Wheely dangerous

Spent yesterday (I think, even our RTC victim was better orientated to day/date than I currently am) with the local LIVES volunteer doc (who is also an ST1 Anaesthetist and previous A&E Nurse & Army Paramedic), trawling the county for car crashes and cardiac arrests.

It must have been the quietest day in ambulance history. We had 8 1/2 hours without a single call. And even that was only a tiny piece of scone gone down the wrong way. We drove 30 miles on blues to get to it, as it came through as a cardiac arrest. I never even saw the patient, since there was a crew already on scene.

Instead, we spent the day on what amounts to an 'Intro to Pre-Hospital Care' course :)
Toured our local A&E (and left shocked at finding anaes units with halothane in them - even I recalled that my notes say it's no longer used! To be fair to them, there was a note on the halothane section recommending use of another agent).
Went to the local Fire station and checked out their search and rescue vehicles - they are literally massive store cupboards on wheels! Scissors the size of my body for cars, ropes thicker than my arms, huge lights for nighttime accident scenes, blocks to stabillise RTC cars... Plus everything you could ask for to completely destroy a car in a matter of minutes, from chains, glass cutters, scissors, separators, and 'ram's - hydraulic cylinders that are wedged under dashboards and extended to pull the entire dash forwards and up, away from anybody's legs! Strangely enough, they also had everything you could need to pull a cow out of a ditch...
Headed out to the smaller ambu-station that sits mid-way between us and the coast, where we found a single crew with their feet up watching morning telly :)
In that same town is our LIVES headquarters, so we went up there too. Had a lovely chat with two of the guys there, about how LIVES works, how it's funded, what it's capacity is, success rates, job variability, growth of local responder groups, AED access in public places, etc. Also checked out the recording from an AED brought in after an unsuccessful resus on a cardiac arrest. The guy had been down for 20 minutes before the responder got there, with security staff doing CPR until then. The trace was coarse VF, so he got 2 shocks. It was so easy to see where the CPR was occuring and when the responder stopped to do rescue breaths, and the timings of everything. After 2 shocks, he went down to asystole, but CPR continued for 26 mins total. The ambu crew took 33 minutes to arrive. Sounds shocking, but it was in a pretty remote area, and the responder was actually on scene just 4 minutes after the call was made.
After visiting HQ, we travelled on, out to the coast. The station out here is pretty tiny too, with 3 ambu's. Gorgeous weather, so we had a wander along the sands with a portion of chips each! Town was packed to the gills with chavs and oldies. We thought we'd check out the hospital too, and boy were we in for a shock! Residential street, with a (very) large house on one end. Yup, that house is the hospital. The original 'cottage hospital' sign was still above the door! Inside, we were almost on the set of The Royal. The house had been marginally converted and added onto over the years, but the A&E dept. was a corridor with the original rooms stripped and a hospital trolley added in each. Resus was a curtained off wider room at the end. Forget the horror of halothane gas machines, there were no gas machines! The radiographer went home at five, so no scans after-hours. Any trauma was taken straight out of town, 20-30 miles down the coast. We exited in complete hysterical giggles. I honestly didn't believe places like that existed. It was genuinely like being in The Royal!
The station was still dead, couple of Cat C's at lunchtime but nothing for us, so we headed north to another seaside down. It was so depressing that we drove straight through. Now was when we got our 'cardiac arrest' call! Quick satnav instructions, lights and sirens on, and we were off!
Horrendous roads, horrific corners, at horrible speeds. I think we did a minimum of 50, and that was in the corners. [Disclaimer: at no point did we exceed the emergency driving regulations of being more than 20mph above the speed limit.] Arrive at the nursing home. Para wanders out, looks a little surprised to see us, and explains it was a momentary choke-vomit-back to normal. Quick break to let the adrenaline of the drive wear off, and we were back on the roads, heading back towards HQ town. Well-deserved cup of coffee, an episode of eggheads, and we got our big shout. Entrapment/RTC!

