End of Days

It is either sunrise or sunset; that not bright shadowless light leaves everything in pastel colours. The air has the golden quality of early summer, filled with the hopes and memories of success and excitement. It has that precious bite to it that the first and lasts days of summer hold, that delightful coolness after healthy warmth.

I am in a place safe and secure that I feel I know well. I am in a warm comfortable room. The room is brightly yet comfortably illuminated. There is a single bed, a comfortable one with used pillows that are in a good condition; not overly puffy but not lumpy or thin. There is also a comfortable chair, a small table a comfortable recliner and a bookcase. The room is completely clean and feels homely.  The sound of the ocean and the occasional seagull can be heard in the background.

My body feels comfortable; neither warm nor cold. The clothes that I wear are comfortable and I feel comfortable in them. I am wearing laced up takkies, jeans and a long sleeve t-shirt. I feel clean. I feel deeply rested. My body does not ache. Behind me knees are not sore, neither are my forearms or elbows. I feel relaxed and calm. The constant desire to move is gone. There is no anxiety. My thoughts are still and do not focus on anything.

There is a knock on my wooden door; two distinct taps. I do not feel threatened by it. I approach the door and open it. A woman in her middle years is standing at the door. She is in a pristine white dress and looks healthy and motherly. She smiles warmly as I look at her. She then speaks the reassurances that no human being can ever honestly offer another:
“Do not worry. Things are going to be ok.”

It was finally over. The struggle was over! I no longer had to fight my depression, fight to fit in, fight to get up in the morning, fight for my food, for my degree, for my friends. It was all over. No more suffering and death at the hospital day after day; no more betrayals, shattered dreams, anguish, hate and fear.

I walk from my room. Around me is nature, completely unscarred and untouched. There are birds and animals uncaring about my passing.    I see smoke rising from a hill. I walk towards it, following a path of dirt between the foliage. I walk up the gentle curve of the hill.

Upon its summit I find the place where I belong –the place I have been looking for my entire life. It’s so familiar.  A large gnarled tree sits to a side upon the summit; next to it is a fire burning between a ring of grey stones. The air upon the hill is completely still. The smoke rises straight up in the twilight sky. In three directions there is nature as far as the eye can see;   a rolling land of forests, plains hills and valleys. There is no sign of other human life and no sign of danger.  Directly in front of me was the gentle slope of the hill leading down to a virgin white beach with azure water which seemed to almost glow and stretch out into infinity in the eternally fading light of the last day.

Around the fire sits my friends. Those who I love and those who love me back. There are no issues, no fights, no worries, and no places to be or to go. This is it – the moment after end of days. It is around this last watch-fire of humanity in the eternal twilight we shall sit and be: to love and to remember in contentment until we fade from our own memories.

Inspiration

I am feeling completely unchallenged and uninspired at the moment. Vascular surgery is easily the most boring subspecialty of surgery, which isn’t particularly exciting to begin with. All the patients have the same problem: there gross diabetic feet, with thickened nails and bad smells, are sore because they have developed peripheral arterial disease with critical limb ischaemia. They all get numerous ultrasonographic and radiological investigations to outline exactly where the disease is, then they get a bypass or a stent or balloon angioplasty.

I have read the course reader. I have started going though the powerpoint lectures and reading up on the fringe rare diseases, but I am not motivated.

Socially, the big push before exams is coming and people are stressed. I want to hang out with people and smoke nag, but smoking nag makes me feel sick and tired. I’m a bit frustrated with my friends and I feel uninspired and bored.

My family’s good. My dad still sits around all day and waits for the phone to ring, though he will deny it.

My ADSL business is not taking off as I had hoped.

There are no women in my life and I feel ok about it.

Every day I finish university early and feel completely uninspired to do anything. I normally wind up having a 2 hour nap then playing computer games and watching South Park or Simpsons. Yesterday I started going through lectures.

