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  1. Phil-on-a-bike

    Friday August 31, 2018

    Morning all!Crisis time here! One of the RNs in clinical haematology has a major birthday and mixed messages were sent about who was arranging cake. Everybody seems to have assumed they were on cake detail, so there's a basically a mountain of Sponge. Obviously, I'm helping out as best I can with that.Catching up with everybody's news...Tweety, you've reminded me - I should look at my online competencies. The list gets longer every year. Feel your dilemma re. your doctor. My GP surgery used to be a father-&-son partnership - now they're part of a group and it just seems to be a revolving door of locums. Fortunately I haven't needed to use then for anything other than routine check-ups.Nel, the bookclub mention reminded me of something I've noticed - we all seem to be readers here. Always a good sign, I reckon.Ted, I had zero time for musicals. Just left me cold. (and if I'm honest, I was a bit snobby about them.) But my better half prevailed on me to come along and see 'Chicago' with her, and I thought it was just great entertainment. High-fives to NSIME & Dianah for pulling extra duty. I reckon there's still a public perception of nursing as one of those professions in which people are willing to go the extra mile. Whenever we have to stay late I think of it as giving that reputation a little polish. (I find that's a more positive way to think of it, as opposed to; "surprise surprise, dumped on again")It's a pile of admin to chew through for me this afternoon, and then out for a beer after work.Enjoy the weekend!
  2. Phil-on-a-bike

    Tuesday August 28, 2018

    Afternoon all! Sudden case of "Prize Racehorse Syndrome" today. Participant on an early-phase drug trial reported new symptoms, so we drop everything and investigate the heck out of it. Thankfully, everything turns out to be innocuous, but we have to be able to present evidence of thorough investigation to the sponsor within 24 hrs. (I always liken these situations to your prize racehorse developing a limp the day before the Derby - there's a lot riding on these early-phase participants, and we watch them very carefully.) Then we've got a bit of Byzantine politics - one of the clinical teams has had an Expression of Interest about a study which involves giving out questionnaires, and comes with some funding. With a bit of opportunism, they reckon "forget letting research know... we'll do it ourselves, and the funding goes to our department". This sometimes happens when a clinical team gets a sniff of research funding and think it's essentiall 'free money'. Fine by me. Obviously, the research team will take the study through the set-up process, arrange contracts, submit it for ethical approval, author all in-house documentation, host the site file, and archive the project when it's done. No, don't thank me... least we could do. After which, we shall submit an interdepartmental recharge to cover the cost of the aforementioned. I have the strangest feeling that said cost is going to end up being exactly what the study funding fees are! Coincidence or what? Like I say... this sometimes happens when a clinical team gets a sniff of research funding. I like to make sure it doesn't happen twice! Tweety, I LOVE bowling! Not that I'm any good at it - as long as I'm not worst player of the evening, I'm happy. Had to chuckle at your pooch's digestive misadventures. Dogs are just built for mischief! While we're on the subject - J22, your trusty terrier looks SO sceptical in your avatar pic! Whatever story you're telling him - he's not buying it! Herring, we're in English plum season here. We get South African plums and Spanish Santa Rosa plums year-round, but our native damsons, Victoria plums and greengages have a short late-summer season. They're sensational. Day two of operation 'leftover ingredients' - bag of arborio rice (about as old as I am) and some random herbs and seasoning was turned into a veggie risotto. Not half bad, either. Have a nice evening, all!
  3. Phil-on-a-bike