We drove 40 miles in increasingly heavy downpour, down tiny bendy back roads that our rural county is well known for (and contribute greatly to our road carnage!) as fast as we could safely go. More info comes in as we travel: the main casualty is pregnant, and there are several other casualties. The entrapment remains.

10 miles out, I check the map for the exact road we're after, as Control can't put coordinates through to our Satnav like they can on their own vehicles. I get my fluoro coat on, and try and work out how to get the helmet on, so there's less time faffing around when we arrive.

1 mile out. I have no saliva left, my heart is about to implode, and I'm shaking like a leaf. Quite how Matt manages to drive, and think about all the eventualities on scene, while every drop of adrenaline surges through, I have absolutely no idea. The helmet goes on.

At the end of the road is the Police - Accident cordon. Oh shit. This is not a minor.

Around a corner, and there it is. All I can see is blue lights. As we slow, and a policeman moves the second cordon to let us on scene, I can identify a fire truck, an ambulance, a police car, and a paramedic team leader car. But no mashed car... yet.

As we pull round the ambulance to move to the far end of the scene (our car is less visible than a massive red fire truck, and it gives us time to assess the scene while parking), I spot the underside of a car. Off the road, in a field. In a ditch, to be precise.

We jump out, and I grab our trauma bag while Matt gets his helmet & extrication gloves on. As I deposit our stuff at the equipment dump site (a big tarpaulin the fire service lay out for all of us to put our gear on, so it's central to the scene and in no-one's way), I can see that we're not here for our extrication skills any more. The fire service are carrying a long board (occupied!) away from the ditch.

[I'm dumping our stuff off, and a copper nearby greets me. My immense nerves immediately blurt out "I'm just a medical student! I'm with the doctor (point at Matt)!". Gibbering wreck indeed. I think I was incredibly scared he was gonna assume I had some degree of medical competence and get me to do something! I'd never looked at my helmet before this call (it's carried in it's own fluoro bag) and I was expecting it to say 'OBSERVER' all over it. It doesn't. It says 'AMBULANCE'. Shit]

Matt runs back to the car to check out the damage while the paramedics deal with the patient. A quick glance at the wreckage patterns and physical damage to the car, and we're headed to the ambulance.

Our patient is loaded as we don our gloves (the medical examination ones, not the extrications and I try and overhear everything everyone is saying. We have a lone female patient (other casualties were very minor injuries and are with the police, giving details), 8 months pregnant, driving the vehicle when it flipped.

She's got a fair amount of dried blood in her hair and all over her face and hands, plus one foot (shoeless). First things first; she's talking, so we have an airway. And if you can talk, you're breathing alright. We do a formal assessment as well, cutting through her bra (hope it wasn't her favourite!) to examine her chest for open wounds and have a good listen for equal air entry. Her pulse is fine (turns out she's only 8 weeks, not months, pregnant, so all those physiological differences we discussed on the way in are irrelevant here), BP is normal, and she's satting at 99%, so all good.

The paras/fire service have her firmly tied on a long board, with a collar and head blocks. We get her out of those (with either the para or Matt holding her head straight at all times, checking that the other has full control before letting go) and start poking. She's tender over 3 cervical vertebrae, so that collar is going back on in a second.

Tenderness is also found over the zygoma, temple, and around the back of the head. No open lac is found for all the blood, but her hair is pretty clotted up already. She's quite capable of telling us where it hurts, and can identify the day and date better than I can (I could have sworn it were Monday, and as for the date.... ), so that along with the lack of other neurological symptoms (pupils, etc) is a reassurance.

