June 29, 2012
I count as friends those people that I would not hesitate to ring at 2 a.m. if I needed help. Admittedly I did this to my manicurist last year when completely off my face, but that was a mistake. And one of which I have no recollection. But she does. And tells me actually I rang twice. And the iphone call list doesn’t lie. But apart from that, I think that it is a useful yardstick to measure friendship by, and I hope they would feel able to call on me in the same way. After all, friendship is meant to be two-way. So it got me thinking of my
Top Ten Things That Make
a Female Friendship Real
- A friend is never jealous of you, only happy for your good fortune/great dress/new job/new boyfriend..
- A friend will always interpret everything you say or do in a positive way. A friend will always assume the best of you. A friend doesn’t keep a tally of things they have done for you and what you have done (or not) in return
- .There is no awkwardness with friends no matter how long since you were last together or last spoke
- A friend will tell you when you are being stupid/selfish/unreasonable and you won’t hate her for it
- A friend understands that husband/family may have to take priority and doesn’t hold it against you
- A friend sticks up for you when others slag you off
- A friend is able to make you laugh even when the shit has hit the fan
- A friend will tell you when your bum looks big in that if you ask
- A friend won’t slag off your partner even if they think he’s a twat because they know you don’t think so. (They will agree with you if you say he’s a twat, but they won’t say it first.)
- And a friend is still there (usually with a bottle of something) when the complete twat you were so in love with dumps you
June 27, 2012
After I had written the Top Ten Things I Didn’t Know Until I Was a Parent (in the post ‘And suddenly you’re a parent’), I remembered another. Peer pressure by proxy. Worrying that your child is not doing all the right things at the right stage. It was acute with the first, because that’s the one you learn on, whereas with subsequent ones there was a realisation that actually there isn’t a tick box of specific tasks by specific dates – it’s all fairly movable. Plus we were so knackered by the time we had three under four that we didn’t know what any of them were meant to be doing or not.
I caveat this post with the fact that we were lucky in that there was no real worry that there were serious developmental difficulties. What I am talking about here are the stupid anxieties induced by seeing the achievements of other children and believing they reflect badly on yours for not doing the same. I hasten to add my husband was not remotely afflicted by this. Only me.
The first time I felt it was when I went to visit the friend who had had their daughter the day before our son was born. I was poleaxed by the fact that her eight month old was eating by herself using a spoon. Our boy would grab a spoon if you loaded it for him, but by no means was he independently eating. It was as likely to go on the floor or in his ear as in his mouth. If you let him have the spoon he would use it as a drum stick, sending porridge flying round the kitchen as he banged happily in to the bowl. I came home from that visit with the first pangs of parental peer pressure by proxy. Although, it wasn’t really peer pressure as my friend had not been gloating or insinuating our son was slow. It was just how I felt. And a bit jealous.Then everyone else’s babies started crawling. Ours didn’t. Just sat. And lay down. No crawling. No standing. No pulling up on furniture. Made it simpler for me as I knew he’d still be where I left him if I popped to the loo or went out of the room for whatever reason. He would flap his arms up and down and bounce on the spot to the Neighbours’ theme as I had become addicted to it whilst breast feeding him so I think it was a Pavlovian response to the music. But apart from that no attempt to move.
For his first birthday we bought him a wooden push along trolley and he dutifully pulled himself up to standing using it. But then flopped down. But he could at least pull himself to standing with something to help him. By now he would bounce along on his bottom if he wanted to get from A to B. But usually he wasn’t inclined, and would happily sit and play for hours with his toys in exactly the same spot.When he still wasn’t crawling or walking by the time number two arrived it made it easier for me, although there was some relief when he did eventually start moving. He bypassed the crawling stage and went straight to walking at about 17 months. Fairly late, but got there eventually. Of course, as ever with these scenarios it is easy to overlook the positive things he was able to do and simply focus on the negatives. In fact he had great linguistic capabilities and could comprehend completely what we would say to him by about 10 months. And he was brilliant with his sister when she arrived not long after he turned one.
But of course it was at school where the intense comparisons started. With little girls leaving nursery aged 3 and 4, clutching their armfuls of paintings with their names scrawled at the bottom, I would search for any crayon capability. Any drawing. Any painting. Any writing. Any artwork at all. There was none forthcoming.
All he did was run about outside, sometimes wearing a Batman cape, sometimes play Lego or Playmobil. No real interest in reading, although we tried and he loved his Dad’s storytelling. But no interest at all in writing or drawing. I did get a bit worried, but I was confident he was bright enough from the converstaions we would have and that he could do basic mental arithmetic with me when we went shopping.