    Monday, 8/27/18

    Ouch! Reminds me of that punchline: "On Monday... it's your turn in the barrel." FWIW, it seems both situations turned out about as well as could be expected, given the circumstances. Something I'm profoundly grateful for is that research is a speciality in which the only patients you need deal with are the ones who want to help. The obnoxious and malcontent tend to self-exclude immediately by declining to participate. (Thanks, chumps - you just gave me a free pass on having to put up with your buffoonery.) I have done my time, though - I started out in Accident & Emergency. It was like every shift had to contain a statutory quota of knuckle-draggers and tinfoil hat wearers. It's a bank holiday weekend here in the UK. We've been for a pub lunch at "The Cosy Dove" (steak-&-ale pie with fat chips for me, a falling-off-the-bone lamb shank for herself) Then some retail therapy, and now I'm watching Charlton Heston being epic in his 1972 vanity-project version of Shakespeare's 'Anthony & Cleopatra'. I cleared out the kitchen cupboards yesterday in a merciless massacre of out-of-code ingredients, so this week's dinners will consist of 'ingredients that need to be used up, sharpish'. There's a makeshift curry in the slow cooker right now, to get things started. Afternoon, all!
  4. Morning all! Back in harness after a packed day at the Edinburgh Fringe festival. I took the scenic route to Edinburgh, past Otterburn battlefield and through the Redesdale forest. Very scenic, all mist-shrouded hills and farmland. Then crossed the border and encountered Scotland's premier revenue-generating industry: the speed camera. Literally every few miles - what an absolute pain. I'm about 90% sure I wont be getting an official envelope with a Scots postmark. (The honeymoon's over for speed cameras in England - south of the border, they're few and far between.) Edinburgh is absolutely buzzing for both the International Arts Festival and it's accompanying 'Fringe'. There are street performers everywhere, flags and bunting, and everybody seems to be having a blast. We picked up our tickets from the festival office - girl behind the counter read out the events I'd pre-booked and asked if that was right. I looked back deadpan and told her she'd just blown the whole day's surprises. She was mortified! Fortunately, my better half had been reading posters, rather than listening to the transaction - the element of surprise was maintained! We got our map of the venues, and over a leisurely brunch I found and marked all our event locations - all our venues were within a 1.5km radius. (Which is a somewhat anally-retentive way of telling you it was all within easy walking distance! First stop: Japanese traditional dancing. Herself's a huge dance fan, so I thought we'd start with something right up her street. The show was composed of several dance pieces - some traditional, some newly commissioned - based on the customs and history of rural Akita. There was a 400-year old katana-wielding victory dance, some new pieces based on a famous painting of the local peasantry's preparations for winter, and an interval with sake and local smoked pickles. Then there was a short film explaining the tradition of the Namahage - grotesquely masked and costumed demon figures which visit each house, roaring and stamping, to check for "crybabies and lazy, bad behaviour persons". These hulking figures were rampaging about, while the younger infants of the houses were bawling in terror. The adults think it's healthy for the kids to get a good scare, and happily hold their panic-stricken offspring up to the Namahage (who are eventually placated by sake, before moving on to the next house.) I thoroughly approved, but I'm a monster. That was followed by a Namahage dance, obviously. The dancing was very impressive - the movements so perfectly controlled - and was accompanied by traditional Japanese instrumentation which segued seamlessly but surprisingly into big, brassy, Lalo Schiffrin-style jazz during a couple of the modern pieces. Next we went to a one-man show called "Eric's Tales of the Sea". (I chose it on the title, because herself is Anglo-Swedish, and has several relatives called 'Eric', who were sailors!) It turned out to be the reminiscences of a retired submariner. The venue was one of Edinburgh's famous vaults, and the arched room was made to suggest a sub's interior, with black panelling, red lighting and sonar 'pings'. At first, the show was a likeable mix of rough-and-ready naval humour and touching comradeship... then the mood changed to almost unbearable tension as Eric recounted the horrifying story of an emergency escape drill from a sub 603-feet down, which turned into a genuine emergency. The whole audience were holding their breath! I'd booked a show called 'The Artist' next. The show used a mixture of mime, prop comedy, dance and acrobatics, to depict a struggling artist trying to paint a picture. He was sabotaged at every turn by comically uncooperative everyday objects, and by his own tendency for distraction. It wasn't what I expected (it was listed under 'dance'), but it was really inventive and entertaining. My favourite moment was the bored artist repurposing his 'still life' bowl of fruit as a banana nightclub, with a determined pear trying to evade the banana doorman to gain entry. Inspired lunacy! What I really liked about this show was how universal it was - you could have an audience of all ages, who needn't understand a word of english, and they'd all be entertained. "Dollywould" next: two wildly obsessive Dolly Parton fans tell their idol's life story (conflated with the life story of Dolly the cloned sheep, who was named after Dolly Parton.) and the story of their pilgrimage to Dollywood (conflated with the story of their visit to the neighbouring Tennessee Body Farm, where research into human decomposition is carried out.) It's punctuated with Dolly's greatest hits, and - I swear I did not know this when I booked - much of it is performed topless! It was.... different. Tuneful, of course - infectiously celebratory - subversive in an affectionate (and refreshingly non-snarky) way - but good gracious, so much jiggling. Lastly: "Garry Starr performs Everything". The premise of the show is that failed actor Garry Starr has been dumped by the Royal Shakespeare Company. They think he's a complete train wreck - he thinks he's an unappreciated theatrical genius. The audience is invited to watch Starr vindicate himself by single-handedly performing every known genre of theatre. To some extent, it went for easy targets - Shakespeare's long-winded, Pinter employs pauses, ballet involves prancing about. But the show's fast-moving, so nothing outstays its welcome, and Starr has that thing of 'having to be really good at something, in order to be able to do it comedically badly'. Some cringe-inducing audience participation aspects made the front row a very dangerous location. We were there. I did things. I don't want to talk about it. My pick of the street performers were some tremendous Flamenco musicians from Granada. If I'd done anything differently - more of the same, to be honest. Stayed over and done two days of shows! After that lot, I couldn't be bothered playing speed-camera hide and seek in the dark, so it was home via the A-roads. (Still plenty of speed cameras on the Scots side of the border, but way easier to spot on a straight, well-lit road.) There you go - Fringe in a day! It can be done, but I would have appreciated a nice long lie-in this morning...
  5. Phil-on-a-bike


