The Runton Diaries

Other Peoples’ Insides, Part I

Jul 9th, 2023

Until recently, I had assumed that whereas everyone else was made of kidneys, intestines and lungs, I was made of lights, immortality and magic. While still generally of this opinion, I am now more familiar with other peoples’ insides following seven weeks of full-throttle anatomical study, as part of my new role up the hospital as an MRI science man.

This means I have left my previous post, of course. My last day was made complex because one of my colleagues managed to jam the patient lift by getting a sandwich caught in the door mechanism. This was remarkable, but not surprising, because things like this always happen to exactly the type of person you would expect to, for example, jam a lift door with a sandwich. When called upon to investigate, I therefore decided not to ask how it had happened, but rather focussed upon what type of sandwich it was (ham) and what his favourite sandwich was (ham and cheese). In an echo of the ‘Would-you-rather?’ questions that theatre staff debate to while away time during surgical procedures, I ended my investigation by ascertaining what sandwich he would have, if he could only have one sandwich for the rest of his life (ham and pickle). I suggested that he might be happier with jam, but he didn’t spot the rather weak joke. I never had a supervisor in my last post, because no one really knew what I did, so I instead gave my report to a patient, who was quite impressed with it.

With the day off to a shaky start, I negated the ‘Would you rather?’ theatre question by instead asking the team to point out the connection between Debbie Harry and Adolf Hitler*. No-one guessed it, despite spirited renditions of Hanging On Das Telephone and Sonntag Girl and, just like that, my time in theatre was over. It was evident that none of my colleagues knew I was going – despite demolishing thirty fucking quids’ worth of cake I had generously left in the staff room before I had a chance to have any myself – as my leaving card was signed only by those who happened to be at work twenty minutes before my final shift ended, many of whom habitually called me Chris anyway. Now I come to think of it, instead of establishing a link between New Wave and the Third Reich, the day’s brainteaser should instead have been what my fucking name is**. Ah well.

And so here we are. It’s seven weeks later. My new job – or to be precise, the expensive tax-payer funded career trajectory I have flatteringly been chosen to follow – is underway. It’s, you know, OK and everything. There’s a lot of studying, slanted for the first few months towards anatomy and physiology. This makes sense, because for all the wizardry of Magnetic Resonance Imaging, the primary skill is recognising what you can see on a monitor. It’s nice to know about subjecting hydrogen protons to magnetic fields and interpreting the energy released by the resultant change in relative precession rates – or ‘flip angle’ – as an image on a screen, and it is impressive, technology wise. However, if you don’t know your way around the major nerves in the brain, or what a torn anterior cruciate ligament looks like, you will be hopeless at it.

Working in MRI, I therefore concluded, is an exercise in anatomical recognition rather than quantum physics. Equally swiftly, I concluded after claiming that ‘Physics doesn’t exist – that’s why you can’t see it’ that MRI staff are a bit po-faced about this sort of thing. ‘Of course physics exists’, countered one of my new colleagues ‘It forms the basis of all life’. I replied that ‘I think you’re getting it confused with the Force’ and, while I am no stranger to a filthy look, the one I received in return was fucking rancid. I might follow this up on my next shift by saying that maybe physics does exist, because my horoscope was spot on yesterday. I am curious to see what happens, which kind of makes it a scientific experiment, after all.

Photards:

Main: My commuting transport. I love this bike. Fixed gear, weighs a ton, even without panniers full of uniform, books, food, laptops and so forth. Incidentally, you would never usually photograph a bike from the non-drive (ie chain and sprockets) side, but on this occasion I have because it was standing up entirely on its own, having presumably become sentient, and I didn’t want to make it angry.

Inset top: My current girlfriend’s response to the sandwich-in-lift news.

Inset lower: This is the lumbar vertebrae or, as we presumably call it in MRI, a back. Note the strong signal from the cerebrospinal fluid, which tells me that this is – yes, that’s right – a T2 weighted image. Note also the saturation band to prevent flow artifacts disturbing the field of interest, and my careful placing of volume slices through the spinal fibrocartilage, all but eliminating cross talk.

*The answer is ‘Blondie’. It was the name of Debbie Harry’s band and Hitler’s dog.

**Paul
Adventures in Magnetic Resonance

Mar 31st, 2023

My hospital was recently revealed to have the lowest staff morale of any medical facility in the whole National Health Service and therefore, we may safely assume, the entire world. Imagine that.