Then he went in to Reception Year. Just four years old and at school all day. At the end of the year the young teacher told us that she thought he may have learning difficulties. She wasn’t sure. He was in the bottom 25% of the class academically. I was stunned. I couldn’t believe it, but she was insistent. He could only read a few simple words, and not that well, he couldn’t write , she wasn’t sure he understood what was going on. I was taken aback. I could not believe she thought our boy was not the brightest thing known to man.
So I did what any mother would do – I went and told on the teacher to her boss who happened to be his old Nursery teacher and about to retire. I was near to tears. Bizarre really that I should take any notice of a wet behind the ears newly qualified teacher.
The old and wise teacher was 100% reassuring and explained he couldn’t develop everything at once – things just had to take their turn. So he had been busy developing physical and creative skills with the games he played, building and mathematical skills with his Lego , linguistic skills with his conversation etc etc. But he wasn’t yet ready to develop the literacy. Reading and writing would come to him when he was ready. She was absolutely sure he was bright as a button. I had been too in my heart, but needed the external expert validation somehow.And sure enough his reading suddenly took off in Year Two and he has never looked back. A faster and more avid reader I have never met.
And I would love to meet that stupid Reception teacher (she left the following year) to tell her how utterly wrong she was for writing him off. And to push his English Masters degree in in her face and say “Bottom 25% academically? I don’t fucking think so.”
June 24, 2012
My medical training was traditional. None of this modern PBL (problem based learning) for us. No integration of pre-clinical and clinical. . Rote learning for two years then on to the wards to try to make sense of it all. It was a shock to the system to go from standard student life (albeit highly timetabled compared to todays lazy arse Arts students) to the clinical years where we had only four weeks holiday a year. We still got Wednesday afternoons off for sport, but basically we were on the wards before patients’ breakfast to take bloods and would be there till routine ward business finished around 5 or 6 ish. It was one of the student duties to do all the blood taking.
So before we were let loose on the patients we had a session being taught how to take blood. As with all medical training it was a case of ” see one, do one, teach one.”. We all watched the doctor quickly and easily extract about 10ml of blood from one of my fellow students. It was over in a flash. We all then had to do it to each other. It was hardly brain surgery, but surprising how much of a performance it became. Working in pairs we are all looking over our shoulders seeing what others are doing. Are we doing it in the right order? Is that a vein? How do I know it’s not an artery? How do I open the needle to attach it to the syringe? How tight do I make the tourniquet? (Tight enough to stop the flow of venous blood, but not so tight it stops arterial – that way the veins below the tourniquet will get full of blood as the tourniquet stops it going any further – a bit like a dam) . Questions questions. We are asking each other and ourselves, not the doctor of course. That would be cheating. And it’s only each other we are stabbing repeatedly, unable to find the enormous veins that inhabit the antecubital fossa (elbow). Of course we eventually all do take a sample successfully and the next day are let loose on patients.
This of course is an entirely different kettle of fish. We turn up on the wards and the Houseman (most junior doctor, just qualified) gives us a huge wad of forms. “You need to get these done” he says.”And there’s another load in the nurses station .” We divvy them up between us and set off to find the equipment we need from the treatment room. Each different blood test requires a specific bottle for the blood to go in. It is critical to get the right bottles for the right tests. Some bottles have special anti-clotting agents in, others have chelating agents and all are different colours to ensure easy identification, and different sizes as they require differing amounts of blood. Each bottle has to be labelled with the patient’s name, number date of birth, ward etc. If you are lucky there will be stickers with this info on in the notes. Otherwise it means writing them all by hand.
Approaching the first patient I was incredibly nervous. I had my bottles, syringe, needle, swab and cotton wool ball in a small tray and my tourniquet in my pocket. I had worked out how many ml of blood I was going to need to do all the tests and was praying it was going to be OK. The patient was a lovely old man who was wearing pastel striped pyjamas. I remember his thin wrists were poking out.
I pulled up his sleeve and put the tourniquet on. He had blood vessels like ropes along his arms. My heart was hammering as I tore open the alcohol swab and cleaned the skin. I opened the needle and attached it to the 20ml syringe. I felt his arm and found the brachial artery easily. I needed to avoid that. Next to it I could feel the fullness of a decent sized vein. With shaking hands I held his arm flat with my left hand and inserted the needle at about a 30′ angle to the skin. His skin was paper thin and there was no resistance. I pulled back the plunger on the syringe and hey presto blood appeared in the barrel. Phew!
