. Only by asking did i discover we are expected to do an e-learning package, whatever the hell that is, a lit erview and a 7,000 word dissertation... on something or other.

It gets worse: I foresaw this miscalculation on the part of the course directors so decided to organise my own project. My friends over in Vascular Surgery have given me the perfect project - looking at the traditional versus new (retrojugular) approach to the carotid from an anotomical perspective. It is perfect and inherantly publishable. however the course directors wont lift a finger to help me to achieve it, i was even told that it 'wasnt fair' for me to do such a project because not everyone has such an opportunity. I couldnt believe it, just because i made some contacts in the hospital and was prepared to use them i was not allowed, because not all the medics had these contacts!!! ahhhhh!!!!

So I have spent an entire term doing corsework, reading papers, making notes, doing more coursework, making more notes and reading, reading, reading. I have spent all of my holiday sat at a desk revising for my 4 January exams (another oversight on the part of the course directors - most BMS students have 2 exams, we for some unknown reason have 4) i have done at least 8 hours a day, every day, the only time off i have had since October was Christmas Eve, Christmas Day, New Years Eve and New Years Day. And im still a far cry away from where i need to be before the start of my fast approaching exams.

I've got to admit, i really am starting to wonder what the point of this BSc is! at this rate, im going to know very little additional anatomy, have missed an opportunity to get a paper published, done lots of irrelevent neuroscience work and have read lots of papers. I suppose the only additional skill i will have gained is learning how to read a lot of scientific papers very quickly and sort the good from the bad. Other than that I am just gaining lines on my forehead!

In Sum: Anatomy in Relation to Medicine? Hell no - There is no anatomy and it has absolutely F and A to do with medicine

End Rant!

[yeliab_cram]

oh jolly good; its 8 days until my first exam and i have contracted a rather nasty seasonal illness, so shall be quietly dying... why do you always get ill at exam time, when you really do have better things to do!

The last time i was seriously ill, i caught some god awful disease of a bloke in a respiratory ward who choughed all over me, and for the next week I and a good few of the PRHOs and SHOs were bedbound - not together i might add. So at least its not as bad as that - i have never watched so much daytime TV in my life!

Alas, not today. Today I am finally starting to revise some anatomy - hazah, something i know and understand and that doesnt involve having to read countless journal articles. Is it sad that I find the prospect slightly exciting?? Its been a long term!

[yeliab_cram]

my g/f has just started teacher training, and has been slightly perturbed over the last few days due to the noticable increased incidence of flatulence in particular class. She informs me that whenever she is doing maths with them, a couple of the little boys proceed to fart rather unsubtlely, every time, without fail.

this reminded me of a really great 'on the wards nightmare' moment. I was in second year i think, and we were having some bedisde teachg from a consultant on a GI ward. Actually I'm talking absolute rubbish, it was early on in my first firm in third year. Anyway point is, there were 6 of us around a patient with the consultant, curtains shut. He was taking us through her case one point at a time.

I saw out of the corner of my eye, a nurse wheeling a cammode into the ajoining cubicle. I remembered hearing the little old lady in the bed next to us ask for one a moment or two ago. I didnt think much of it. But this was a GI medicine ward, and on GI medicine wards, going to the toilet is neither a simple procedure, nor a pleasant or quiet one.

At first there were just a few unpleasntly wet sounding farts, of course this soon gave way to a barrage of noises that our virgin ears were just not prepared for. I'll be honest, i am normally i pillar of profesionalism and respect on the wards, but at that moment i was biting my lip hard not to piss myself laughing. As i glanced around the bed i noticed all the other med students were doing the same. What can i say, there is a little 8 year old boy trapped inside all of us.

The assault on our ears was continuous, and appeared to be building to a creschendo. however i never noticed it get there, because, of course, not only are curtains poor sound absorbers, but they are even worse at keeping out noxious smells. Just as our ears had been assaulted, our noses were next. It was not just shit, but sweet smelling nasty crappulence. It could have choked a donkey at 100 paces. It was terrible. I wanted to run from the cubicle screaming "no more, i canot stand it" but of course i did not. I regained by composure and attempted to focus on what the consultant was saying rather than what the lady next door was saying via her bowls.

It was at this moment that a) the consultant began questioning us and b) the lady next door finally finished (and started demanding a nurse take her poo away - lovely). Unfortunately none of us had any idea what he wanted to know because we had been putting all our efforts into not cracking up.

More practice in multi-tasking is definately needed. Or perhaps just more experience dealing with shit?

In other news today, i can actually feel my throat closing up, its awful, i tried gargling with neurofen, paracetamol, and a mixture of the two, but nothing will calm it down (although mummy's chicken soup did help). Anyway my hapiness to embark on some anatomical revision was met with sudden boredom by the realisation that in the month since my spotest, i have forgotten all those useful details which i knew. Anyway, as i tried to relearn them i decided to produce 5 feindish head and neck anatomy MCQs on this site. If the admins put them up, i'll shove links on so u can all go and try them out. Let me know what u think

[yeliab_cram]

Im feeling rather sorry for myself: i appear to have tonsillitis, which is not very nice at all. The mucosa over my palatine tonsils looks very angry indeed, and the creamy exudate dripping down the back of my throat is making me feel a tad rough. Anyway, onto the antibiotics we go... this would all be fine if i didnt have exams looming very very large on the horizon.