[While Matt is doing his poking and prodding, the para grabs me to the feet. "I think her ankle's dislocated - it just looks wrong. What do you think?" Erm.... I think I'm supremely underqualified for this! However, my bedtime reading of Essential Ortho came in handy. She had pretty pudgy ankles (due to obesity, not pregnancy) that obscured any tuberosities or prominences, and a very curved foot. I had a quick press along the front of the tibia, and there were no depressions, abnormal movements or points of weakness (and no sudden screams from the head end!) and the same along the dorsum of the foot. We took the other shoe off to compare, and it seems she just had really tiny curved feet! I couldn't find any evidence of either fracture or dislocation, and Matt had a check of both ankles/feet on his secondary survey and found nothing either (he had the advantage of being able to ask her to flex/extend her ankles and wiggle her toes, which I couldn't do because she was busy answering his questions about head injuries!), so I was pretty pleased with myself on that count. I will add that I did explain that I was only a student before I did anything/said anything else.]

Matt's pretty sure we won't travel, given her stable condition and fairly minor injuries (given the mechanism of injury), so we cannulate. 1 grey stops at a valve, so he leaves that dangling while he gets another one in further up the dorsum of her hand. Some choice words from the patient to fill the back of the truck with blue air, but given that I can pass out at a tiny 22g needle, I don't blame her with two 14g's in her hand! I use my new ambulance skills to anticipate the alco-swab, saline flush, tegaderm, and dressing pad (for the failed cannulation attempt) - ok, small contribution, but it makes me feel useful. I get to hang the saline, too, if only because the para is about four inches shorter than me!

We negotiate an A&E destination, recommend a trauma call to the receiving team to be ready in case of any deterioration en route, and leave them to it. The fire truck and all but one police car have gone by now, having done their bit. The fire truck in particular hightailed it out of there as soon as the patient was out! The ambulance pulls away as we strip off gloves and gather ourselves together.

Time for a longer look at the scene, now the casualties are sorted. The skid marks on the road are obvious from the corner (opposite to the direction in which we arrived), swerving across the wet road. There's a gouge out of the tarmac with some scrapes of car paint that show exactly where it flipped (I never realised it could cut holes in the road!), and the flattened long grass at the roadside shows where it slid across, to land pretty squarely on it's roof, wedged in the ditch.

We head down into the ditch to have a closer look. The roof is squished in, down to about head-rest height I reckon (couldn't estimate properly as the seats had been fully reclined to get the patient out through the boot. She'd been suspended via seatbelt, but unclipped herself and tried to self-extricate, but not got far.), and quite crumpled. The back end is relatively unharmed, suggesting a front flip, rather than side. The back windscreen is way back towards the road and the front is attached round the edges, but fully splintered from ground contact. The side windows have all been shoved out too. Inside the vehicle, the dashboard is completely intact and appears undamaged. Blood patterns on the roof inner show dripping and dragging rather than any spurting (how CSI?!). Shoes and umbrellas are scattered underneath the car. Round the side, we find speaker casings, windscreen wipers, and the front grille (still with logo attached) scattered across the field for around 10 yards. The front of the car is tricky to see, with the bonnet and the ground keeping each other company. I have tons of photos of the wreckage (plus impromptu ones of Matt (also taking photos) and of the copper who came to put his 'Authorities Aware' sticker on the wreckage) - tis entirely legal to take photo's, so long as anything involving patients is fully consented first.

So, get the bags (completely unused, but soggy) back into the boot, get helmets packed away, and dry off with the in-car heating :) Then we headed up to the A&E where our patient had disappeared to. Rang R on the way to organise my lift home from the station, and that's when the shock hit. Partly cos he flipped his car a couple of years ago. I didn't even know him them, let along have seen the wreckage, but looking at that car in the ditch, I could only imagine how terrifying it must have been to flip over at speed... He came away with a fragment of windscreen in his knuckle, and a torn earlobe. Lucky sod :) I do believe I told him (on this phonecall) that he was never ever driving again. I calmed down over a cup of tea in a pub en-route (to give A&E time to assess our patient and get some scans/treatment organised) though.

Turned up at A&E (about 2100hrs by this point) and wandered round to resus, only to be accosted by a nurse and doctor. Ahem, is the entire fluoro jump suit (marked in huge letters with the words 'ANAESTHETIST', 'DOCTOR', 'BASICS', and 'LIVES') not clear enough? Plus, we knew the patients name, injuries, and location/type of accident. We'd hardly just wandered in off the streets.

