Jozi, Meryl and Ulysses…

 

Johannesburg...

Johannesburg…

IMG-20141116-WA0025

Meryl and I chilling. That's my post-call face on Friday evening

Meryl and I chilling. That’s my post-call face on Friday evening

If anyone asks, I’m off to go see about a girl… Those were my last words as I left Port Elizabeth for Johannesburg on Friday afternoon. For some odd reason I have had Matt Damon and Robyn Williams on my mind a lot lately. So come Saturday morning Meryl and I were at our favorite little DVD shop on Queens street in Kensington on a mission to fulfill my latest little resolution. Unbelievably they didn’t have Good Will Hunting… “It’s too old,” the lady said, “Too old?! 1998 isn’t old… and besides it’s a classic!” I said in exasperation. It was the second DVD place I had been to that morning that didn’t have it. The nice lady even called another branch but they also did not have the film, presumably for the same reason. “…Unacceptable!” I exclaimed, only half joking…

So we proceeded to choose another one, then two, then six movies, mostly because we couldn’t agree on what to get (we never do apparently, according to the lady that works there 😌) Walking out with that number of movies meant that it was officially going to be that kind of afternoon, which neither of us minded as that really is one of our favorite things to do together.

Getting breakfast at Uncle Merv's, Maboneng.  Highly recommended,  they have an awesome selection of smoothies :-P

Getting breakfast at Uncle Merv’s, Maboneng. Highly recommended, they have an awesome selection of smoothies 😛

IMG-20141116-WA0029

IMG-20141116-WA0016

There was a rugby game later that afternoon, the Springboks are currently in Europe and were due to play against England. I was forbidden to take time out to watch 😓! “It’s just 2 hours I’ll be across the road at the Troyville Hotel and back here immediately after…” I pleaded. “So it’s QT vs the test match eh? are you going to defy your woman?” Rodney, my best friend over the phone, having a giggle at the tussle I was in. As a married man he has much experience in these delicate matters. I like to think I’m an intelligent man, so there was no rugby that day. My (subtle) sulk was met with a dismissive “You can always Youtube the highlights later!” Really…

 

Tha evening Rodney came over and he, Meryl and I hung out with a new acquaintance of ours, Ashley. She is an American living and working in Swaziland, who was passing through Johannesburg (as one does) on her way to Cape Town. We all got stuck into one of the most interesting conversations I have had in a long while; gentrification, reincarnation, heaven and hell, Anglicans and Catholics, and child rearing. How’s that for a list of topics? And all before any of us had any dinner! 😋

The next day I turned 31. Just like that. “Je ne sais pas comment j’en suis arrivé à ce point!” Me, in a conversation with my dad on the phone. Time really does just go on, regardless of and in spite of you paying attention. I mean I know exactly what I’ve been up to for these past 31 years and it’s not that I have any regrets or anything but jeepers has it been 31 years already?!

Just the other day I was like 19 years old! :-o

Just the other day I was like 19 years old! 😮

Not that I necessarily would have but there wasn’t much opportunity for any kind of celebration as I had to fly back to Port Elizabeth in the afternoon. I got what I wanted though, some time with my girl over the weekend, and seeing Rodney the night before. My mother, and both of my sisters also called, Muriel in particular sent me a video over WhatsApp of a bunch of little Smurfs singing happy birthday, which I quite enjoyed! 🙂 Henriette, a friend of mine, came over and she met Meryl for the first time. We all shared a quick lunch at Maboneng’s weekly Sunday Market. Then I was off to the airport, and back to PE.

Curiocity Backpackers

Curiocity Backpackers

A good place for a night or two if you ever pass through Jo'burg

A good place for a night or two if you ever pass through Jo’burg

The walls of Curiocity Backpackers, where we stayed over the weekend are adorned with words, parts of Lord Alfred Tennyson’s ‘Ulysses’ one of the greatest pieces of writing ever penned. ‘… I cannot rest from travel… How dull it is to pause, to make an end, to rust unburnished…’ Fitting, for a place continuously housing restless travellers but also I think, as the writer may or may not have intended, quite inspiring for a cerebral soul such as myself. Everytime I walked past a paragraph on a wall I couldn’t help thinking and imagining. I felt overwhelmed with a sense of possibility that the words seemed to suggest.

IMG-20141118-WA0000

That is what was on my mind as I got onto the plane. One could go anywhere (in the world) if one wanted to really…

IMG-20141116-WA0016

Advertisements
Standard

Crescendo!