    Evening all! I spent this morning in the darkroom, playing with light-sensitive samples. Came out blinking and asking people what year it was. This afternoon - a loaded conversation with my departmental lead that's been in the offing for a while: why haven't I applied for a departmental lead role? Bottom line? It's just not an attractive deal right now, and I said so. Recent reorganisation has left the departmental leads doing what was, until recently, two people's job. And the salary step-up doesn't reflect that workload, or the hassle. But... you still have to show willing, and mean it. Just because it's ultimately a state organisation doesn't mean I get to put it in neutral and just mark time. Especially in the research directorate, there's a culture of moving forward and being able to demonstrate a commitment to CPD. So I pointed out how I was extending my role and contributing to the directorate with my teaching role, taking PI duties on low-intensity studies, and my departmental link roles (Moving & Handling, Advanced Life Support, Aseptic Technique certifier) . I think I blew my own trumpet fairly well. I also had to make it not sound like I was a world-weary self-server making excuses for shirking career-progression. Not so sure I was 100% convincing on that score.... But enough of this - what's been going on? Nel, it occurs to me I've been to Boston four times, and never set foot outside the airport. It does sound like I've missed out. Also, I'm trying to imagine what a miffed horse looks like. A miffed horse looking very pointedly at a clock. (I think my horse expression-reading probably needs work.) Joe, mate, you sound like you've got the exercise thing nailed. I'm quite envious of the ability to make it a regular habit - I tend to go crazy then let things slide! Ted, I LOVE a binge-watch! It's so immersive! And it's not often I get the time to do it, so it's a real treat. Tweety, there was a lot about US cuisine I really enjoyed. Barbecue and chilli are elevated to fine arts there - and I love how competitive people get about who does it best! (Grits, though... grits are vile. That's post-apocalyptic survival rations, that is.) Herring, thank you for that song! The only thing I've heard that's in the same ballpark would be the soundtrack to "O Brother, Where Art Thou?"... which I went straight out and bought after seeing the movie. Why does nobody break into a yodel mid-song anymore? And I second NSIME's props re. your homeless acquaintance. Being a friend to someone in those circumstances is just thoroughly decent. NSIME, I'm glad you're seeing the light at the end of the tunnel with the whole social security business. Dealing with bureaucracy always makes me think my axe-wielding heathen ancestors had the right idea about how to get things settled! Dianah - thanks a BUNCH. I will never be able hear a song about a horse again without mentally picturing a 'soiled dove' in place of said equine. (You've been across the desert on a WHAT with no name? There never was a WHAT like the Tennessee stud, now?) Right - off to my well-earned slumber, and Edinburgh in the morning!
  6. Phil-on-a-bike