I then had to continue to pull the plunger back and keep the needle in the vein. It’s not as easy as it sounds or looks. Especially if your hands are shaking. I had got about 5 ml of blood in when I inadvertently pulled the needle out of the vein. Blood oozed out of the hole. I couldn’t simply stick my needle back in because I couldn’t see where to put it. The blood was coming out at a fair lick. I didn’t know what to do so tried using the cotton wool ball to press on it. It soaked through the ball in no time. I asked the patient to press the sodden ball to try to stem the bleeding whilst I went to get some swabs or anything that would soak up the blood.
I came back and the blood was streaming down his arm. He was unperterbed and so nice to me. I got a handful of swabs and pressed as hard as I could. I got him to bend his arm up in an effort to stem the flow. After a couple of minutes I unbent his arm only for the blood to start pouring again. “I’m so sorry” I kept saying, having no real idea what to do next. I thought perhaps he had a clotting disorder and I should have read up about him in the notes before I started.
Just then one of my fellow students walked past and I beckoned her over with a scared rabbit expression. “He won’t stop bleeding” I hissed. She came closer. “Perhaps you should take the touniquet off ?”.
Poor man. I took it off and of course the blood was able to flow back to the heart instead of building up an increasing head of pressure with its only release being to pour out of him, and so the bleeding stopped within a minute or so. And like so many patients he was so utterly charming and forgiving he let me attack his other arm as I hadn’t even managed to get the blood we needed for his tests.
June 21, 2012
I have mentioned before that during the summer of 79 I worked in a pub in central London in the evenings. It was a busy pub, full mostly of men after work. One day the manager asked if I could help him out on a Tuesday lunchtime and run the bar upstairs. I worked in a photocopying shop during the day, but was able to wangle a two hour lunch break as I had been promoted to manager so was organising my own time. I hadn’t even realised there was a bar upstairs, as I don’t think it was used in the evenings. Anyway, I agreed. Didn’t really think anything of it.
I turned up and went upstairs to the bar. The room had a small stage at one end and rows of chairs for an audience of perhaps one hundred. The bar was at the side and relatively small. There were a few people already in the front row when I arrived at 12, but apart form that it was empty. Gradually over the next half hour or so it started filling up and I served the men their pints. Nobody was drinking anything else. Then I saw a couple of women go in to the ladies which was just at the end of the bar. They looked like working women if you get my drift. The lights dimmed and the bar area cleared as the men took their seats. There were no more than thirty punters in altogether. I suddenly realised this was going to be a strip show.
The women came out of the toilets barely dressed and carrying a huge boom box. I remember thinking they were doing themselves out of a few minutes titillation by already being half naked. They pluggesd in the boom box, inserted a cassette (those were the days) and the music began. One stood at the back of the stage near the boom box whilst the other started gyrating to the music. I suppose it was early pole dancing without the pole. Within moments I realised the audience were showing their enjoyment in a particularly male way. I saw that everyone was seated separately, and busy pleasuring themselves whilst they watched the woman tease them.
“Pint of bitter and a Teachers please love”. Two old lags were at the bar. Seen it all before, not bothered. Or perhaps they were the womens’ minders. I found it hard to tear my eyes away from the action I admit.
The music stopped and there was a break for the men to refill their glasses. I was very reluctant to handle their money knowing what they had been doing, Sticky fingers agogo but my bar tending instincts took over.
The music restarted and they took their seats. I washed my hands. It didn’t occur to me what was about to happen until it was too late. The woman who had been operating the music called an audience member (excuse the pun) up to to the stage and before my very eyes they were having sex on the stage. Full on, no holds barred, no protection. I just couldn’t believe it. She was standing up, bent over and he was ramming her from behind. The audience were frantic in their involvement.
The other woman walked down in to the audience and helped a number of men get the most out of the act. She used every tool avaialbale to her, but spent probably no more than 15 – 30 seconds with each. There was no need.
After coming to its natural conclusion the men sloped off, the women got dressed in the loo and I cleared up the bar. I walked downstairs still dazed and fazed by what I’d just witnessed. Only to hear Michael Jackson imploring “Don’t stop till you get enough”. If ever there were an appropriate soundtrack to my day it was that.
