Solitaire

So this is how it ends. Two years of living alone. All those adaptation (and maladaptations) that have enabled a single, simple existence now face a whole assortment of adjustments.
At this dusky hour on a Saturday in the dying weeks of a summer that once held so much promise I begin to reflect on how things are going. Where paths have crossed and doubled over; how the endless longings and earnest yearnings have transmutated into something I can't recognise. Something I would perhaps rather not recognise.

We are told that life is not a race - but we're sprinting ahead. Perspectives are muddled. The finish line gets blurred into the horizon. Angst and anxiety replace suffering. The umbrella of Weltschmerz shades us from the glare of our own sad reflections that threaten to expose us to the reality outside - the reality of those who truly suffer while we coccoon ourselves inside our fragile shells and worry about tomorrow's worries.

My prayer is for humility. In large doses. Enough to ensure that pride and recklessness don't overcome my feeble, fickle mind. Difficult. Very difficult.

Kaleidoscopic remembrance

Sometimes we feel scared. Sometimes life throws us a curve-ball that smacks us in the forehead without reason or warning. In the few seconds between perception and action we stand - our legs bridging that chasm - spanning deep thought and rapid reflex. What do we do at the crossroads? Which way do we turn?
Each strange experience seems to make me 'level up' - to put on that outer suit of armour and block the blows that would otherwise be my due. The danger is, however, that I'll get so used to the emotional distance and eventually forget how to feel...or even care.
Often, I wonder - why? There are so many reasons - answers, theories, explanations - for the 'ultimate question' - what is it all for? From the religious to the philosophical, the scientific to the whimsical, the utilitarian, nihilistic, spiritual or even the response 'who cares' - the answers just burn more questions in the mind of those who ask.
What is your favourite memory? Memory is a sure reflection of ourselves - our past and our perceptions of that past. The objective and subjective are blended into a foggy mist that settles into the clear picture we insist is the absolute glimmer of perfect remembrance. Memory is a fragile, beautiful thing - a shimmering constellation of sounds, images, smells, tastes and feelings. The image of perfection through the lens of life.

Lies and deception.

http://www.medical-student.co.uk/issues/current/files/May2006.pdf
Pages 1 and 7.

Nothing left, nothing right.

I am questioning my calling, waiting and watching, simply wondering what went wrong. Where did all the time go, how did I fall so low, staring at the past while the present fades away? Give me a second chance - just another day so that I can try to find my way home.
Subliminal messages are lost on me; I'm not sure I can 'read' people very well. It's only day two and I'm feeling the strain.
Plug on, plod on, take the strain, bear the yoke, feel the pain. Swallow the bitterness whole and wonder how it came to this. How can any higher purpose justify itself? How did Giancarlo Rastelli do it?

Half empty or half full?

Do you or don't you? Do I or don't I? I don't know, and neither should you.
The thread of life is thinning and I'm tying myself in knots.
Why can't happiness last? Where is it to be found? More questions than answers.

Unsafe and incompetent, lacking confidence and inappropriately compensating by walling up within a fortified encampment. Yep, a pretty good summary of life so far. Exams loom large, firms are in my face and those endless afternoons of pathology are going to seem like halcyon days once the derailed train of my life rumbles onwards to the dark tunnel of the future. What's at the other end? There is no other end. The train has been derailed and will crash and burn somewhere inside that dark, never-ending tunnel. The world outside will crumble but that won't matter because the passengers within know that their own fate is sealed within this tragic one-way locomotive ride to the far far beyond. Where is the escape? All those sidings and stations - where are they now? They are still there...for the next train...to heed the warnings of this miserable wreck of a human being - get out! Get out while you still can!

What do you do when you cannot get what you want? What do you say when those trivial pursuits of yours avoid the angler's bait and swim out of those carefully laid traps? When you retire to bed and lie in the stillness of the midnight air all you can feel is the cold hand of fate choking the life out of your dreams. You try to localise the sensation and it seems to move up the nape of your neck, up to the right pterion. Gnawing away. The Chinese description of 'eating bitterness' is very apt. You swallow your dose of bitterness and cough up a hairball of cynical, jaded bile.

