Where have I been?

So I decided that blogging in the run up to finals was a massive mistake, and I stopped. Needless to say sugar intake increased 100-fold..but guess what I lost a stone and a half.

That was because I trundled off to the cold climes of Cusco and then came back to London via the sweat fest that was Colombia. WOOOO!

Whats new? Directionless boyfriend is now ex. Deeply saddened by this development as despite the lack of his direction the only thing I was sure about was him (you don't admit your weaknesses' when complaining about others now do you? anyway from the outside it looks like it doesn't matter..I'm a Doctor nah nah nah - in my mother's eyes this equates to having made it therefore what other direction do I need).

This temporarily besides increasing the sugar consumption caused me to have a sense of humour failure, general breakdown and act like a crazy bitch. Rita is bitter. Oh well, all is good in the proverbial hood now but I have seriously pondered how do people normally do it?

This was my first, nay my only long relationship and it is completely inhumane, I realised to expect people to break up and stop contacting a person they have been in daily/hourly contact with for often in cases, years. Of course the case is different when it is a mutual decision, or when two people just realise they grow apart but there was no real reason for us breaking up or nothing that could be sorted out so how do you stop thinking about calling that person whenever something funny/sad/downright weird happens? Its a test of nerves...

Also a test of nerves is the fact that I was on the wards today and in the middle of reviewing a sweet old lady who was a few days post-op for a bypass. She was fine and suddenly next door the Nurse shouted for the registrar "quick!" and within two seconds he'd flown thruogh the curtain and attempted resusciation. all the action around me was so quick and I was left blowing in the winds of the people rushing about next to me. Why was I blowing? Why the f**k wasn't I helpimg?? Given that I'm starting my job in under a month it really freaked me out that I was unable to collect my thoguhts and start acting in a positive way in that situation. I hear from the hospital vine that this stuff comes with practice and the first month is a very steep learning curve. I also keep thinking about all those retards who barely turned up but managed to get through 5 eyars of medical school, surely I'll fare better than them? Only time will tell but all I can tell you is my pants are full of shit.

Our medical elective in Peru was quite unremarkable. They had a strange stipulation only divulged when we arrived after a week, that we had to be there for a minimum of 30 days before we coudl do any hands on work. This made for a pretty boring practical elective but let me tell you how fun it is trying to take patient histories in Spanish when you have spoken about 3 words only. ever. The good thing about htis is that you learn pretty fuckign quickly and lluckily most medical terminiology has its roots in Latin plus the usual grammatical rules of accenting and adding an o on the end of english words emant it wasn't as hard as I thought it woud be (delicate -> delicaaado and so on). One thing that was organsied well was that we had a few days of introductory medical spanish. Thankfully our teacher changed after one day and I say thankfully as we later realised the first taecher had been teaching us the most inappropriate way to call over a waiter, the way reserved for those who deem themselves a part of the higher echelons and thier waiters their minions.

Aside from the unremarkability of the practical side, obviously there were a lot of little differences which when I consider, sorry, REFLECT upon are actually pretty major. in terms of hygiene, there is a questionable approach. Hands are barely washed and when they are they are wiped on the sheets of whichever patient's bed is nearest to the sink. If that's not available they'll wipe it on whatev's. Thats often the white coat of a junior doc. Hmmm.

I take issue with the fact that this hospital is one that is maintained by a contribution from the average peruvian's pay packet and should have a better basic standard of hygiene. It is not that they don't have gloves and can't afford them, they're just whimsical about their use and its totally variable. Some complain about the nurses chasing us around with their pump spray but I would much rather this than what I saw when the resources are available and there is a slapdash attitude to hygiene.

Forget any concept of privacy as well for there are no curtains separating the beds on the all female or male wards. Covers are whipped off for all to see and I will remain scarred by the 55 year old lady who showed her prolapsed vagina to the entire surgical team in full view of the The entire entire ward and the eager intern who was (after donning gloves thank god) poking and prodding it. although the patients didn't seem to mind the transparency, I wonder if they did but they don't say and if this is in part to do with the way that as in India, Doctors are revered, I quote from an orthopaedic surgeon bearing more than a passing resemblance to the Fonz "Somos dioses" (we are gods). I half expected him to clap his hands and produce an ECG from his backside.