Turns out they'd only just assessed her. We popped in to say hello anyway, and she was sufficiently compus mentis to recognise Matt ('that nasty doctor' - who was perfectly nice until he wanted to put big needles in!).

Got back to the main ambu station about forty minutes later and called up to check on her progress. Still not scanned, but at least the CT had been ordered by now.

I got a text at just gone midnight to confirm that she only had scalp lacs, and no skull fractures! All good news! A&E staff were suspecting a depressed skull fracture cos her head was pretty 'boggy' at the back, but turns out it can feel like that with scalp lacs because of the looseness of the aponeurosis and the way blood can fill that gap, outside of the skull. So she'll be in til today for observation, and possibly for O&G input to check on her baby, but at 8 weeks, with that amount of padding, I'm pretty sure s/he's just fine :)

All in all, I'm incredibly grateful for the day I spent with Matt. Even with only one call, I learnt a hell of a lot, and I haven't even seen him do anything outside of a paramedic remit yet!

The adrenaline rush of turning up on scene not knowing exactly what awaits you, while knowing that it must be serious seeing as we haven't been stood down en-route, is just.... immense.

I've already started putting out feelers for what I can do in pre-hospital care, even at this stage of my career. I can't wait to see what the future holds....

Bedtime!

Urgh. I was rudely awoken by an alarm clock at 6.30am (lots of rude awakenings recently. Don't people have manners? Don't people understand my need for sleep?!). Unfortunately, it was mine.

The MRI centre is 90 mins from my flat, on foot. Uphill. My toes are still bleeding. But I got a nice nap for 20 mins, with a cosy pillow, and some massive retro headphones. Great, aside from the CLUNK CLUNK CLUNK of some gigantic magnet spinning my protons (I think. A level Chem seems a long time ago). Fun, exciting new times anyway.

The other half finished his exams today, and (conditional to results) is now a second year! And promptly rang me to rub it in my face. Lovely man. Possibly our first functional phone call (yes, in over ten months of dating, 70% long distance, this is the first. Don't begrudge us our fights), with no awkward silences, no bickering about talking over each other, and it was a genuine 'I missed you and wanted to hear your voice' call, so aww *cute smushy face*

The 'after-MRI' bit of my day, like post-1030, has been... insignificant. Failed retail therapy - where have all the cool t shirts gone? Slogans, pictures, patterns? I already have a cupboard full of plain tops, dammit! Last time, I resorted to TopMan. My Grr shirt is my new favourite thing, ever.

I did come home with a ton of pick n mix sweets though, most of which got consumed instead of lunch, and left me in a hyperglycaemic haze until dinner. Which was great for my afternoon of anatomy revision. Aclands knowledge can be absorbed through the ears, bypassing the need for the mind to be switched on. My boyfriend agrees. And he's a psychologist, k?

Finally, expect death. All water outlets are being tested for Legionella this month. Suspiciously, 5 of my flatmates now have the early symptoms of Legionnaires.

Oh Library, why do you hurt me so?

I have spent eight hours locked in there already today. Stupid, stupid exams. Stupid, stupid dumb blondes who sat across the room from me all evening and whispered and giggled. How do you like Vanders, eh? Nice, eh? How do you like it shoved in that oversized food hole?

The only thing tougher than revision right now is writing a dumb cover letter for my CV, for a research project that I thought I'd already guaranteed my place on. How many times can you wax lyrical about molecular pathways in one side of A4? I'm aiming for a new world record.

Finally, MRI tomorrow morning. 9am, so no revision time wasted. Except for the fact that said hospital is not on any transport routes that I'm familiar with, and therefore is a 90 minute walk. I do not 7.30am. I like it even less when I'm outside in it.

I live in Halls. Hellhole Halls.

A Saturday fire alarm and a confiscated kitchen item should have been warning enough. Bad things do not come in twos.