So where do I start… Let’s go with ‘What’s the worst, most hectic thing that could happen on a call?’ The absolute worst thing, in the  medical admissions ward on yet another all-day, all-night call at my little hospital…?

My answer is always the same here. In my setting a diabetic ketoacidosis, the kind of patient I should be paying all my attention to but hec I can’t coz there’ll be 20, 30 odd other admissions over the whole 24 hours. Sure that’s tough, but it happens relatively often so to spice it up a bit I would add an unconscious patient, intubated with the vital signs monitor beeping away all night (infuriatingly!😠)

 

Three. I had to look after three DKAs on call last night!! We were sitting on two, and doing alright until… I don’t really have words to describe what went through my head when DKA numero tres  was wheeled in through the door. Add to that four patients in heart failure,  two of them severely distressed, unable to get off the face-mask oxygen. Next try a phone call from the lab at about 2.30am informing me that the blood results of one of the  heart failure patients (think it was the third one I saw, 60something year old with dreadlocks, smoker…)  showed his Troponin I levels were 1110 (now there’s an ‘oh s#1t’ moment if there ever was one!) That’s a really high number,  some real damage done to the heart muscle there. Heart attack or to be physiologically correct, myocardial infarct. The textbooks say the patient feels like their chest is on fire while being squeezed really powerfully at the same time, you can’t breath, the room is closing in on you. A sense of doom. Dramatic much? 😰

 

Screenshot_2014-11-14-16-57-58-1

 

 

Screenshot_2014-11-14-17-01-46-1

 

 

I rushed off from admissions, upstairs to the male ward. “Bed 1” the night Nurse in Charge said as I got there (I had called ahead). A dose of morphine for the pain, an aspirin, and sublingual nitrates to dilate the vessels supplying the heart muscle with much needed blood, nutrients, and oxygen. Keep him on face-mask oxygen. Done, for now. See you the morning ward round buddy, I thought as I walked back down. Another patient in respiratory distress, possible pleural effusion based on my clinical findings, X-ray shows total white-out of the right lung. Poke that, get a sample of pleural fluid and send to the lab. Drain a whole lot more (no more than about a litre) he’ll breath a little easier, admit him to the ward, work him up for possible tuberculosis.

 

A one hour dose-off, awake again at about 6.25am. Casualty has sent across six new patients.  Six!! Why do they do this?! 😩 No way we’ll see six patients by 8am. Some will have to be seen the new shift…

 

I have to admit that as stressful as it was I feel good about that call. Controlled chaos, is what was like. Thirty-four new admissions in all.

 

The consultant that was in charge of the post-intake round this morning is my favourite out of the four physicians in our department at Dora Nginza hospital. He’s a really intelligent guy, very well-read, meticulous. “Let’s talk about acute coronary syndrome” he says to the intern and I. “Sure Doc lets do that…” ‘Cause I haven’t been up all night working,  I need to be stretched just a little bit more 🙂 In his thick Cuban accent “What are the contra-indications to percutaneous coronary intervention?” I return him a blank look, and the intern stares down at her shoes. “Read it, tell me on Monday,” he then says.

I will look it up, sometime this weekend,  sometime in between everything else that happens in the next couple of days,  I want to I do…

Maboneng at dusk...

Maboneng at dusk…

It’s late afternoon now, I still haven’t slept off that call. I’m finishing up on this blog post sitting at a backpacker’s in the Maboneng Precinct in Johannesburg. Got here from the airport just a few moments ago. Meryl will be here in a few minutes. She sounded really surprised on the phone a few minutes ago, she hadn’t known I was coming… 😉

 

 

Standard

Queenstown shuffle

My legs were hurting, really badly. Something very tender and inelastic had taken residence in my left leg where the calf muscle used to be. I also had this insatiable urge to eat copius amounts of junk food and then sleep for a many more hours than would be healthy, strictly speaking.

 

It was Saturday evening 01 November and I had just arrived back in PE, having driven in from Queenstown where I ran a marathon in the morning. Queenstown is a small town about four and a half hours inland from PE, still in the Eastern Cape. I had driven out there the previous afternoon, after waking up from my mid-afternoon postcall slumber.

