One of the inevitable admissions during any given call will be a suicide; most people have a good reason for it (or at least they think they do) but they end up fucking it up in one way or another and manage to make it to hospital.

The problem is that because they very rarely get it right they end up waking people (namely me) up at four in the morning after spending the whole day dealing with road traffic accidents, 16 year olds with headaches and 35 year olds wanting 3 day weekends

The main mistakes people make when attempting suicide are related to a lack of understanding of the medical concepts underlying their chosen method.

For example I don’t think that people know that when they slash their wrists the should be aiming for arteries that are pretty darn deep (they are in fact closer to the bone than the skin) and they usually end up cutting into a vien and tearing through a couple of nerves causing paralysis and numbness across their hands which is probably going to be there for the rest of their lives and won’t have any effect on their life expectancy in the short term.

Another thing is that people don’t seem to know that panadol will kill you in a very slow and painful manner. If you take a panadol/paracetamol overdose you WILL get acute liver failure which is largely permanent. This results in a slow often painful death (which is not exactly what the person committing suicide was intending) as your body gets more and more jaundiced and the signs of liver failure begin to manifest.

People even manage to get hanging wrong; there are two ways people can die from a hanging (self inflicted or otherwise):

• either by smacking the first two vertebrae in your neck against each other resulting in a hangmans fracture (which is when part of your second vertebra breaks off and embeds in your spine causing paraplegia and instant death)

• or (as in most cases) they end up inducing a far slower and more painful death through asphyxia (cutting off the blood supply to the brain) which may take 40 minutes to an hour. (yes, I know everybody says the brain only survives for 3-5 minutes without oxygen but what they mean is that permanent brain damage starts after 3-5 minutes).

So the next time somebody thinks of committing suicide please bear in mind the following:

• You probably won’t get it right and will have to live with the permanent damage you have inflicted on your self.
• The doctor who is coming so treat you will have a splitting headache, be tired, bitter and will have very little sympathy.
• It will take 24 hours to get a psychiatrist to see you (this is the Ministry of Health afterall)
• Suicide is never the answer. Please consult a psychiatrist (preferably a good one) as soon as you can. Believe it does help and tends to put things into perspective and will hopefully stop you from making a mistake that everyone will regret.

P.S. kudos to the l33t h4×0r who tried to get my password hash last week

A couple of months ago a 37 year old Sri-lankan woman came in complaining of pain in the right lower quadrant of her abdomen. She described it as an aching type of pain that had been there since earlier that morning (about 4 hours ago).

She hadn’t had any surgeries before, any changes in her bowel habit or urinary symptoms but her period has been late this month. An ultrasound and pregnancy test were requested and she was asked to remain in casualty until they were done.

Two hours into her stay in casualty the pain got alot worse, she said it was like somebody was punching her from the inside. The ultrasound hadn’t been done (damn radiologists!) but the pregnancy test was positive. Her abdominal examination revealed a tender board like abdomen. She was also hypotensive (meaning she had low blood pressure) and her heart rate was through the roof; all these signs pointed to an internal bleed, more than likely in the abdomen. She was taken to theatre and had to endergo emergency abdominal surgery. This is what we found:

She had an ectopic preganancy, this is when an embryo (developing human) starts growing and is implanted outside the womb. In most cases the mother ends up presenting to casualty the exact sameway this patient did but because the condition is relatively rare people/doctors tend to think of other causes (appendicitis, gastroenteritis, urinary tract infection, etc) before they think of it.

The wierdest part is that the thing looked so damn human !

Oh and incase you were wondering the patient made a full recovery and is doing well, despite the best efforts of the radiologist on call that day…..

I went to see the Ironman movie the other day (which was awesome BTW) and it got me thinking about how/if superpowers could be explained medically. Both Batman and Iron man were easy; they (literally) paid their dues, but some of the others are just as feasible (well in theory at least)

Lets start off the the hulk; I’m going to avoid the whole transformation part which I’m just not smart/educated enough to find an explanation for and will concentrate on the super human strength and why he turns green when angry:

• The superhuman strength is easy, he just has an over-active hormonal axis which leads to high levels of adrenaline, testosterone and growth hormone which gives him an increase in muscle mass (at the expense of his fertility which explains why there is no Hulk junior.)

• The green skin color comes from the effects of gamma rays on his skin cells which produce biochromes rather than melanin and have become chromatophores (cells which can change color) allowing him to change his color where he feels angry/threatened, similar to various aquatic animals.