Number three arrived at 4am. Grr, already.

Then add smashed windows, intruders, destruction of flat contents, and the calling of police and window-repair-men, and grr does not even partly cover it. Fortunately, it wasn't my flat, but it was 2 floors down, and with single glazing and very thin floors, it sounded like it was in my bedroom. And it was damn scary!

Cue much gossiping the next morning, considering only I and one other girl had the nerve to come out of our rooms to find out what was going on. Drunken psycho's, I believe was the conclusion...

Either way, the Ghetto has certainly told us why it deserves that nickname. Thank goodness for the new flat being in posh-trendy area :D

I love my boyfriend....

The day after Pre-Spain Drinkies (2), H and I were at the pub as normal. It sounds like I'm out every night painting the town red, but honestly, this was one crazy fortnight. It's not normal. I'm still recovering from sleep deprivation...

Anyway, H got a text from S saying he was coming to take us out, and had R with him. Cue H and I getting very excited, then horrified as we realised neither of us had perfume, make up, mints, hairbrush, etc.

I missed the look on J's face when R walked in. Apparently it was a mixture of jealousy and fury.

We went for a drink at 'our' bar, and then when we went to move on to a different bar, we realised that most places in town had shut. So we ignored the normal option (give up, go home) and instead did this.

Drove to Tesco to buy a DVD, wine, vodka, cherryade, cookies, Doritos, dip and Ben & Jerrys ice cream. Then drove to S's to watch the DVD while consuming everything else we'd bought. There's something surreal about eating Phish Food at 2am while watching Blades Of Glory.

But less surreal than realising its four am and that the sun's coming up. So we piled back in the car and drove. Drove for miles, out into the country, looking for somewhere to park to watch the sunrise. Aren't our men romantic?

We missed it. At least, we think we did. We were facing the wrong way, or behind trees, or just totally lost. It was a fun crazy road trip though. By this point it was five. Again, we could have called it a night then.

Nope. We headed over to H's, who lives practically surrounded by fields, grabbed a couple of blankets, and headed to the top of the nearest hill to watch the rest of the sunrise. We saw the first early morning blackbirds. We saw foxes frolicking across the meadows. A sparrowhawk circling the dewy fields. Rabbits leaping from grassy tussock to tussock. And a snail, who tried to invade our blanket. He went for a short flight.

It was so incredibly romantic, to be laying on a blanket watching the dawn chorus with R laying next to me. H and S were a short distance away, supposedly out of sight (although from what S said to me later on msn, he saw plenty of me and R). There's a fantastic video on R's phone of S and H wandering across the field in opposite directions to find bushes to pee in, and then you can hear R and I talking, and then a scream (from me) when S creeps up and puts the snail on R's head. But it captures that morning perfectly. The four of us hanging out companionably, yet having a lovely time with our other halves.

I saw R again the next afternoon (well, I guess it was that afternoon really). He'd had no sleep, having left H's at half six to be at work for seven, whereas H and I had crashed out on her sofa for a few hours. I went to decorate the house. Painting while hungover and sleep deprived is not generally a good idea. L found it entertaining anyway.

And I met R's mum for the second time. I met both his parents the first day I helped out with the house. His mum had turned up while we were wandering in from the garden, arms round each other, and although I wasn't introduced as the girlfriend, it was certainly implied. His Dad may have not immediately approved of me because at the time he appeared I was splattered with paint, as was R. Not much paint had made it onto the walls.

But his mum definitely likes me. Possibly because while R was arguing with her about something, I ignored him and started washing down the brickwork on the front of the house, which she'd been on at him to do for ages. See Mrs R, I'll be the perfect daughter in law. Did I really just say that? Argh.

Basically its all going fabulously. I was round at the caravan last Saturday (because the house is as yet not habitable) and hung out with R and L for a few hours. R and I went for a walk round the village, and then when we got back he asked me out :)

Then we broke up half an hour later.

It wasn't my fault! Much...