Anyway more to come later, I'm off to have coffee and tell my friend my Colombian tales.
Ciao!

Day 4 in the house of chocolate. Been too busy to blog, catching up on working, busy trying to hold fat people's heads and oxygenate them. I am ashamed to admit, as I am only used to mannequins until now, I never realised how difficult it is to stabilise someone's head in place with one hand, whilst holding an oxygen mask and trying to bag them at the same time.

So first things first, since I last blogged, a bag of maltesers, a minty aero, can of full fat coke and sticky toffee pudding with brandy cream (I'll justify this later). So all in all not a bad 3 days for me when we consider my normal sugar intake, but it didn't stop me tasting my morning mid-stream urine to see if it tasted sugary, hence if I had developed diabetes yet.

This is getting ridiculous, and slightly disgusting so I am joining a gym later on today. The time spent going to the gym/showering/gymming will leave me with less time to contemplate which Hummingbird cake I'm going to go for next.

However what also needs to stop is my love of fine food. This may not be too difficult though after an outing to Gordon Ramsay's gastropub "The Narrow" http://www.gordonramsay.com/thenarrow/ last night. Very disappointed. With the food. Had an offer on the lovely toptable, 3 courses for £22. The venue was nice, on the Limehouse end of the Thames, view was lovely, if a little too quiet for my liking as it always is downstream from the Southbank end. We (the boy, a girlfriend and myself) got there for 7.45 on a Thursday evening and it was empty-ish and got a lovely reception from the door staff as we were taken to our seats.

The waiter although nice, was not fully understanding our requests and couldn't recommend a decent beer for the boy, lumping for a Peroni recommendation when there was actually quite a large beer selection (though I didn't get to see what was actually on tap at the bar). I made a trip to the toilet, having consumed a litre bottle of water to try and scare a constipated stool out of my body before leaving (sorry too much detail but my bowels are the bane of my life, so just deal with it, its my blog I'll cry if I want to).

The toilets were clean, though I have to confess a pet hate for restaurants/bars whatever that don't have paper towels to dry your hands as this was - I hate using hand driers, especially unhygenic ones that aren't automatically activated - defeating the purpose of washing your hands.

So after taking a wizz returned to find gladly the crowd had picked up slightly which added to the ambience. So we settled down to choose from our set menus because of the offer, of 4 starters/4 mains. The boy and girlfriend plumped for rabbit terrine with quince jelly, whilst I opted for garlic mushrooms on toast. All in all for me a pleasing bite, the mushrooms were the bouncy and the right side of juicy but the terrine was in my opinion quite flavourless and looked sad, the quince jelly was definitely needed in addition. other offers for starters were pumpkin soup and salmon fishcakes.

To mains we go, where I had Hake, mussels and clams in Suffolk cider with chive mash and the other two had game pie and mash which didn't all come at the same time, boy was waiting for a while before his came. I'm seeing some kind of conspiracy here, but glad to say it worked it in my favour as my dish once again trumped theirs. They liked the consistency of the pastry, flaky without being too oily but weren't sold on the flavour. I on the other hand decided to demonstrate my delight for my fishy brothy which arrived in the cutest little crock pot by doing what my friend does and sing to my food. It began as tastefully tangy, but about four spoons in the cidery-vinegar-lemon taste became a bit too much and there was nothing to take of the edge, even with a huge dollop of what felt like instant mash with a few dried herbs thrown in for good measure. I personally like mash with skin on but I guess I can't expect that at restaurants.

We had a delightful time contemplating whether we could be as demanding as the customers that had been on a recent show of F word where they had local restaurants competing about food, but decided we didn't have the cojones to do this. However our collective cojones were forced to grow when after our desserts (me and the boy sticky toffee pud, nice with a bitter bite and friend having Treacle tart with blood orange syrup and vanilla ice cream - she was disappointed, the tart was too dry and the syrup ice cream mixture was not sufficient to hydrate the dessert) we waited 25 mins for a green tea and americano. We had to ask two separate waiters twice for the items but to their credit, the manager didn't charge us for these and also took off the service charge and apologised, explaining that they were short staffed and didn't expect so much custom.