On the other hand, if you go into an MRI scanning room with keys or coins in your pocket, they will immediately accelerate to fifty miles per hour and ping about the place like machine gun fire. That, surely, is pretty exciting. There are no statistics available on what happens if you take an actual machine gun in, but a couple of years ago a gun rights activist helped his mother into an MRI room in, I think, Brazil, and the magnetic pull was so strong that it caused a concealed firearm he was carrying to discharge through his lower intestine, fatally injuring him. Closer to home, on Level 2 of the East Block of what we now know is the most depressed hospital on the planet, I am shortly to be let loose in our own MRI room. Leaving aside the fact that our MRI room is the most dangerous part of the most depressed hospital on the planet, it sounds like quite a larf. On my first day I’m going to wheel a shopping trolley in and watch it bounce about like a pinball because I’ll still be supernumerary – or, as I shall insist upon being called, ‘superluminary’ – and can’t get in trouble.

The change from being someone whose main function is to get things out of cupboards and, slightly later, put them back again to herding people into the MRI scanner has come about as part of my recent and improbable elevation within the medical world. Crucially, it also gets me onto a science-based career path, away from general healthcare, which means I never have to be a nurse. As discussed in previous entries, you never see a happy nurse – and rightly so, because it is an awful job. Nonetheless, I was surprised to find our entire hospital was so gloomy. Be that as it may, for those of us about to undertake an epic journey to being radiographers, then radiologists, then radionauts, these are giddy times indeed. There’s a lot of training ahead, and it’s possible that our natural lifespans might end before our studies do, but Radiology is one of the few parts of healthcare I want anything to do with, so I am chuffed to be able to progress within it. As I am fond of saying, it’s nice to still have a career in front of you and, no matter how dismal the rest of the hospital may be, I am grateful for the opportunity.

That said, there was a great deal of dicking about beforehand. This mainly concerned taking Functional Skills classes in English and Maths to replace required GCSE certificates which no longer exist. I was supposed to take the Maths exam this morning in fact, but I had to cancel it because I had an online lecture to attend. As it turns out, I subsequently forgot to attend the lecture anyway because, as the UK’s only baseball fan, I was watching the Dodgers beat the Diamondbacks on the opening day of the new season, but still. My new post doesn’t officially start until the end of May, and in the intervening time we’re just being ‘gently felt up’, to borrow a curious metaphor from a fellow student, so it doesn’t really matter.

I took the English Functional Skills exam last week, and am awaiting the result. Incidentally, ‘Functional Skills’ means that you have proved yourself to have the lowest measurable grasp of the English language, but sitting the exam was stressful nonetheless. As I demonstrated that I knew the plural form of ‘tooth’ was ‘teeth’ and ‘river’ was ‘rivers’, I was aware of how slowly I write with a pen these days. For years, I habitually wrote with a fountain pen because I am a bit of a ponce like that, so perhaps it was because I was wrestling with a biro. Anyway, fingers crossed that I pass.

Touchingly, the fact that I had to do it at all caused outrage among my fellow cannon fodder, whom I shall miss when I become the hip new kid on the MRI block. This is because, equally touchingly, I am seen as something of an academic, largely on account of owning a Kindle and habitually reading things on it, even though I’ve told them it’s an Etch-A-Sketch. Indeed, with the typically direct vernacular of NHS workers in the lower pay bands, one of my colleagues pointed at me during a team meeting and said, ‘It comes to something when a brain box cunt like that has to prove he can read’. Admittedly, there is little in the way of finesse about this remark but I do not often have cause to blush over compliments these days, so I was grateful for the opportunity to do that, too.

Picters:

Main: My hospital finally gets on the map.

Top: Setting up for some procedure or other.

Lower: These sponges are used to paint iodine on the patient when in theatre, but I also like to use them to signal the patient’s overall well-being to the guys in the control room.
Twenty Twenty Three

Jan 2nd, 2023

Christmas passed off nicely in our tiny corner of the north Norfolk coast. Sid’s interest in astronomy gathered pace after I told him that the stars flash and change colour during the festive season, and he picked up some agricultural experience as a shepherd in a local nativity play. Elsewhere, I thought the King did well in his first Christmas speech. I was still eating dinner when it started, so stood in the doorway to the front room so I could see the telly while leaning back into the dining room to chew when he was off camera, so as not to be disrespectful. At one point the dog acted in a potentially treasonous manner by barking at a wandering horse outside while he was talking, however, I suspect it was a republican horse and in any case King Charles is named after a type of spaniel so I am sure he wouldn’t have minded.

At work, I was able to tell patients that we’d got them a stent for Christmas, but we’ve kept the receipt in case it isn’t the one they wanted, and so forth. This was against the backdrop of the Training Mania outlined here and here, still raging like wildfire to the probable dismay of our Minor Injuries Unit, which deals with burns patients. As a shortlisted candidate, I have to present the school certificates I don’t have to the selection panel on Wednesday. There has been a great deal of to-ing and fro-ing in my quest to find these. Not getting a job because you make a mess of the interview is fair enough, but not getting the interview because your education authority no longer exists and there have been too many Bank Holidays to make alternative provision would be a bit annoying. I’d have to leave and be a social worker instead, and I don’t want to do that because at least when you deal with people in the hospital, there is a chance of them getting better.