L and I were joking about how R was clearly second best because I'd got with S just weeks before. Then I was kidding about, saying R and I were only sharing in Spain because it was either that or two other lads.

R got majorly oversensitive about it. And broke up with me. Mardy arse.

So we both sulked for half an hour or so, while I sat under L's duvet on one sofa and R sat under his duvet on the other. Then much sweet apologising and kissing and making up followed. Which meant he had to ask me out again. Haha.

I am falling in love with R so fast it's unreal. He's the first thing I think of when I wake up, and I don't go to bed without texting him first to say good night. He does the same. The background on his phone is a picture of me on our last date, mucking around wearing a roman helmet at the museum. His profile pic on FB and msn is of the two of us out for a drink. I can't go more than a few days without seeing him. He blew off his man-date with S to hang out with me tonight so we don't spend the entire weekend apart.

We're quite coupley. He feeds me jaffa cakes. I change the settings on his phone. He lets me pack my excess baggage in his suitcase for Spain. I talk about him non-stop at work. His friends know everything about me. I refer to him as 'the boyfriend'. When we're together we're always touching, holding hands, hugging, kissing.

I love how we can go from a really romantic kiss to wrestling on the floor, from holding each other close to tickling, hand-holding to thumb-wars. We just click. He doesn't mind me going off on random tangents in the middle of conversations, whether its about umbrellas or some crazy idea for winning the apprentice. He mocks me for everything, but is quick to say sorry and kiss me if he oversteps the mark.

We have the nuttiest conversations about everything. Tinkerbelle wings on humans, stealing roadsigns, hats, just random crazy ideas about nothing. Occasionally now I'll make a comment when I'm talking to another friend and they'll look at me as if I'm cuckoo, and I have to remember that not everyone understands the conversations R and I have.

I don't care. This is my own little world, and right now it has R in it. I'm trying to be oblivious to the fact that this ends in September, that I wouldn't trust him being so far away and that I wouldn't cope with being away from him for so long. I know we're only been together officially for 6 days, but I can't stop myself.

I want to copy that scene from A Walk To Remember. When she says 'Promise me you won't fall in love with me'....

Officially the other half of R

Ok, so much has happened since I last managed to scribble anything down here that I'm a little lost myself. The basics are that R and I are now officially an item. As are H and S. Where would life be without Facebook's relationship status'?

I've lost track of how many times I've seen R. There was the pub/bowling night, which was pretty amazing. Stunningly amazing. Dinner at the pub was alright. I met his friend and housemate L, and we got on like a house on fire.
Then R, L, H, HW, and I went bowling. A bit of competitive banter between me and R, and L, and then we all got thrashed by L. Although he later described me as a 'worthy opponent'. Love it....
What happened after we left the bowling alley was just... surreal. I'd spent the evening being mocked for never having seen classic Disney, so we got out to the car park and R put his car stereo on, and puts 'Under The Sea' on. Somehow, over the next hour, the five of us ended up dancing in the moonlight, in this empty car park, to Disney tunes, and oldies Queen songs, and some funky S Club.

The following weekend I somehow managed to get roped into decorating. I'm not arty. I'm not even co-ordinated. Yet R and L willingly handed me a paint brush and let me loose on their new house. Muppets....

Another reason that R is totally amazing: he made me conquer my fear of heights.

He put the ladder up and then told me to climb up, while holding it secure. Oh, I should also mention that this ladder was positioned ON THE STAIRS, so I was as far from the floor as was humanly possible.

I was stood at the top of this ladder, holding tightly onto it with one hand, and gingerly painting with the other, when I turned slowly to ask for more paint to realise that R was just sat in the hallway, watching me. Not holding the ladder. Needless to say he ended up with a considerable stripe of paint down him for that.

But after that, I was up and down the ladder like a little painty monkey, standing backwards on the top rung and leaning out across the stairway to paint the whole hallway. A kind of Van Gogh - Tarzan hybrid, if you will. With two ears....