I have the time and I have the energy, but I do not have the inspiration or the passion. I do not know what to do?

Escape from Freedom

Friends

In order for me to have a good relationship with you there are a few things that I need.

Dishonesty is something that I find fundamentally unacceptable. Obviously there are times and places where it is necessary to lie. In my opinion these times would be confined to places where telling the truth would be harmful to somebody else and any benefit caused by telling the truth is far outweighed by the harm. To say something true but hurtful and unproductive is of no benefit.

There are two forms of dishonesty.

The first type of dishonesty is direct dishonesty where a claim is made that is untrue, for example I am a Christian. Another term for this type of dishonesty is the sins of commissions. You are committing an act that is dishonest.

The second type is indirect dishonesty – the dishonesty by omitting something that should be said – the sins of omission. The classic example in this case is where you are cheating on your girlfriend and don’t tell her. You know she should be told yet you still do not.

Do not be dishonesty with me, especially when it’s about something important because if I find you out, depending on how much I like you, I will either have a big fight with you and get over it, or I will just walk away. The big fight’s reserved for good friends and they only get one chance.

A sense of humour and a glimmer of intelligence are both important for you to understand the way I interact with you. People who are too serious cannot handle my inappropriate sense of humour and, although I can modulate it, I choose not to do so with my good friends. Life’s too serious for seriousness.

My humour is often higher-grade and if you don’t get my jokes then you don’t understand me.

I do not like people who are assholes. If you have nothing nice to say about anybody or if you are consistently rude to others I do not want to hang around with you.

Don’t try to impress me because it’s often lost on me. Don’t try to convert me to your religion. Don’t talk to me about politics or sport. Don’t boast or be arrogant because I grew up with arrogant people and I neither notice it or nor appreciate it.

Over The Line…

I had a really unpleasant experience on Tuesday this week.

On Sunday night I went to the launch of the book “Like a phoenix from the ashes.” It was written by a friend of mine and a guy that I really do not like, both of whom were my madrichim in Habonim. The book is about the movement from 1998 to 2002. It was an interesting event. There was one guy, an anaesthetic registrar, who was the madrich of the authors, then there were the people from the author’s time in the movement, then a few people from my age group and then the up and coming leadership.

I smoked nag and hung out with Best Friend and the mifaked and a few other people. I went to say hello to the author that I don’t like. His response to hello and a hug was “You know ‘Dinger’s the rudest person in cyberspace. He replied to my nice email inviting him to a talk saying “Please remove me from this mailing list.”” I was fucking pissed off with him. I missed parts of the speech because I’d rather smoke nag than listen to the guy I don’t like talking – and boy can he talk.

There was catered food, including salmon which was awesome. I hung out for a while after the launch and smoked nag. I smoked a bit too much and was a bit light-headed when I drove to the badger for nag. I knocked my back passenger side tyre into the pavement twice on the way there and fucked the tyre up, so after some chilling and hot chocolate at the Badger we went out into the road and changed my tyre. I then gave this hot promiscuous girl a lift home to tygerhof area.

I developed an awesome migraine while struggling to fall asleep. I fell asleep after 04h30, so I didn’t go in on Monday.

On Tuesday I was there for the lecture, which was cancelled, so I went through to the endoscopy suite / vascular lab for a tutorial. As I walked through to the lab this man that I had seen the previous Tuesday with one of the consultants started shouting at me. He had worked himself up into an amazing rage, blazing bright like a sun. The jist of what he was upset about was as follows:
1.    I had asked him the question: “Are you sober” meaning have you been drinking in the past while. He has an alcohol abuse history and is on the program and has been sober for 15 years and he thought that I meant are you sober right this moment. I only asked this question because the consultant had asked me to find out if he had an alcohol history. I understand that it would have been more appropriate to ask if he liked to drink, etc. I thought that sober was the more professional word, though I had learned from this particular experience.
2.    He thought that I thought he was drunk
3.    He thought that I had told the nurse to give him two fleet enemas to spite him because he was drunk. In fact the consultant had ordered the two enemas because he said he was very blocked up
4.    He thought that I had told the consultant that he was drunk and that the consultant had then told the flexible sigmodoscopist not to give anaesthetic because he was a drunkard. In fact they never give sedation during flexible sigmoidoscopy.
Because of the above mentioned transgressions he had complained to the medical superintendant about me and was going to sue me, despite being a pensioner. He was also going to take the story The Voice and there was nothing that I could say or do to get him out of repeating the same things over and over to me and demanding my name.