    Monday August 20 2018

    Just caught up with everybody's weekend... you lot make me look very idle in comparison! Ted - I haven't watched 'Bosch', but I rate the lead actor, Titus Welliver. One of those guys who - back in the day - would be 'villain of the week' in a bunch of cop shows. (Ed Lauter, anyone? Brion James, Robert Tessier, John Vernon, Albert Popwell...) The good thing about having a gajillion channels now is those 'second-string' guys are getting decent roles. Long-time 'thug No.2' bit-part actor Jonathan Banks was just brilliant in 'Breaking Bad'. Tweety: I'm giving away national secrets here, but if you compare a list of places with enviable cuisine; and a list of places Britain invaded... I mean, France, India, China... its almost as if we were in search of better grub! 'Mushy peas' are delicious! Peas coarsely mashed, seasoned with mint and served as a side with fish 'n chips. The charge role thing... really feel you there. I long came to the conclusion that I'm only any good at 'leading' people who are already pulling in the right direction. I do not have the patience to spend time or effort trying to turn malcontents around. Also... I kind of resent it. I manage to turn up every day and behave in a professional manner. But these muppets need management input just to get them to behave like grown-ups?! Unbelievable. Nel - tipping? Aaaargh! Kryptonite to the British! We don't know the rules and we feel embarrassed asking! Taxis, barbers, restaurants. That's pretty much it. Back-of-house staff? Stroll on mate, you're having a giraffe. (Rhyming slang: giraffe = laugh.) BC - I miss peach-picking in Georgia. Top communal day out in the sun, and then for weeks afterwards people keep giving you pie and cobbler. I'm too polite to refuse! We do pick-your-own farmed strawberries and raspberries here, and blackberries grow wild. I do like a morning berrying. Now I'm inspired to be more productive at the weekend... an urge which will last right up until the moment I hit 'snooze' on Saturday morning!
  7. Phil-on-a-bike

    Monday August 20 2018

    Morning! Once again a weekend of rampant debauchery... failed to occur. I'll never get in the tabloids at this rate. The vagaries of annual leave and part-time schedules have left me on my own today - This morning's clinic was hectic, with both new potential participants, and participants in ongoing studies who were due a follow-up. I caught 8 out of 9 on my list - one of my follow-ups attended and left while I was consenting a new participant. Then had to beat the clock to get samples away, and now I'm enjoying lunch before heading back to clinic for the paediatric haematology clinic - just one follow-up on the clinic list, though, so I'll have plenty of time to write up this morning's activity. The other thing I've got to take care of today is renewing my passport. Fewer and fewer places physically stamp your passport these days, and my current passport has a fine crop of proper old-school ink stamps - Cuba, Iceland, Indonesia, Ukraine... and I'll have to swap it for a blank one like it's my first time out of the village. Tch. I haven't caught up with the weekend diary yet - I'll give it a read this evening. Be happy!
  8. Phil-on-a-bike

    Friday August 17, 2018

    Well, there's no danger of any weight loss in this neck of the woods this evening - we're off to Solomon's tandoori for a curry big enough to drown a yak and hot enough to cook it. (Lemon pilau and a garlic naan on the side!)
  9. Phil-on-a-bike

    Friday August 17, 2018

    It's a great little study, Ted: it's one of our own 'in-house' projects by two NHS clinicians - a pharmacologist & a gerontologist. Their premise is that there needs to be more specific data on the absorption and metabolisation of Direct-acting Oral Anticoagulants in the over-65's. We screen medical admissions, cardiology and CotE units online for anyone over 65 who's on a DOAC - take trough citrated samples for clotting studies pre-dose - then take a series of precisely timed samples post-dose. We love this study for many reasons - the one-time-only intervention makes it an 'easy sell', so over 90% of patients approached sign up. The fact that we're out and about on many different wards is great for raising the team profile and letting the ward teams know which other studies we're running and what inclusion criteria we're looking for. That always bumps recruitment to our other studies! Because we're running it start-to-finish in-house, it's great for taking students and new staff right the way through the study procedure. It carries university funding - always good to be bringing money in to the NHS. And it involves a bit of lab work, which I really enjoy. The only fly in the ointment is a feature of the study design - they want equal numbers of participants on each DOAC. What that means is the cohorts on the more commonly-used meds are going to reach their targets and close very soon, while the cohorts on the less-frequently used meds crawl very slowly towards their total.
  10. Phil-on-a-bike

    Friday August 17, 2018

    Morning All! My elusive 'frequent flyer' CHANGED HIS MIND overnight about study participation! I had everything lined up and ready to go! We're up to 88 participants on this trial - precisely TWO have withdrawn. Still burns! Had to write a gracious and tactful withdrawal letter, studiously avoiding the phrase "WHYYYY? WHY ARE YOU DOING THIS TO MY LOVELY STUDY?" Which accurately reflected my feelings, but which may not look so good in the medical notes. Tweety, the tech situation sounds exasperating. (Actually, my first choice of words was somewhat crude. So was my second. I worked through various downright vulgar options and eventually settled on 'exasperating') Keep your powder dry... in my experience people of that ilk tend to hang themselves if given enough rope. And in the meantime: may their next bowel movements be hedgehogs. Nel, yesterday's infiltrated IV line is a worrying reminder for me. We've got an infusion-centred drug trial starting soon, and it's nearly a year since I inserted cannulae on a regular basis. I badly need practice... definitely one of those skills you've got to use or lose! BC, I booked parachute lessons last year - got my medical done - first session cancelled due to bad weather. Tried to rearrange - same story. I gave up. This summer's been glorious, but the idea of following up on the whole parachuting thing had slipped my mind 'til now! In other news... Her Majesty the Queen's homeopathist has been run over by a truck. Am I bad for thinking that if only somebody had quickly dipped a ' Hot Wheels' in a glass of water, maybe he could have been saved? Enjoy the weekend, all!
  11. Phil-on-a-bike