Then the following night was Double Date II. S was finally back from the wilds of the Lake District, so the four of us went for dinner. H and I displayed our wonderful lack of punctuality by only being half ready when the guys showed up at H's to pick us up, so guess which muppet had to wander downstairs sans make up with damp hair to open the door?

I got home at 3am the following morning, with the massivest grin plastered across my face.

Dinner at a lovely italian restuarant (paid for entirely by the men) was followed by drinks at what has now become 'our' bar. We played some pool, had a few drinks (supposedly paid for by us girlies, but I don't think it worked out like that), and the two couples had a little kiss n cuddle on their respective ends of the sofa.

Then we headed back to S's. I'd asked R a few days beforehand if I could borrow a DVD; namely Enchanted. Yes, the Disney one with Patrick Dempsey in it. Yep, R owns that. And knows all the words to the songs. So he'd brought it with him, and we all piled into S's front room to watch it, with some rose that S had nabbed from H's bbq the week before....

Driving home as the sun rose was kinda cool. I missed most of it. I was half asleep, stretched out across the back of the car with my head on R's chest and his arm round me. S was doing his normal 'I am a cop and therefore shall drive as if on blues n twos' driving, and R asked him to slow down, and then told him off for driving round corners too sharply cos I was asleep! Sweet... And then when we got to mine he had to wake me up. I would have resorted to poking, if not tickling. R didn't. Lovely, sweet R.

That night (being the same day that I'd got home at 3am) the four of us met up AGAIN, for Pre-Spain Drinkies, as it's now popularly known. Plus M, M's new whore, RF, and L. No, L and M's W aren't coming to Spain, but we felt like being inclusive. Especially cos some of the real crew couldn't make it.

S was doing all the introductions, because none of us knew M's W, and he introduced me as R's other half :)

And then nearly a week later R finally asked me out....

Making up for a lifetime of singledom

Jelly still has the massivest grin pasted across her face.

Not only was the double date absolutely fabulous, but R is still texting me as frequently as ever, and there has been another date since.

We took H along with us, cos originally it was gonna be a group night out, and then one by one everyone bailed, so we went to play pool and then H buggered off home about half way through the night.

Which was nice timing, actually, considering that R and I were just at the hand-holding, sitting-very-close-together, mushy-early-romance point then.

So we had half a night hanging out with just the two of us, and I think we managed it alright. Not too many silences, and any silences you do have while curled up on a window seat together don't tend to be too awkward anyway...

Finally I drove him home and we then proceeded to spend a further half hour parked on his driveway getting further aquainted. Fortunately his housemates were out...

I don't think anything can beat the first kiss moment, but a seriously amazingly second date kiss was alright by me. And the car still smells of him. It's all I can do not to inhale deeply every time I get in it now.

Oh, and Double Date II is already in the diaries for next weekend. S is away this week, so I have to put up with a mopey H while trying not to waffle on about how unbelievably lovely R is, especially since I promised I wouldn't put her in the 'friend-in-the-middle' position.

K knows about R and I. It isn't gonna be pretty when we next meet. Bring it on, girlfriend. He's mine... :D

Jelly and R, sitting in a tree...

I cannot wipe the grin off my face.

The most amazing, weirdest double date occurred last night. H, S, R and I went for a drink. Somehow in a few hours it morphed from a planned Pre-Spain drinkies event into a seriously mushy sweet date.

So... several wires have been uncrossed, and even more tangled.

S is with H. I am with R. Everything is looking fabulous.

Reflections... ...snoitcelfeR

I'm starting to seriously question whether I can cope with Medicine. I don't think I'll have issues with it intellectually. In fact, I cannot wait to start with the textbooks and labs and research journals...

But I do worry about coping emotionally.