On Saturday I was up at about 4.45am to go around to Bonkolo dam just outside Queenstown where the race started at 5.30am. It was chilly, overcast and raining. I was wearing the red Crusaders running club red singlet and shorts. Ideal attire for running (in hot sunny weather that is!) The starter’s gun was fired and off we went. I finished the the 42.2km race in 4hrs 11mins, after having passed the half-marathon mark at 1hr 46min. So yeah things obviously went pear-shaped sometime in the second half…

My run stats, courtesy of Endomondo tracker app

My run stats, courtesy of Endomondo tracker app

I ran for almost as long as I drove to get out there,  so yes I will take a medal, albeit for participation!

I ran for almost as long as I drove to get out there, so yes I will take a medal, albeit for participation!

 

 

There is a lot that happens in a long race, one of the things I have noticed is that any old injuries that you may have had before creep into your run, ostensibly at 30something kilometers when you’re just starting to think that this thing will be over soon. My right knee and left Achilles heel are my most frequent unwanted niggling visitors. The left calf is a new member of this club, I first started feeling it at about 23km, had to stop and stretch, then carried on in a fair amount of pain. This isn’t me making excuses for how my race went, but yeah that’s what happened…

 

After about 30km my long graceful strides start to resemble a (somewhat slower) forward shuffle

After about 30km my long graceful strides start to resemble a (somewhat slower) forward shuffle! 😛

 

When I have a bad race, afterwards (or sometimes during!) I go through a bit of a what-went-wrong in my head. I wasn’t happy with my result, having hoped to go under 4 hours, even if only just. However, having thought about it a little, the b

ottom line really is I just hadn’t done enough work in preparation. I’ve been going through somewhat of a lull in the last few weeks. That is to say I have been in an amotivated state, as opposed to a motivated state. In the week leading up to the race I had managed to dragged myself through two 20km runs, and a solitary 15km run the week before. Not nearly enough. The week before that I was away on a bit of a holiday (been meaning to blog about that actually) so no work-outs then. Prior to that I had been doing my usual two or three runs per week.

'nuff said!

’nuff said!

 

“More hills,” a fellow runner said to me after the race on Saturday. “…and more speed work,” he continued. “You need to be running twice a day if you’re going to be…” At that point I more or less stopped listening. Yeah sure, I’ll get up early everyday go for a run, then go to work, get back from work later and go for another run. In between all of that I’ll fit in a couple of hours of reading (specialist physicians don’t make themselves!) Well… I suppose there are 24 whole hours in a day 😌.

 

I love my running but... yeah, each to their own I suppose :)

I love my running but… yeah, each to their own I suppose 🙂

 

Speaking of studying, I haven’t done much of that lately either. “Are you ready for the Part one exams Dr Mukenge?” My HOD asked me facetiously the other day. “Well Doc, you see I haven’t really been… You know, it’s just been really… I was on leave the other week… then there was that presentation I had to prepare and… uhmm…” “But that was last week” He said, clearly enjoying the sight of me squirming.

 

I did get started on some reading durduring the week actually,  I went through some short notes on valvular heart disease and cardiac murmurs (I may or may not elaborate on these at some point). It’s a lot more interesting than say the cell and it’s organelles, or the nitty gritty of carbohydrate and protein metabolism, some of the stuff I’m supposed to be getting through for the primary exams. I get this soul-wrenching guilt everytime I catch a glimpse of my medical physiology book at the flat. I think I should just hide it away somewhere 😒

 

My sombre mood re the Queenstown sojourn was somewhat lifted on the drive back. I have previously mentioned my appreciation for good scenery and the need to ‘capture the moment’. Well I have to confess I am not impartial to ‘forcing the moment’ at times. On the trip back I actually stopped the car at the side of the road a few times to take some snaps…

I think that is the Kliplaat river, about 30 minutes outside Queenstown.

I think that is the Kliplaat river, about 30 minutes outside Queenstown.

Waterdown dam

Waterdown dam

More of the Eastern Cape!

More of the Eastern Cape!

 

The pain in my left calf has me limping 😦 I’m really hoping it’s something relatively mild and that I’ll recover promptly. I always have some or other niggle from running or working out and end up having to explain to people, mostly my colleagues at work. “You hurt yourself doing… what?!” A nurse once asked, “What kind of a grown man falls?” she continued. “And what were you doing running?! Were you late for something?” Now she was enjoying herself “Were you trying to catch the bus?” Picture cackling with laughter “Was someone chasing you?” Now unable to hold herself, practically guffawing… Some people have no appreciation for athletes.

 

Screenshot_2014-11-02-00-52-01-1

Standard