Next up we have the man without fear; Daredevil. His ability to see sound is similar to that of a dolphin:

• Dolphins can tell how far an object is by the amount of time it takes for sound waves to reflect back off it.
• They can detect it’s speed by alterations in the pitch of the emitted sound wave (via the Doppler effect)
• And the nature/consistency of an object by how it distorts a given sound wave.

More Details

The areas of the brain used by dolphins to interpret sound waves are infact found in the human brain; but are largely under developed (probably due to lack of use); In Matthew Murdocks case (largely thanks to a hefty dose of radioactive boo ha ha as child) they’ve been made active and not only give him the ability to see sound but also to detect lies by hearing a persons heart beat.

Lastly, there’s spidermans wall climbing antics and they’re the easiest to explain. Spiders stick to walls using globs of silk secreted by special glands, there’s no reason why the radioactive spider can’t modify a persons DNA at just the right point and allow his sweat glands to do the exact same thing. Hey, if it can happen to a goat there’s no reason why it can’t be done on humans, any volunteers?

Learn the lingo kids:

404 error: missing file/document/CAT scan etc

Goomer/ C&Ts/Cabbages and turnips: Comatosed patients

Rear Admiral: Procotolgist, ass doctor,

ALP (ACUTE LEAD POISONING) Gun Shot Wound

Ass Grapes: Hemorriods, the kind that tend to hang out.

C in C (Crack in Crack): Anal Fissure (more on that later)

Bordeux: Blood stained Urine

AGMI: Ain’t Gonna Make it

AHF: Acute Hissy Fit

HYS: Hystrical

APTFRAN: Apply pillow to face, repeat as needed.

ATS: Acute thespian syndrome (faking it)

B-52: 5mg Haldol + 2mg Ativan (yisda7 feel)

Baby Catcher/ Stork Whisperer: Obs and Gynea Specialist (baby/mommy doctor)

BBCs: Bumps, Bruises and Cuts.(i.e. nothing serious)

Pecker Checker: Urologists- usually specialising in STDs or STIs

Jock/QB/Blade: Surgeon

Gas man, Gas Jocky, Gaswallah: Aneasthetist

Cath Jocky: Cardiologist

BMW: Bitch Moan and Whine

Brothel Sprouts: Genital Warts

Calling Doctor Blue = I don’t know what the fuck is wrong with him

Celestial Discharge: Dead

CHAOS: Chronic Hurts All over Syndrome

Chocolate Hostage: Constipation

Cockoo= CCU= Cardiac Care Unit

Dilligaf (”dillygaf”): Do I look Like I Give a Fuck.

DPS: Droppy Penis Syndrome.

ELFs: Evil Little Fuckers= Annoying Kids

FABIANS: Felt Awful But I’m Alright Now Syndrome.

The Sad fact is that I’ve yet to use any of these terms in Kuwait …. it’ll only add to the chaos and turmoil.

“

1. NHS Blog Doctor

John Crippins commentry on the faltering goliath that is the NHS. A most read for any doctors in the UK

2. The Psychiatrist Blog
Dr Michelle Tempest; she provides interesting food for thought despite her Tory touting.

3) Dr Grumble

Very well written articles, updated frequently.

4) A Fortunate Man

Chronicles of a GP in England…… I didn’t like it but the site I stole this list from did.

5) Hospital Phoenix
Was very good at giving an anonymous but personal account during the MMC disaster. now dead. (the blog not the doctor).

6) Dr Rant
This is written by a team of people and is like House, MD only even better.
7) Fat Doctor
This is an American [=big,fat, married] blogging physician.

The Ferret Fancier
“Done some really good undercover reporting”

It’s the same article over and over and over again !!

9) The Junior Doctor
Gives a personal account of life as a junior doctor

10) Of Short White Coats and Stethoscopes
Gives a personal account of life as a medical student.

“

Source

Huzzah ! I now have 3 posts and 200 hits ! Life is good !

Those were my exact words nearly a year ago when I first got to Kuwait.

I now work in a hospital and have very little to look forward to these days and so it begins ….*

[puke] my very own blog [/puke]

Most posts will be based around the desolate wasteland that is the Kuwaiti health care system; others will include various aspects of my complete dissatisfaction with my current working environment. Oh and DON’T EVEN THINK OF ASKING ME ANY HEALTH CARE RELATED CRAP; EVERYONE WHO KNOWS ME KNOWS I’M NOT THE GUY YOU ASK ABOUT WHY YOU GET ACNE, ARE FAT OR YOUR [insert bed bound 90 year old relative here] CAN’T BE CURED OF DIABETES, HYPERTENSION, A STROKE, OR SMOKING.

(and yes; I lifted that picture from here )

*I know there are 2 ands in the that sentence.Live with it;
grammar just doesn't work on teh interweb.