It was Thursday night and we were left a little disappointed. The portions were a good size and the service though at times slow was made up for by the lovely manager. Flavoursome it was not but cos its Gordon, I want to give it another try perhaps not with the top table offer and see if there's any difference.

Will post again, perhaps something medical related, until then adios...

the imminent threat of type 2 diabetes, London GP receptionists.

In a vain bid to lose weight and avoid almost unavoidable risk of contracting diabetes I begin this blog in hope that exposing my self to the harsh virtual world I can get some perspective on my addictive personality and beat the choc attack. Of course I possess a myriad of other problems which I won't divulge now that may well affect my clarity and lack of judgement when it comes to sugar. But I thought rather than make this a boring health/weight based blog I'll just blog about what I do best, being bitter. Rita is bitter. About everything.  Almost.

So already this morning before 12.00 I consumed a belgian chocolate cornflake square and a slice of Sainsbury's hot fudge cake. I justified the cornflake square by replying "yes" when the starbucks barista asked if that caramel macchiato was to be skinny. Skinny my arse. Anyhow it gave me a glimmer of hope that I could consume my drug of choice without guilt.

But of course, life as Rita doesn't allow justification for chocolate through a simple interaction with skilled baristas deskilled in the art of personability. No, Rita had already this morning had an altercation. London is full of shitty shitty people. I was feeling particularly uneasy and ill this morning and decided to go to the Doctors having not visited them or even registered as I hadn't needed to and besides about to qualify as one myself I feel licensed to deal with my own problems. So after NOT abusing the service and NOT taking advantage of it even though I have in the space of 3 months had serious back pain, sprained my ankle, required physio etc etc I decided to perform the "simple" task of calling the GP to find out how to register.

I received in reply a bark that said "Grufffff wooof come anytime between 9.30-12.30, register, maybe we make appointment same day grrrufff wooof.click brr".

I trundle along the paths laden with black ice, performing some kind of precarious invalid ice dance having just argued with boyfriend about his direction in life behind me. not waiting to catch me if I fall but just keeping out of my way. Get to surgery and stride to reception eagerly hoping the NHS is not going to fail me. How wrong could I be. "WHAT ARE YOU DOING HERE WITHOUT YOUR NHS NUMBER OR PROOF OF ADDRESS? WHAT AM I GOING TO DO WITHOUT THIS" says Barky McNasty.

I explained that it would have been nice to have been told on the phone the items to bring, to which Barky bark's "ARE YOU TELLING ME I DO NOT KNOW WHAT TO SAY ON THE PHONE I SAY IT EVERY MORNING", I in return say that it is quite possible that people make mistakes not everyone's perfect.

I trundle back, falling twice for good measure and return where Barky reads my rent contract (I'm a student. at halls. I don't get fucking bills) "OHHH E1 that's not our catchment".

Short of punching this motherfucker in the face I calmly point out that she's reading the wrong part. And finally after 2 hours DTN (that's door to needle time) I am registered. A process that should have taken 20mins given that there were no queues when I arrived at 9am.  If Barky McNasty could do the right thing.

Why are such evil people the gatekeeper's to the GP? I don't want to tar everyone with the same brush but how often have you had to divulge your personal affairs to the receptionist under duress in order to get an appointment the same day - "I have been bleeding out of my bumhole for 72 hours and I don't know why".   In clear earshot of all in the waiting room.  London GP reception areas definitely don't cater for privacy.

Sure I understand that they can't possibly fit everyone in but there have been countless times when I have said I prefer to tell the GP about this but they insist that its on a need to know basis, and they need to know...

Just as graduate medical students are "handpicked for their personalities" (Read obnoxious, type A, ball busting bitches (with exceptions)) is this how GP receptionist's are picked? To date there has only been one practice where I have found that the receptionists adopt a people friendly approach to, well, people. This may be because they're in the midst of one of the most notorious estates in East London and the likelihood of tipping these people over the edge is high, or it could be because the Practice Manager had a customer focused approach to training the front desk?

Whatever it is I just wish that more receptionists had people skills. I don't think its a lot to ask but I just wonder if its an unwritten rule that GPs must employ Barky McNasties? Is it a phenomenon local to London and other inner city areas? What are the receptionists like in leafy suburbs? I am interested in your thoughts.