I've been a volunteer on a medical ward at my local hospital for fourteen months. I love most of the staff, and occasionally I enjoy the afternoons I spend there. I'll admit that I relish the afternoons when the F1 on call adopts me and lets me shadow for a few hours (last time, I got to listen to aortic regurgitation! Whoosh! Whoosh!). Mostly I clean stuff, and tidy up, and run the odd errand. Mostly to send sample off to the lab, or fetch stuff from other wards, or, on special occasions, to get ABG results (I got to use the machine myself! I think the bloke who demonstrated it thought I was just a dumb doctor, rather than clueless volunteer), etc.

There is the occasional shift where I come home emotionally drained.

Memories of spending hours with a chap who had advanced Parkinsons, trying to persuade him to stay in his chair. He was so strong that once he was stood, I was powerless to stop him, so it was a case of prevention by distraction. I can still see him turning slowly around the centre of the ward, dancing with his wife.

A succession of shifts doing one-on-one work with a bloke in his 50's who'd had a stroke. He was physically fine, just prone to confusion and wandering. I used to sit in his side-room with him and read Heat magazine, or play draughts, or chess. We'd sit for hours and listen to the music chart on the radio. I'd mock him gently for wearing his trackie bottoms half-way down his bottom like some young chav.

And today.

I heard the yells and screams from the staffroom, where I'd escaped to in order to text R (and S - we haven't been for that coffee yet). I could also hear moo-ing. I returned to the ward to find an exasperated bank nurse. She had a distressed old dear in pain from terminal cancer that was refusing to calm down.

I spent the following two hours sat with this woman, holding her papery thin hand, stroking the velvet skin, softly in fear of tearing open the fragile veins. Telling her everything was ok; telling her that she needed to stay in bed to gather her energy; telling her that the nurses were looking after her, doing their best to get her well again.

I could see the tumours. A massive swollen abdomen, like a full-term pregnancy. A mass the size of her head protuding from her chest. Every so often she would shift, writhing from the pain in her bones, riddled with metastases.

She refused her tablets. Refused the soluble paracetamol I proffered. And sobbed. Cried. Dry tears, with a desperate plea in old eyes. Help me. Let me go. Let me die. And begging, in a low mutter 'I give up. Let me die. I just want to go. Let me give up. Let me die. Help me. You're a volunteer. Help me with this please. Just help me die.'

She'd spent the early afternoon telling every other member of staff to go away. Only once did I get told to leave, and that was when, against my better judgement, I was trying to get her to drink the paracetamol while the nurse gave her a Clexane injection. Every offer of tablets, painkillers, insulin; all met with a polite, but firm 'No thank you.'

She drifted in and out of sleep by the end of my shift. I sat by the bed, one hand gently clasping hers, my smooth tanned skin against her wrinkled bruised. Her eyes, once bright with sparkle, were dull, half-closed. I read, analysing an article that a nursing student friend had had published recently in a prestigious journal. I was thinking of my future, of a career in medicine. She was thinking of the past. She has no future.

One thing she said will stick with me for a long time. 'You don't know what it's like to be like this'.

She's right. I never want to experience the pain of metastatic cancer. I don't want to pass away in pain. I don't want to be so alone at the end that a volunteer sits with me.

But, when I get to that point, I want to be that defiant. I want to be as polite, yet firm. I want to wind the nurses up, yet be the type of person that they still care about even after their shift ends.

I don't know if I want to die on my terms. It got me thinking about euthanasia, and I don't want to go into it here, because I will just go round and round in circles, but how is it fair that I can walk out of here because of a petty argument and kill myself if I want to, yet a lady who has lived her whole life and wants to end the pain that she's in, can't?

I left her asleep, calm. Serene, compared to how I'd met her earlier. The nurses thanked me. I wanted to thank her, for letting me in, allowing me to see beyond 'death by cancer' and learn.

It's still haunting my mind. There is no way of walking out of the hospital doors, leaving everything there. I bring that emotional baggage home.

How do I cope with this? Will this get easier to deal with? I don't want to end up as an emotionless drone just to save myself from falling too deep into the lives of my patients. Is it humanly possible to emotionally connect with another human being and then walk away unattached?

I don't want to lose myself in the emotional trauma of the job, though...