    Thursday August 16, 2018

    Evening all! Digging for data today, w-a-y back in patient's histories. I do like a bit of detective work! I've had to chase 20-yr old blood results from a hospital in India before - today's trawling wasn't in that league! I also managed to pounce on a 'frequent flyer' who we've been after for a while. He's right for one of our studies, but the moment he's admitted, he starts agitating to go home, so he's either gone or awaiting transport home by the time we get to him. This time's no exception - his ambulance home is booked for lunchtime tomorrow... but he's agreed to participate in our study in the morning! Tweety, I've done years of bank (pool) and agency work... I loved almost everything about it, EXCEPT waiting to see if you'd be called in or not! I hadn't heard of Randy Rainbow - I'll have to give him a listen, because I'm a big fan of live comedy. My current favourite US stand-up is Reginald D. Hunter. It's the deadpan delivery. I like Rich Hall, too... he just does bitter, hangdog, hard-done-by so well. The abortive early post is down to Harriet the Rescue Kitty. She's assertive about the head rubs and brooks no refusal! Edited to add: Aretha Franklin.... WHAT a voice! One of the all-time greats, for my money. Be happy!
  12. Phil-on-a-bike

    Wednesday August 15, 2018

    Whoah.... the "like" button seems insufficient! (Despite it being so close, my visits to France have been of the stereotypical "day trip to Calais" variety.) Your trip, however, was Travelling Done Right. Thanks for sharing that!
  13. Phil-on-a-bike

    Wednesday August 15, 2018

    Edited to add: Crosspost! Morning, Joe! oh... okay... that was a new comment box, NOT the 'editing' textbox? Meh, I can live with it.
  14. Phil-on-a-bike

    Wednesday August 15, 2018

    Morning! Your diet sounds enviably healthy, Tweety. My lunch is usually a pre-packed sandwich from one of the hospital's shops. I go through phases of preparing home-made salads, but it doesn't last! Busy clinic this morning with loads of potentials for our Biobank study. I despatched my colleagues to round 'em up, which was absolutely the right use of the team skill-mix, but it burned because I LOVE SIGNING PEOPLE UP FOR STUDIES! It's my favourite part of the job. Cold approach to a new patient, and you've got just a couple of minutes to make a good impression, explain a quite technical and involved trial without putting them off, answer any questions accurately and reassuringly, and leave them with the participation info material, knowing that you sold it and they're going to sign up. Anyway, low-intervention studies like biobanks get high recruitment numbers, which makes everybody look good. Meanwhile, I've been playing with dry ice, getting the processed samples from Monday's more intensive study visit off to central labs in Europe. I like a bit of lab work - my role involves just enough of it so it doesn't become a chore. Be happy!
  15. Phil-on-a-bike

    Tuesday August 14, 2018

    Evening all! I spent the morning getting certified to cascade-train in respiratory equipment use. (A little left-field for my clinical role, but since research teams are small, those of us with teaching qualifications tend to provide training for staff right across the directorate.) Then tidying up somebody else's mess... The research teams support a lot of PhD study projects from students at our affiliated university. These are clinicians & biomed scientists taking baby-steps in research, and their attention to detail is... variable. I have to put a retrospective polish on two - mercifully modest - PhD studies which were very sketchily documented at the time. By the time they go to archiving, every 'i' has to be dotted and every 't' crossed. Y'know... like it should have been at the time? Early finish and straight to the dentist - £21 for X-rays, scale & polish. (It's an NHS dentist, but there's a nominal charge if you're a wage-earner with no ongoing conditions.) And then our regular salsa lesson, during which I was just plain embarrassingly flat-footed. I'm mortified thinking about it. Hold the front page, though... there's a horse called "Justice" ? The fearless courtroom avenger with the velvety muzzle! Not only should he win, but he should get his own 'Law and Order " style tv show. I'd watch the heck out of that. (Although I could probably manage quite nicely without ever hearing the phrase 'prolapsed penis' again.) Have a nice evening, all!