Royale with Cheese...

It's just the little differences, really. McDonald's is referred to as “Macca's,” Burger King as Hungry Jack's. The big things missing from my diet? Cherry coke zero, Diet Dr. Pepper and good sushi. No great loss, I hear some of you say, but do not underestimate these things. However, one awesome thing about the sushi/Japanese restaurants--

Yup, little plastic fish-shaped soy sauce capsules. They are awesome. And re-sealable.

In terms of the DEM (dept of Emergency Medicine, vs. ER or ED), there are also quite a few useful terms I've added to my vocabulary. My personal favorite is “acopia” (pronounced “a-cope-ia”), used to designate someone or someone's family member unable to deal with their issues (sometimes medical, often not) at home. It was apparently at one time an honest to God diagnosis that they would enter into the computer before a memo put an end to it-- formally at least. It's equivalent back home is my favorite (or, favourite) FTC for “failure to cope,” applied to patients in the same situation beyond the age-range of the more traditionally accepted “failure to thrive” diagnosis. Close seconds are the expressions “fronto-palmal” and “fronto-dorsal” to describe Pt “affective types”:

And the ever-popular “haema-chuk,” or what is spilled onto the floor when an upper GI bleed makes itself apparent. As an aside, to “root” for a team is an expression that has a very different meaning here and should probably not be used in polite company (though I'm curious to see what it would look like in practice...). To say you're a fan of a certain team in, Australian rules football, for example, you would say that you were a “supporter” of that team. “Root” is the unpleasant and impolite equivalent to “shag.” Similarly, “how are you doing?” is here “How are you going?” (how is “it” going does not exist), but I just can't get it in me to say, “I'm going well.” Saying so makes me feel like I'm making good time on some sort of river voyage. Not sure why.

Oh and a few other things. This sign is up in the utility room in the DEM. I tried to get it in focus, but it didn't come out right. It is a conversion chart for converting between kilogram and, wait for it, stone. That's right-- stone. As in, “He probably weighed about 13 to 14 stone.” I just have images in my head of a code in which someone is calling out drug dosages in “mgs/stone.”

For those of you who are fans of The Daily Show, you may recall their “Pantry of Shame,” which includes microwavable blueberry pancake-wrapped sausages on a stick and something called “Baconaise,” which is mayonnaise w/ bits of artificially flavored bacon already mixed in. Well, I saw this ad for Beconase, trade name of an inhaled nasal steroid, and couldn't help the mental

connection (much like the Ceylon industries bakery that produced the chocolate cookies mentioned in a previous Liberia post...).

I showed a co-worker here a section of my blog from back in Liberia that had my photo on it, and came in to sign out the next day with this as the computer wallpaper:
Apparently there's a website where you can upload your pictures and do things like this to them. With friends like these, who needs friends, right?

For those interested, I saw the group Tripod the other day on television. Like it sounds, three guys who do music and comedy. I noticed them while in Melbourne when I came upon an ad for their performance of “Dungeons and Dragons: the Opera.” I couldn't go because of my work schedule, but was really close to shelling out $300 for last minute plane fares... Anyway, they may be playing this upcoming Friday and I hope to swap shifts around to head out there. Some of the lyrics from the tv performance I saw follow. Imagine sort of a jazz quintet doing a little bossa nova number, the lyrics to which describe the lead singer's anxiety that as a bookish geeky technophile he likely does not have the skill set to compete under the new conditions created by the collapse of modern society...

“...when the polar icecaps melt and the oceans rise / just like in Waterworld, well / I'm pretty sure I don't have the upper body strength / for all that much rowing.”
“...And even if the post-apocalyptic dystopian wasteland of the future / isn't exactly like Mad Max, /
there'll probably be a healthy amount / of fending off marauders, / and I'm not very good / at
fending off marauders.”

Speaking of marauders, I awoke one morning to find this bad boy trying to die on my oven range:
He is a fine specimen of what I believe to be a “huntsman” spider, one of the rare varieties of Australian flora/fauna that are not imminently deadly to humans.

Interestingly, 10 of the 15 most dangerous snakes in the world live in Australia. Clearly, God does not want us here... :)

For the medicos out there, this is an interesting piece on the over-importance placed on medical care and documentation done for “medico-legal” reasons. I agree with his point, but the problem is as long as there's someone out there who's willing to say this or that to make a buck (which is always), it's going to be a long road to hoe.

http://journals.lww.com/em-news/Fulltext/2009/11001/The_First_Great_Lie.3.aspx

And this snippet is from the article referenced below which itself is extremely moving. But I enjoyed the emphasis this little bit puts on how our job changes our perspectives on things. Most people's jobs don't involve people dying every day, or pregnancy losses or broken relationships (“No, Miss. Regardless of what he told you, trichomonas is not something you 'just get' from having sex. Well, people who have sex with him could 'just get' it I suppose...”). I don't know-- for me personally it's led me to be a bit of a nervous Nellie when it comes to crossing cross-walks or having first aid kits and fire extinguishers in the car or not drinking on nights I'll be driving. But I also hope it's made me appreciate those moments I have with the people in my life, be more straight forward and up front about some things. Certainly this little bit is a reminder to be understanding of the people who've not had the same experiences you've had. The author is finishing describing the passengers/family involved in a collision in which one of the parents has died, and the other was driving intoxicated.

“The son has abdominal pain, which ultimately proves to be from a small bowel perforation. One laparotomy later and he's fine. (The most traumatic event of his life, possibly ever, and it warrants only 2 sentences. The ED has shifted my perspective so far that my own kids won't come to me for their minor [“trivial” to me] injuries. “Dad's only interested if there's an exit wound,” they say. This can't be good for me, my family, my patients.”

JR Suchard. Unhappy Birthday. Annals of Emergency Medicine 54(4). October 2009, Page 627

Finish off with some pictures of the Gorge, where the kayak championships were held recently, and a view of the North Esk River as it comes in to the Central Business District of Launceston.