Sequelae

So it begins. The terminal decline. Descent into darkness. Loss of innocence. End of days. No, not the events wracking the world around, however momentous they may be. I'm referring to the little world inside this coccoon of self-denial that threatens to unravel a tangled web of deceit. Summer rains are here but they only wash the pavements; the rumbling sound of thunder outside reminds me of the constant grumbling in my addled mind. How did I get myself into all of this?
More to the point - how do I get myself out?
Some problems are a bit like thrombi. They may resolve, embolise to affect other aspects of your life, or extend insidiously. Apart from dwelling on the aetiology of the thrombus it might be wiser to concentrate on managing the situation - although a thorough understanding of how the problem came to be would guide the appropriate course of investigation and treatment. I only hope it's not too late.

Heart of Darkness

Hit the ground running...every time.
Endless hours on a 'plane, half-wrecked sleep with the drone of an engine and the shrill cries of an unhappy infant in a bassinet ringing in your ears as you turn up the volume on the entertainment system that isn't very entertaining after the 40th replay. Cramped spaces, jostling for elbow-room...the fun never ends. When you fly halfway round the world for 15 minutes before promptly flying back again - the cabin becomes your world of darkness, a portal to the other side...

Live Voice

Fear makes men tremble.
Hope gives them courage.

Apparently the Javanese aim for perfection in the following order:
1) Build a house
2) Find a wife
3) Have a family
4) Ensure you have transport
5) Acquire a singing bird - to enjoy life.
Ah, the simple life...although given the circumstances it isn't that easy.

A Fool's Paradise

Meat on a stick. Nutrition in powdered form. Chinese powdered peanut cookies wrapped in foil and bright green boxes. The opium of the masses is not religion but convenience foods. Not that I'm complaining - what tastes good may not always be good for you but it sure beats cooking.

Age is an illusion! Young or old - we're simply people sliding along a time-shift...and the chronological rheostat will dim for everyone...
Time doesn't stand still on holiday. It runs faster so that it can afford to rest longer during term.
I think I've been ageing far more rapidly than I'd hoped. Peering into crystal balls seems to have that effect. Peaks and troughs of enthusiasm and disillusionment zoom faster into focus than I'd expected. The words 'decade,' 'how time flies' and 'it's been a long time' are never far from my lips. Nostalgia is like a pacemaker...people with broken hearts (?!) can't live without them. Oddly enough, I think I'd rather be cardioverted.

Clouded thoughts

Hope is a star in the darkest night.
When old men stumble and young men fall
If beauty fades or shadows pall
Hope lingers near.

The beaches, landing grounds, fields, streets and hills

The notion of globalisation is not entirely new to our time. The various ages of hegemonic empires spanning oceans and continents (think: Mongols, Arabs and British) each brought disparate peoples closer - linked by shared subjugation by/allegiance to a greater power. However, the current climate of interdependence is unique in its multipolarity and flux - while technology and travel easily bridge time-zones, our times are marked not by universal feelings of peace and stability under the aegis of an all-commanding power. No - the hallmark of our days will be how we adjust and cope with these unceasingly changing and 'interesting' times. Security is a thing of the past and the very nature of culture is being redefined by the undercurrents of change that shape our world. This is no Babylon - it is a Babel.

I have been re-reading old blog entries - the slips and slides seem hard to believe in my current self-anaesthetised emotional state. Certainly, I'm glad to be home - but the sheer uncertainties in my life are a source of constant frustration.
Over a pancake lunch some of those feelings I've been walling up (yes, the Chinese like walls) for the past two years have been beginning to peek over the parapets. The response last time was to build higher, thicker, stronger walls and double the sentries on duty. Perhaps this time it's time to open the gates. I'm cynical and self-tortured enough - perhaps letting a bit of light into my dark little world will bring some things back into focus. Oddly enough - I seem willing. Eager, almost. However, I'm also aware that this is exactly how it began last time - except this time there appears to be a slightly more rational basis for this change of heart than mere impetuosity. That may be good - I like them 'rational.'