The year closed with a blizzard of Star Wars Lego and an afternoon of classic war films with Sid, who thinks Hitler and Darth Vader are the same person. This did not prevent him from raising philosophical questions regarding the nature of good and bad during the Battle of Britain. Struggling to think of a definition that would make sense to someone who has just turned six, I focussed upon the difference between action and intent, which after all is the basis of law in a civilised country. Therefore, the German pilots are doing a bad thing but are not necessarily bad people, and so on. He seemed happy enough with this, pointing out that another way to tell the good guys is that they always play the badpipes, as per the arrival of the 92^nd Highlanders in Waterloo. I agreed that, yes, this is probably true and, thusly armed, we marched into 2023.

Picters:

Main: Badpipers arriving at the battle of Waterloo.

Top inset: Leads, for wearing in the room during procedures.

Lower inset: 05:30, and about to set off on the commute.
Losing A Finger, Part II

Dec 24th, 2022

In our hospital, if you’ve broken a bone or been in an accident, are otherwise ill, or work here, you’re fucked. On the other hand, if it’s parenthood or cancer you’re after, you’re in luck, because the oncology and birthing units are excellent. In fact, midwifery was my first choice of working area, because I like the idea that, as soon as a lady’s contraptions start, you are dealing with two patients – the lady and her lovely new baby. Male midwives are not exactly encouraged, though, which I suppose is why childbirth is so disorganised. In any case, the advantage of working in a disintegrating NHS is that if you keep your wits about you and dodge the worst of the crumbling infrastructure, you can end up wherever you want – and, as mentioned last time, Santa may have provided us with a path through the flaming wreckage to something worth doing, which is very fortuitous indeed.

I work in Radiology, and Radiology is great. I was sold on the idea of working here when, on a pre-employment visit, a recruiting nurse pointed to our unit and said ‘no one really knows what goes on in there’. Now that I do know what goes on in Radiology, I have decided that I, too, would like to earn a living by injecting dye in to people and then taking pictures of their kidneys. Imagine my delight, then, when a Christmas miracle arrived in the form of training to do that exact thing. Yes, there are two years of preliminary training to get through first, but this involves being a mysterious, specialist Radiography nurse, and not a fat, unhappy, normal one. I initially missed the news, because Mr Universally Inept and I were dealing with a patient and consultant who looked like R Kelly and David Bowie respectively, causing us great amusement. I wanted treatment to include a duet of Starman. Anyway. There are four training places up for grabs and, as I am one of only two applicants without a significant learning or behavioural issue, I consider myself to have a fighting chance.

Well, there’s a thing with that. Remarkably, the Inner London Education Authority has lost all academic records for my school, so there is no proof of my pass marks at both English and Maths. I therefore have no way of proving to the University of Derby, who are providing the training, that I have basic literacy and numeracy skills, and that educationally speaking I am a safer bet than the mentally handicapped. There’s no point me waving a Masters Degree in Politics around either, because that’s a Humanities subject, and this is a branch of Science, so it doesn’t count. Also, there are mutterings that the University gets extra funding for special needs students, putting me at a further disadvantage. I don’t believe this, at least not in the rather nasty sense it is implied. I mean, God knows the NHS is a freak show, but still.

One of the reasons I don’t believe this is that, as several of us crowded into our unit’s Bad News room for a Zoom call about the course, I found myself next to Mr Universally Inept. There is a legend in Radiology of a mysterious angry giant whose mighty footsteps cause the masonry to shake and the theatre lights to flicker. This is, in fact, Mr Universally Inept crashing bed-ridden patients into every single door frame and supporting wall along the main corridor in our unit. Everyone’s crashed a patient into something, but it’s usually just one of the cleaners. Not everyone has crashed a patient into a massive static display screen while wheeling them into an operating theatre, causing their procedure to be postponed for several days while a replacement screen is found, and subsequently crashing them into a wall on the way back out, but Mr Universally Inept has. Within ninety seconds of sitting down, he had banged his knee on the desk, struck the monitor with his forehead, dropped his biscuits twice, discovered that a pen had leaked in his pocket and somehow caused his staff door pass to disintegrate. He is a catastrope of a man, and it was like sitting next to some kind of localised natural disaster. I do not think a career in renal surgery is a natural move for him.

Fortunately, one of my more niche duties is proof reading NHS governance for our matron before it goes off to the Department of Work and Pensions. She rather generously describes me as being of ‘the highest integrity’ and that, if I say I have the required qualifications then, as far as she is concerned, I have. She’s on the selection panel too, so I am hoping she will be a useful ally. So keep your fingers crossed if, unlike Mr Universally Inept, you are able to do that without somehow breaking an arm and starting a fire.