The other lower GIT consultant approached me and I was so thankful for his impending help, until he said “Could you two please take this fight somewhere more private.” I then walked around the suite with the crazy gentleman following until I found the consultant that I had worked with the previous week. He explained that I could not be held liable for anything that I did and said he’d sort it out, which he did, and then he spoke to me about it afterwards. I am very thankful for his help.

I went home early and felt terrible for the grief that I had accidently caused this gentleman

On Wednesday I had a very short day and spent the rest of the day playing computer games like a little nerd.

Today I arrived late for my lecture because when I (finally) got my cell phone alarm clock I saw that it was quarter past, so chilled for a while, then it was 25 past SEVEN. Woops. I spent over 4 hours assisting in Endovascular aortic stent procedure. I sweated through my scrubs and was quite bored, though it was an awesome procedure. The poor guy who had the operation was a 21year MVA motorcyclist who had an above the knee amputation with a degloving injury to the stump, he also had a spinal cord injury resulting in paraplegia and he had a lung full of pus which we suctioned with an R83 000 flexible bronchoscope.

Why Windows Vista 64 Blows

Last weekend I saw DJ for a shwarma on Saturday at the waterfront, which was nice. I also tutored and collected money owed to me. On Sunday there was a logicalist messup which resulted in the badger not coming to visit, but buddy coming. We ate hummus and hung out. We spoke about a long standing issue we were having with a common friend and decided to deal with it.

On Monday I had a very long day in colorectal surgery, then went to visit Best Friend. We smoked nag for an hour or so, then I went home. I saw them

On Tuesday my favourite doctor ever came to the Shawco clinic. He was amazing. He told me that I would make a great physician one day, which made me feel awesome. I saw some interesting patients at Shawco and got to bed quite late.

On Wednesday I did not go to uni – I was too tired. I got my rear shocks replaced and cooked a thai green curry for supper for my family. My clinical partner phoned me on the way to the shocks place to tell me that the watch that I had lent him was stolen out of his bag while he was in theatre. I had lent him the watch at shawco. I had told him that it was valuable, sentimental and my dad’s and that he had to look after it. He had forgotten to give it back to me. I had smsed him from the bus saying “Fuck my watch!” He said he’d give it back to me at uni.

I saw very sad because the watch carried a lot of sentimental for my father. When he was about 20 he was working for my grandfather (his father) in their jewellery shop in Aderly Street. He had asked his father if he could have the watch, his father said no, so he had to buy it for himself. He had worn it for many years. He was proud to see me wearing it when he had given it to me. It was something valuable and sentimental between us and now it was lost.

I was also angry at my clinical partner for not taking better care of it.

Two separate people suggested that maybe he stole it. It upset me that people would think such things and it upset me more that they were able to plant such bad thoughts in my mind. After I saw him at uni on Thursday I was fairly sure he hadn’t stolen it.

I was still quite bleak the whole of Thursday.

Friday was an absolute waste of time. The first lecture was cancelled and the pharmacology lecture was crap! Afterwards we were meant to have a plastic surgery tutorial, which was cancelled for the second week in a row. We had a ward-round with one of the colorectal surgeons, and a tutorial on CT scan interpretation. I then waited around for an hour for the pharmacology wardround which was given by the lecturer from the morning and was even worse than the lecture, so I left.