I'm feeling a little 'hyper' at the moment. The post-project buzz hasn't dissipated and the void left in my sad little life after the handover seems to yearn to be filled...

Dimples of Venus

...the pair of sagittally symmetrical indentations sometimes visible on the human lower back, just superior to the gluteal cleft and directly superficial to the two sacroiliac joints...known more formally by the medical profession as fossae lumbales laterales...

Pater noster...

This is a timely warning. A warning to the medical profession everywhere else in the world, particularly in Asia. Where I come from, families fight tooth and nail to give their children an opportunity to study medicine - specifically, MEDICINE. The respect and regard for the medical profession surpasses everything but religion and family ties. It is the ultimate goal for many people and while many doctors may not be well-paid, that wasn't their motivation anyway.

The shambles in the NHS, with MTAS and MMC just highlights how completely bankrupt society has become, using billions of pounds to prop up needless bureaucracy and management instead of delivering the actual health services that patients require. Pen-pushing has become a goal in itself to the detriment of jobs and training for the people who actually treat people - the doctors. You can blame the government - you could even blame the electorate - but the responsibility (as always) lies with doctors themselves. The British medical profession (and alas, doctors in most of the Western world) have allowed themselves to be trodden upon. The media is more influential at changing what people believe about health and science than doctors or scientists. We have abdicated our authority to the lowest of the low - politicians and the media. Most of all, we have locked ourselves in our ivory towers trying to keep our intellectual purity, trying our best not to be too 'paternalistic' and theorising that the public is the best judge of healthcare and politicians are the best judges of public needs. We have failed to see that without engaging the public - or at the very least, resisting the onslaught of bureaucratic burdens, we have made ourselves completely powerless. At this dire moment we have become pawns for the politicians while they systematically dismantle everything that made medicine a profession to which only the best could once aspire. We are divided and disunited.

Whether the current situation is saved or the whole thing collapses under itself, there is only one lesson that must be learned from this pitiful tale of woe. The medical profession everywhere else in the world must not allow itself to crumble. We are professionals, not peons. We devote our lives to helping the sick but that does not mean that we are desperate weaklings, 'nice guys' who can be kicked around at will. Most of all, the medical profession must retain its POWER - for power matters when confronted by power. Where I come from, the government would not dare meddle like this - for as long as doctors assert that THEY - and THEY ALONE make the best decisions in the best interests of patients, such trauma will not befall us again.

We have turned paternalism into a dirty word and lost our authority and now we are no longer healers but servants of the state. Doctors everywhere else - don't give an INCH!

The Late Fool

I still can't figure out if it's an April Fools' thing.
http://meded-portal.ucsd.edu/webportal/announc/taking_up_residence.html
How touchingly perfect. A bit like winning the lottery, I guess.

Strawberries and sunny days are here again.

Words, words, words.

Words can be beautiful things. Diverse examples (my personal tastes): "mahogany," "Chloe" "halcyon," "azure" and "lariat." Stunning words render me speechless.

Bubbles

http://www.bbc.co.uk/bbcfour/documentaries/timeshift/raj.shtml
I say, "let them eat cake." We're seeing a repeat of this wall of prejudice today. It's bad enough for 'native' Britons to emigrate to Australia to take up 'cushy' GP posts in the outback. I feel cheated by the slimy mongrel government that dares to call itself the saviours of the NHS. Let the whole rotten system collapse (like the Tube). They probably won't learn their lesson, but a nasty wake-up call to the masters of the universe is long overdue.
Unfortunately, I may depend on them for a job.