In other career news, Sid recently got a Maths Whizz silver award from his school, and is therefore more able to prove his numeracy skills than I am. I would put him forward for the training, but he’s adamant he either wants to be an asteroid and go to space in a rocket, or remain Earth bound and be a ‘cleano winder’ [window cleaner]. Everyone’s aiming for the stars this Yuletide.

Public Service Announcement: We are shortly off to church for carols, followed by fish and chips and present wrapping. it seems statistically unlikely that you’re dashing through the snow in one whore’s open sleigh to the same carol service as us, so I shall instead take this opportunity to wish you a Merry Very Christmas, wheresoever in the Empire you may be, and a happy and healthy New Year.

Picters:

Main: One of these people is my old dear as a teenager, in a dockyard drawing office.

Top inset: A hospital staircase of my acquaintance.

Lower inset: At least the dog’s comfy.
Losing A Finger, Part I

Dec 22nd, 2022

It’s Christmas, so that’s lovely. I’ve had Paul McBeatle’s Mull of Kintyre on heavy rotation while walking the dog, as it is my favourite Christmas song despite being about glens and heather in Scotland. Actually, I wonder how many Scottish couples called Glen and Heather there are? Loads, probably. And don’t believe the hype: even though Scotland likes to present itself as a big cold field where bitter people live, this isn’t true. It is a beautiful place full of brilliant people, and I think they should play to that aspect far more. Yes, if they’d got independence they would’ve wasted all their tax revenue changing the name from ‘Scotland’ to ‘Not England’, as not being England is the most important thing in the world to a major international player like Scotland, but still. Even if you’re Scottish, it’s Christmas. It’s even Christmas at my hospital, where everything’s covered in tinsel and the corridors are knee deep in Cadbury’s Heroes, which makes moving patients around tricky. I’ve been substituting prosecco for lidocaine to cheer them up during surgery, though, so all’s right with the world.

It’s probably worth pointing out that I am not a nurse. As I may have explained before, I’m not even a trainee nurse. Myself and my fellow dogsbodies are, essentially, trainee trainee nurses. We are obliged to do a lot of nurse stuff, because there aren’t any actual nurses, and there aren’t any actual nurses because being an actual nurse is horrible. To their credit, they try to put you off a career in nursing by being overweight, depressed and obsessed with cats, which sends a pretty clear signal. I often imagine that when they leave college, nurses are given a special advent calendar with a window for every day until they retire, and behind each window, as the years grind past, is a little chart to record their increasing disappointment with life. As you can probably imagine, this puts those of us working towards actually being nurses in a bit of a quandary because, as far as our training and exams go, success would be a disaster.

I explained the horror I feel about this at a recent ‘Hey! How’s it going?’ meeting my fellow cannon fodder and I had with a sympathetic consultant. On this occasion, we were talking with Dr Bowler, who I think we met last time. I am fond of Dr Bowler, as he addresses everyone as ‘chaps’ and ‘Dear boy’ and habitually wears a sheepskin flying jacket. As I once remarked to him, my dissertation was on the British Commonwealth in World War Two, so to work with someone who appears to be a Spitfire pilot is very exciting. Then again, it can be a strain on hospital infrastructure as he sometimes comes to work in a Lancaster bomber, which takes up forty-seven parking spaces, and so on.

Anyway. Looking back, when asked our opinions upon our training and eventual destination, I may have been channelling Tom Hardy’s portrayal of Reggie Kray in the pub fight scene from Legend. This is because I found myself saying ‘I’ll tell you all about being a nurse. Fuck being a nurse, and fuck nursing. Fuck oncology and gynaecology and the other ologies. Fuck main theatres, fuck wearing scrubs and fuck fucking about all day with fucking syringes. In fact, I would rather lose a fucking finger than be a fucking nurse.’

Channelling Reggie Kray or not, it was felt by my fellow dogsbodies that this explained our position adequately. It was unclear what someone who appeared to have spent a long morning dog-fighting with the Hun would do about this but, as it turned out, there was good news on the horizon. Or bluebirds over the white cliffs of Dover, if you will. (NB Germans aren’t allowed to have Christmas because they don’t deserve it).

Picters:

Main: Joe in the glamourous Compleat Angler by Norwich station recently.

Top inset: I recently attempted to get Sid to eat more vegetables by hiding garden peas in his birthday cake. He spotted them, unfortunately, but thought it was quite a larf.

Lower inset: A Christmas tribute to the late Queen, who Sid thinks flew a ‘Spitflier’ during this summer’s Platinum Jubilee celebrations.