June 18, 2012
I found the whole experience of being a healthcare professional very humbling. I did a traditional course where you have two years pre-clinical just having lectures, tutorials, doing experiments and anatomical dissection. But not seeing patients. All theoretical. Then the final three years are on the wards (apart from the pathology rotations where you attend post mortems and look down microscopes). Those first days on the wards were scary. We were put in to ‘firms’ – a group of about eight students who would be together for the next three years, going from unit to unit, specialty to specialty together. We were given brand new starched white coats, had our Littman stethoscopes, a green rubber tourniquet, a pen torch, an ophthalmascope, an auroscope, a tendon hammer, a copy of the British National Formulary (a drug index), a pen, a notepad and I had Lecture Notes in Clinical Medicine which fitted in the capacious pockets. Other people had different texts. I chose the Noddy’s guide type of book.
As an introduction to the clinical side of medicine we were given a few sessions on how to take a history and do an examination. There is a standardised way of taking a history that we were taught; what we had to ask and in what order, what we had to write down, what we had to try to find out. There were new symbols to write, new acronyms to learn. There seemd to be shedloads of critical information one had to elucidate from the patient. How would I remember what I needed to do? How would I know what to ask? It all seemed rather daunting.
The first time I was assigned a patient to take their history from I couldn’t belive I could ask them these very personal questions and they would tell me. Me. Just 20 years old and knowing nothing. Asking adults with a lifetime of experience about their bowel movements. Or whatever. What I didn’t realise is that most people are happy to talk – hospital is very boring if you are conscious – and most people like to help the trainee doctors learn. People feel they are being useful. And they are. It took me probably about an hour or so to get the history from a patient the first couple of times. Waaaay too long for real life medical practice. But practice is the operative word and I got better and speedier as I learnt the template and learnt which follow up questions I needed to ask and which I could leave out.
Even more staggering for me was that patients allowed me to examine them. It took me three days to pluck up the courage to ask someone to let me examine their chest as I felt I had no right. It was an invasion of their privacy. Until I realised there was no other way for me to learn.
We would also be taken to see specific patients to practice various techniques of history taking and examining on them. Training to be a doctor then was a process of public humiliation by the tutor. It was mortifying at times. But that’s the way it was. We would stand around the bed and the Consultant or registrar would fire questions at us. The patient often unacknowledged in all this, simply the object being used to terrorise us with our lack of knowledge and technique. I would stand praying that I wouldn’t be asked a question.
One time is etched in my memory. We were taken to a side room to see a young woman. Probably the same age as me. She was sitting up in bed putting her eyeliner on. The consultant asked me to listen to the back of her chest. When one was asked to listen, one had to go through the entire process of examination and auscultation, not simply use the stethoscope. So I started with palpation – where one feels the chest to see if there is any tender areas, then tried to assess the expansion of the chest – seeing whether there is any restriction of movement. Then I moved to percussion – that’s the finger tapping when you are listening for the different sounds made depending whether it is going through air or not. There are three sounds – normal, dull (when there is fluid) or hyper-resonant (when there’s virtually no tissue, just air). So I fumbled through those. Then at last I was ready to listen. The end of the stethoscope (the bit you place on the patient) usually has the option of listening through a diaphragm (the flat one) or a bell ( the cupped one) depending which frequency of sounds one is listening for. I checked mine was turned to diaphragm. It was. Nervously I placed the stethoscope on her back and asked her to breathe in and out through her mouth. I went from side to side up and down the chest. To be honest, I couldn’t really hear anything at all.
I was about to start asking her to “Say 99” and continue to listen in an effort to hear increased vocal fremitus or whispering pectoriloquy (great terms and in those days useful signs – now probably superceded by routine scans and the like), when the consultant stopped me. “Well Miss Morgan, what did you hear?” “I didn’t hear any abnormal breath sounds.” I mumbled “No,” said the Consultant “I don’t expect you did.”
She was looking pretty pissed off. ” It would help if you put your stethoscope in your ears .” She wasn’t smiling. She didn’t find it funny. Not even remotely. I was beetroot with embarrassment. Sure enough, my stethoscope was simply dangling from my neck. It hadn’t been anywhere near my ears as I had painstakingly examined the patient.
The other students on my firm were relieved that they had not been the first ones to have been so completely and utterly humiliated. They were looking superior as if they would never do something as basically stupid as that. And they were finding it hard not to smirk.
But I was able to look back and realise that wasn’t the worst mistake to have made.
After all, during a cardiac arrest it wasn’t me that put the defibrillator paddles so low down on the patient that they didn’t shock the heart, they shocked the full bladder instead. And it dutifully contracted and emptied its entire contents over the Consultant who had been recalled from a posh function and had just appeared through the bedside curtain in his dinner suit.