Anyway, i have just completed my second practice essay of the day, and my arm hurts, so im going to have a little break before doing another one. I though i would share a story with you; not one of mine personally, but a fantastic one, none the less. The reason i am doing this, is because 1) it makes me laugh and 2) well this one is a bit complicated:

It is a story by Douglas Adams, it is something that happened to him in the 70s, he uses it in one of his Hitchiker's Guide books (in 'So Long and Thanks for All the Fish' Arthur Dent tells the story to a woman he's chatting up), which i read a few weeks ago. when i read it i laughed but it felt oddly familiar, but diconcertingly different from how i remembered it. I coldnt help but feel there was a better ending the last time! Anyway last night i couldnt sleep and was fishing around for a book. I found the Salmon of Doubt* and happen to find the full version of the story... which had the desired extra bits. It brings a smile to my face, i hope it has the same effect on you... so here we go.

Its called, COOKIES, but seeing as he and i am British, i am renaming it BISCUITS!

this did actually happen for real, to a real person. I know this because the real person was me. I had gone to catch a train (in April 1976, in Cambridge UK) and was rather early for the train. I'd gotten the train time completely wrong. I went to the nearest shop to get myself a newspaper, to do the crossword and a cup of coffee and a packed of biscuits. I went and sat at the table. Now i want you to picture the scene. It is very important you get this clear in you head. Here's the table in front of me, heres the newspaper, coffee, packet of biscuits. got it? good. There's a guy sitting opposite me, a perfectly ordinary looking guy wearing a business suit, carrying a briefcase. It didnt look like he was going to do anything weird. What he did was this: he suddenly leaned across, picked up the pack of biscuits, tore it open, took one out, and ate it.

Now this, I have to say, is the sort of thing that the British are very bad at dealing with. theres nothing in our background, upbringing or education that teaches you how to deal with someone who, in broad daylight has just stolen your rich tea biscuits. you know what would happen if this had been South Central, LA. there would have very quickly been gunfire, helicopters coming in, CNN, you know... but in the end, I did what any red-blooded englishman would do: I agnored it. And I starred at the paper, took a sip of coffee and tried to do the crossword. But i couldnt focus, i thought: what am i going to do?

In the end i decided there was nothing for it - i was just going to have to go for it and i tried very hard not to notice the fact that the packet of cookies was already mysteriously open. I took out a biscuit and ate it, THAT settle him, i though. But it hadnt because a moment or two later he did it again. He took another biscuit. Having not mentioned it the first time it was somehow even harder to raise the issue second time around. "Excuse me, i couldnt help but notice that you..." I mean it doesnt really work.

We went through the whole packet like this. When i say the whole packet, I mean there were only about 8 biscuits but it felt like a lifetime. He took one, I took one, he took one, I took one. Finally, when we got to the end, he stood up and walked away. well we exchanged meaningful looks, then he walked away, and i breathed a sigh of relief and sat back.

A moment or two later the train was coming in, so i tossed back the rest of my coffee, stood up, picked up the newspaper and underneath the newspaper were my biscuits. the thing i partcularly like about this story is the sensation that somewhere in England there has been wandering around for the last quarter-century a perfectly ordinay guy who's had the same exact story, only he doesnt have the punch line.

- Douglas Adams (2001)

* so this is how the story appears in 'The Salmon of Doubt' Im sure you are wondering what that is so i shall elaborate. I really enjoy the Hitchiker's Guide Series and think douglas Adams is a wonderful writer with a very unique way of explaining scenarios which make you laugh uncontrollably. Anyway I was on holiday in Greece (Zakynthos actually) and after reading the 5 books i brough with whilst sunbathing by the pool for 2 weeks i 'borrowed' a book from the hotel: The Salmon of Doubt, as it was by Adams. (i use the term borrowed loosely, as it is currently sat nect to me, and the holiday was 2 years ago - whoops). It turned out that the book is the first few chapters of the book he was writing when he died, plus a collection of random articles, speeches and bits of interviews retrived from his computer after he died. It is actually a very interesting, very lovely book, which is a lovely tribute to a wonderful bloke!

[yeliab_cram]

So I have a confession to make:

As im sure you have gathered i have been moaning about a bit of a sore throat for a few days now. It has been getting quite quickly worse. Being a medic, i dont trouble my GP lightly, i probably go about once a year when i am in severe need of some prescribed drugs of some sort. Anyway, this morning i awoke is agony, swallowing has become somewhat of a challenge and i could not only feel how tight my throat was, but i could feel pus draining down my throat. When i dragged myself into the bathroom to gargle with some nurofen, i had a peek with a little torch and the aid of a toothbrush, and it is quite clear i have tonsillitis.

I called my GP explaining my symptoms, my pain, my likely diagnosis, and asked for an appointment. The lovely lady on the desk told me that they only had emergency appointments and i didnt count as an emergency. There were no cancellations, i did not get an appointment. I have to go back to leeds on Monday, and the only way i can get seen at the studnet medical practice is to turn up and wait at 8:30 on Tuesday. I know its wrong, but when the system fails you, and you have a prescription for penecillin lying around, its only sensible to self medicate.. isnt it?!

So there you go, i admit, the system failed me, so i went round it, does that make me a terrible person?. I'm sure im only promoting multi-drug resistance, but i did double check the symptoms and empirical treatment in the Oxford Handbook, and i undoubtledly have tonsillitis, and took what my GP would have prescribed anyway (i know my GP!). So i leave it to you, am i sensible, or spawn of the devil?