I went to one of my computer clients in Camps Bay and did work on their network for a few hours.

I switched their router into bridged mode and setup a program called route sentry on their front computer.

I decided that it would be an extreme waste of time to install a DSN server and configure a routing table on front computer so I tried to install route sentry on their son’s computer which was running Windows Vista Ultimate 64bit.

This proved to be not possible. I was unable to install RASPPPOE drives. Microsoft – those motherfuckers – revoked Atsiv’s distribution licence. Atsiv are a software company that made a program that allows the use of unsigned drivers. RASPPPOE is unsigned. I tried to download or find programs to sign the drivers myself. I was not prepared to download WDK from Microsoft.

I eventually found a program that automatically ran windows in disable forced signed driver mode. I tried two others that didn’t work, but once I got it to work I got an immediate blue screen of death.

After 3 hours I had to leave, so I left the son with 2 connections a local and an international. He would have to disconnect the international and dial the local when he wanted to play call of duty 4.

I got a message from him later on saying that call of duty 4 was giving crashing and giving blue screen errors.

I got there and, after trying to install Atsiv and still not getting Router sentry working, I started trying to deal with the errors.

The blue screen errors were caused by a driver error with their realtek gigbit Ethernet card and windows vista. I updated the drivers which sorted out their blue screen error.

The game was giving errors because it was necessary to install disable CHAP on the connection security.

I made R450.

Yesterday I watched Hitchhikers Guide to the Galaxy in the day and saw Dark Night in the evening. The Dark Knight was a fantastic film. I shaved my own head at 4 and half. It’s a lot cheaper than going to the barber.

Today I cleaned a lot of things.

Grossest thing EVER!

On Friday at university I saw the most hectic thing in the entire world ever.

There was a man, HIV positive male in his 30s who had been shot in the abdomen. He had had two operations to repair the damage. At the first operation he had had an posterior pancreatic resection and an Hartman’s stoma, then at the second procedure he had had the stitches removed from his pancreas and the stoma repaired. The stitches should never have been removed from his pancreas. He developed abdominal sepsis and wound dehiscence.

For the next 3 months this gentleman has to live with his abdomen open from xiphisternum to pubis. His intestines are protruding out of his wound and pouring vast amounts of intestinal fluids. His high-output fistula causes such a great loss of fluid and nutrients that he has to be on total parental nutrition, which is fed to him though a central venous catheter in his neck that goes septic ever 2 weeks and needs to be changes.

Some bad things that happened today

We were having a colorectal tutorial, which in itself is pretty bad. The first patient we saw was a gentleman in his 50s with a fissure. We spoke to him for a while. He complained of severe rectal pain on defecating which has caused him to present to casualty quite a few times. He also complained of blood on defecation.

Colorectal surgeons do not examine their patient’s lungs or hearts. Sometimes, like in this case, they do not even examine the patients front. The Doctor just made the man like down with his bum on the end of the bed and his body at right angles to the bed so that his rectum was straight. The doctor then poked and prodded the mans anus.

Now, the next patient was seriously unpleasant. She was a lady in her 40s. She was complaining of urgency, mucoid stools and rectal prolapse resulting in pain. After chatting to her for a while she was laid down upon the bed. The doctor noticed her anus was open, then he did PR and felt the rectum to be open. He then stuck a sigmoidoscope into her anus which showed a completely empty rectum with mucus. Then he put a piece of toilet paper at her anus. At this point I had no idea what I was about to see. If I did I probably still would have looked out of sick desire, but it was truly horrendous and terrible. I’m please the patient was not facing us.

As she bore down 5cm of rectum telescoped out of her anus. It was… just awful in every possible way. Wow

I upgraded my computer’s RAM (now at 2gigs DD2 400mhz) and got a new graphics card (ATI Radeon 3450).