June 15, 2012
Labour itself came as a bit of a surprise. Well, to be frank so did the conception. After an operation for a twisted ovary I’d been told it was unlikely I’d conceive without assistance (medical assistance I mean – obviously I wasn’t expecting an immaculate conception) so we threw caution to the wind and bingo I was pregnant the next month. And technically married to someone else, but that’s another story. I will never forget sitting in the bathroom seeing that little blue line appear. Holy fuck. Wasn’t expecting that.
I’d always said I would give up smoking if I were pregnant. I loved it so much I could never give it up just for me, but realised I couldn’t inflict it on an unborn baby. But driving to work that morning I had half a cigarette. I felt so guilty smoking once I knew I was pregnant I didn’t tell anyone until years later. Ridiculous really as up to that point I’d been smoking 20 a day -including the 6 weeks when I hadn’t realised I was up the duff.
Pregnancy wasn’t my favourite time; an old heart problem woke up and I had fortnightly visits to the hospital. One of my best friends was due two days after me and she rang to say she’d had her baby early. I was livid. Jealous. Pissed off. And assumed that meant for sure I was going to be two weeks late. But that evening, sitting on the settee doing the Sunday Times crossword there was an almightly pop as my waters broke. He wasn’t due for another two days and I hadn’t even packed a bag. We had no baby clothes or anything. My husband couldn’t drive and the hospital was down in South London as we’d only moved to Ealing two weeks earlier. An ambulance would only have taken us to the closest unit and I certainly didn’t want that. So despite having been drinking brandy and not having passed a test, the father-to-be got in to the driving seat of my company XR3i to take me to St George’s. It wasn’t the most relaxing of journeys but we got there.
15 hours and about 300 contractions later I would have rammed the ‘beautiful object to focus on’ down the birthing guru Shelia Kitzinger’s throat if she’d been there. I was offered an epidural and would have happily plunged the needle in to my own back if I could. I’d done it enough times for other people in the past. The anaesthetist did his stuff and the bliss was indescribable. Contractions without the pain. 22 hours in to hard labour the baby went in to distress so all systems go to get him out pronto. The room filled with doctors; some for the birth, some for the baby, some for my heart. One high forceps delivery later a very blue baby arrived with the cord round his neck. No rush of maternal instinct from me – I just wanted the paediatricians to rescucitate him. Meanwhile I opened the sutures for the obtetrician sewing me up. They offered to take him to the nursery overnight (those were the days!) and I willingly said yes. I just wanted to sleep. Well, the first thing I wanted was a diet coke and some toast. Which I then threw up. The husband was despatched to get ‘some of those gro-bag things’ for the baby to wear and had to make his way home on public transport as he had no qualified driver to sit with him in the car.
Parenting did not come naturally to me. Or at least not the parenting of small babies. It was just terrifying. Well, the first one at least. I had no idea. At all. I didn’t enjoy those first weeks and months. Too much responsibility. No let up. No chance to send it back from whence it came. How on earth do single parents do it? Luckily my husband was easy with babies and he saw us through those broken nights and screaming days.When baby cried and I had fed, changed and tried to put him down to no avail, I too would be in tears. I don’t know how my husband coped. I didnt. I couldn’t get up and dressed and out of the house before 2pm. Every time I tried to do anything the baby would want feeding. Or changing. If husband was 5 minutes late getting home I had panic attacks that he was under a tube somewhere and I would be left with this baby to look after alone. The very thought filled me with fear and dread.
So I give you my
Top Ten Things I Didn’t Know Until I Was A Parent
- Despite incredibly busy hospital dotcoring jobs working over 100 hour weeks, I didn’t know what tired was until I’d had continuous months of broken nights
- I didn’t know what responsibility was until I had to care for someone helpless 24/7
- I didn’t know the sheer force and volume that breast fed baby shit can be generated at until I was cleaning up the back of his head after a particularly explosive episode.
- I didn’t realise how little I knew about parenting and how easy it had been to criticise others until I had to do it for myself.
- I didn’t know how to appreciate a night out properly until I couldn’t have them
- I didnt appreciate what I put my parents through until someone did the same to me
- I didn’t realise toddlers really would pick up dog shit and try to eat it
- I didn’t realise I would be able to walk out of the house and leave the front door wide open as I would get so distracted by the children.
- I didn’t know how badly run a meeting could be until I joined the PTA
- I hadn’t anticpated spending an entire boiling hot summer’s day at Disneyland dressed only in a zipped up cagoule and a pair of underpants as I’d had to remove all other clothing and dig a cagoule out of the boot because a child vomited all over me as we pulled up in the car.