Which brings me to the medical bubble. The horrid, reflecting spherical prison that is the world of academic medicine. It's weightless and weird. A world unto itself. A protected place...and yet a trap for everything within it, longing to touch the outside yet afraid to do so, knowing that if those within step outside their boundaries their world and everything they know will burst around them and they will enter a far, far uglier world than anything the bubble held. You see, the medical bubble, for all its unfairness, idealism, caring, bigotry, poverty, wealth, rabid competition, generosity, self-serving stabbing-in-the-back, kindness, slimy sucking-up, pressure, overwork, failure and achievement - is simply a reflection - of the world outside. Leave it and you're no better off because it's just a closed-off continuum of the agony of everything you can experience - just with a different set of rules - in some ways, no better - and no worse...
So I'm scared. Terrified and horrified. Petrified and mortified. My bubble is not bursting - it's imploding.

Splintered

It's been 4 years. 4 years and I'm still the loser I was when I began. No progress there.
I have found a convenient dichotomy - the basis for my current 'framework for living.' It scares me. No, not 'multiple personalities' but just the way that a deliberately self-deluded person finds it necessarily to continue deluding himself in order to keep going. Here goes:
1) Happy me - the eternal optimist, appreciates things 'for what they are' (whatever that means).
2) Sad me - can't let go, clings to the past, constantly preparing for the worst, siege mentality, loner, trusts nobody
3) Kind me - would give selflessly in the name of charity, sees all people as worthy of being loved no matter what
4) Cruel me - sheer survival instincts applied even to daily living in blips of paranoia, vengeful and suspicious

The way in which it's possible to skip between the different extremes (usually in response to external stimuli) can be terrifying. You split yourself so much that you lose sight of what "the real you" actually is, so when people want to get to know "the real you" they see only a facetious lump whose attempts to modulate his accent are a symptom merely reflective of the deeper schisms within. Jekyll and Hyde, but not as grand. I don't even try to 'suppress' things; I merely attempt to behave as dispassionately as possible. I am becoming a drone, an automaton as far as emotions go. It's true to some extent - you can numb yourself to the outside world as a defense mechanism - and compared to many other people, I haven't even been as exposed to horrors that would make such a response more legitimate. In that case, it'll be interesting when the puddles of inconvenience become pools of adversity...

The future is bleak

The more I think about it, the more unhappy I become. The more desperate, dissatisfied, dejected, dolorous, doleful, downcast, downhearted, desolate, dispirited and depressed I become (kudos to Roget's Thesaurus). Only the future could be worse than the present (by no great leap of logic) and I dread what the next few years may bring.

Hoping desperately that I'm wrong, my little predictions of gloom are as follows:
1) The current 'bullish' economic outlook will collapse within the next two years. Just in time for me to finish medical school...
2) Global poverty and widening income disparities will continue unabated
3) No major environmental disasters will stem from 'global warming' and 'climate change' - yet politicians and the media will somehow find a way to blame these for hurricanes and earthquakes

I have no happy future. The world (on average, on the whole) has no happy future. It's going to be utterly impossible to find employment, whether meaningful or not. How does it feel at 21 to think that the past two decades have been an utter waste? It sucks. It sucks, bigtime. It totally, utterly sucks. There is no need for eloquence when you can't see the wood from the trees because the whole forest is crumbling around you in a hail of sawdust. There is no need - because you can't tell if you're wielding the chainsaw or whether that's simply the sound of your mind shredding the last elements of your sanity.

My first week in a laboratory has not done this to me. No, no - the lab has been good, so far. However, it has slammed home how utterly useless I am. I put in my 9-6 every day (it'll increase, I assure you, as the experiments progress) and yet I know I'll never feel satisfied with the outcome, constantly worrying about the past, present and future in a blur of anxiety. This is what happens when you're a pampered child loth to untie the deadknots of apron strings for fear of falling into the abyss over which you dangle, saved only by those same apron strings.

This is all one big delusion. The power to deceive oneself seems to be the only thing that can keep a person going, sometimes. It's an elaborate game of make-believe, where you cling to the past, veiling the present horror with the images of what you perceived you could have been just so you can live on to fulfill the tainted promise of a tomorrow that would be better off if it never came.

Dead and gone.

I have never understood fatalism, but it's starting to become clear that, give or take a bit, everything is truly pointless. No reason to stop striving, but you have to ask yourself why the world is such a depressing place.