I went to my GP to settle a set of accounts from January. Renaissance health has, to date, still not settled the account, despite numerous phone calls to their office every month. I went and paid and then I crashed the side of my car, the panel in front of the driver’s door, into a pole. Fuck!

Why I will not be a colorectal surgeon

There is only one single thing which is even remotely appealing about being a colorectal surgeon – the ability to make jokes about shit that are more funny than average jokes about shit. That’s it.

The following things are not appealing about being a colorectal surgeon
1.    You’re up to your ears in human faeces all day
2.    It smells bad
3.    You have to do colonoscopies. Colonoscopies are gross. I agree that it is a really marvel of modern science to be able to stick a 1.5cm diameter 1.2m long black phallic camera all the way from somebody’s anus to their ileum in their small intestines. That being said, one glance at the 3L suction bottle filled with brown liquid – a mixture of faecal matter and water – is enough to counter this, plus it causes patient’s discomfort and just isn’t cool
4.    You have to do surgery on people’s colon which normally involves shit
5.    You have to do lots of rectal exams
6.    You have to stick a sigmoidoscope up patient’s asses. Now this is a rigid metal poll that is hollow in the middle and leads to large amounts of faeces leaking out of the patient’s ass into a bucket
7.    Sometimes other things, like that colon-anastomosis-1-use-for-R20000 staple gun, up peoples asses
8.    You spend a lot of time doing surgery which is pretty much just glorified sewing
9.    You spend most of your life dealing with people and their bowel problems
10.    Most of you peers spend their time knee deep in human faeces as well… it cannot be healthy

In summery I do not think that I will be a colorectal surgeon for the points listed above.

The beatiful Indian girl

Tonight I am going out with a beautiful Indian chick that I met at shawco. I have tried to make plans with her before, but she had not been too keen. At some point during the end of last week I sent her an innocuous message on facebook asking her when we were going to go out for dinner.

She replied a few days later, first telling me that I should have known better than trying to contact her through facebook. This was a fair comment because she had told me a few times not to contact her through that medium because she does not use it very much. She than said that if I should want to make plans with her I should phone her, which was also fair. One of the reasons, other than anxiety and fear of rejection, that I did not contact her telephonically was that I had lost her number when I had upgraded my cellphone. She then instructed me to have a good weekend.

Yesterday I organised her number. I first felt bad about loosing it and considered getting it from her when I saw her at shawco on Tuesday. I then decided that I was procrastinating. I realised that I did not have the number of the person most likely to have her number. I then smsed one of that person’s friends, who gave me her number and told me not to stalk her.

I decided that I did not want to call her yesterday because that would seem too keen. I had a relaxed night and watched the movie “The Paper Chase,” which I thought was very average and that it had a shit screen play.

Today I thought about phoning her but felt anxious and decided to put it off. Then I decided I was being a pussy and tried to call her but she did not answer. I then did a whole lot of chores in the house and made pancakes which were gross. They tasted like pancakes should, but I found them gross.

I planned to make Thai Green Curry attempt II for supper tonight. My step mother smsed me to say that they had eaten way too much and they were going to have fruit for supper. She said that my father had eaten so much that if he tried to eat anything else she would call the police. I decided that I had no supper plans, coupled with the fact that the beautiful Indian chick is busy doing a very chilled block at the moment meant that, despite my anxiety; it would be a good time to ask her out for supper.

After a brief nap I called her. The line was bad and the conversation was poor, but she agreed. I asked her what kind of food she felt like, and she said she did not mind the type of food nor the time of the meal, so I told her that I would pick her up and seven and sort out the food. She told me I didn’t have to put effort into sorting out the food, but then I told her that a lot of places were closed on Sunday night, so she said fine and we ended the conversation.

I am feeling moderately anxious, but nothing too bad. I read a little about dating on the internet and thought of conversation starters. I had a shower, a smooth shave, though I still left my gothi and moustache, got dressed in a nice new shirt and smart shoes and my decent jeans and I am feeling ready to roll.