Resus update

Well, I made a resolution to practice resuscitation skills, and I have (on Matthew). And since, unlike Annie, he can give feedback (because he is, in fact, not a dummy), I figured out what I was doing wrong. Apparently you’re supposed to make a complete seal around the mouth, whereas what I was doing was more along the lines of making sweet mouth love to Resus Annie. I mean, I let her die horribly, but I’m pretty sure she had the best time of her short, plasticated life while doing so.

So, I’m very pleased. No longer am I the med-student who can’t perform first aid!

My exam results are made of fail. And AIDS.

Well, we haven’t had the results back from the semester 1 exams, but I think it is likely that I’ve failed.

I’ll be surprised if I haven’t, to be honest, because I deserve a fail. I did almost bugger all to prepare. In fact, I spent the whole week-and-a-half between my last class and my last exam playing minesweeper on difficult level. After almost two-hundred attempts, I finally won a game. The night before my last exam.

I think part of the problem is that during the course of the semester I put far too much faith in the belief that I would do some work when exam-time came around. So I did hardly any work on the course material as it was being taught, and then exam-time DID come around, and I thought, ‘fuck it, I’ll just play minesweeper.’ I think my new year’s resolution shall have to be to always assume that, under pressure, I will inevitably find some unproductive addiction to procrastinate from learning, and consequently to prepare as much as possible in advance for this.

In a way, I’m disappointed that I didn’t try harder to get a better grasp on the material, because I do genuinely find it interesting. But, on the other hand, if I had wanted it that much, surely I WOULD have put in the effort. I’m not sure. I think I just liked not being under any pressure to do well. That sounds ridiculous, considering I’m at med school – the standards are kinda high. But what I mean is, I’ve spent the last however many years labouring under what mostly consists of others expectations of myself to perform well academically. But now, I’m in a year-group with 239 other creams-of-the-crop. I’m nothing special anymore – and it’s kick-ass.

But if this semester has taught me anything, it’s that I would like myself to do better than I have been doing. And now that I’ve had this chance to start over, I feel that I can better motivate myself to perform better from now on, knowing that it’s MYSELF I have to answer to, and not the potential disappointment of others.

So, along with writing up my learning outcomes on the WEEK of the relevant lecture, my other resolutions include:

• Join the fucking gym. Go at least twice a week, for an hour at a time. My heart rate is startlingly high. And the confidence acquired by conforming to the general standard of attractiveness might revive my currently withered sex life somewhat.
• Practice ressuscitation. We had a ressus session in one of our clinical skills classes this year, and I think I was the only person in the room who couldn’t breathe into the fucking dummy. How embarassing. I don’t know if it was the fact that I wasn’t tilting her head back enough,or if I was accidentally blocking the airpipe, or if I wasn’t holding the nostrils shut firmly enough, or if it’s just that my mouth is too fucking small, but I was disgustingly bad at ressuscitation.

 

 

…My chest compressions were excellent, though.

Abortion in the 21st Century

On Monday I attended a debate hosted by the divinity college on abortion – a real debate, this time, unlike the one I got tricked into attending by my religious studies teacher in 5th year, which is another story entirely.

In the red corner we had Ann Furedi, Chief Executive of the British Pregnancy Advisory Service, arguing from a pro-abortion stance, and in the blue corner, John Wyatt, Professor of Neotal Paediatrics at University College, London, defending the anti-abortion lobby. I hesitate to use the terms ‘pro-choice’ or ‘pro-life’ because they imply that the other party is opposing choice, or life, respectively.

Both speakers were very concise, and although I am in favour of a woman’s right to terminate an unwanted pregnancy at will, I did feel that Wyatt’s arguments were well-put, and both speakers ultimately agreed that ideally, there should be fewer abortions – they just didn’t agree on how to make that happen.

Furedi opened her ‘pragmatic’ pro-choice argument with a statistic - 1 in 200 women who correctly use the pill well get pregnant every year in the UK. Other methods of contraception, even when used properly, can also fail to prevent pregnancy. Adequate contraception is not enough to ensure total reproductive autonomy. We live in a society where we expect to be able to enjoy sex outwith the aim of reproduction. Hence, there is a need, a demand, for abortion to be available. This not confined to the realms of those who are too young, or poor, or unsupported to bring up a child – 1 in 5 women treated at abortion clinics are married.

On the other side of the coin, she also offered an ‘ethical argument, addressing the issues of respect for life versus autonomy. She made the (largely overlooked) point that few women, when faced with an unwanted pregnancy, will be easy with having an abortion. I feel this is an important point to stress as many of those who argue that abortion is too freely available will say that women will rely on it as a ‘fall-backplan,’ that they are using it as contraception. As if it’s such a casual thing. From her experience, she said, most women will find it to be an unpleasant procedure, and may feelings of guilt at being responsible for taking a life.

The issue, she argues, is not so much to do with when life begins biologically, which is of course at conception, but when that life begins to matter – when the entity itself can experience self-awareness, self-interest, and consciousness. A human life ‘matters’ when it is valued by the person living it.

She mentioned that a lot of pro-life activists, in arguments with her, have compared abortion to such atrocities as the Holocaust, and that she finds this extremely offensive to the memory of those people who died under Hitler’s rule. She thinks that to compare the life of a developed, conscious person to the value of that of a foetus is insulting. Hence, the mental and physical well-being of a woman with an unwanted pregnancy should take precedence over that life of the neonate.

Of course, one could argue that a newborn child also lacks self-awareness and self-interest, in which case infanticide is also, theoretically, morally right. She anticipated this argument and countered by stating that a newborn child can be cared for by society without infringing on the autonomy and bodily integrity of the woman.

Ultimately, the decision should lie with the woman herself, as it is her life it affects – whereas the medical or even legal staff can go home to find their lives unchanged whatever the outcome, she must bear the responsibility of whatever decision is made. And so, she should have the right, and the responsibility, to make that decision herself.

Responsibility was an aspect she stressed on this issue. She said that many overlook the difficulty involved in making such a decision – whether or not to terminate a pregnancy. And, that by proposing to hand the decision-making responsibility to someone else, it is implied that society does not trust a woman to be capable of making the morally right decision. I appreciated this point, as sexism is now so much of a taboo subject – we all like to assume that the problem of gender inequality is solved, and often ignore the subject in order to avoid being labelled with unattractive stereotypes, but in fact, gender bias and prejudice is still a hidden influence in many circumstances and situations. She expanded on this point by stating that in England, a woman can refuse to consent to having a cesarean section performed, even if she knows her child will die without it. This invasive procedure cannot legally be performed without the woman’s consent. Also, a parent, or parents, can refuse to consent to life-saving treatment, such as an organ transplant, for their child if he/she is a minor. Why is it that only in the case of abortion is autonomy being challenged?

She finished her argument with some Dawkins quotes – “to take away the ability to make decisions takes away a person’s humanity,” and “tolerance is the price we pay to be able to live in a liberal society.” Or something like that.

Wyatt also opened his argument with some statistics:

• 1 in 3 women in the UK will have an abortion during their reproductive lives
• 1 in 5 of all pregnancies in the UK will end in termination

He made the point that the abortion debate is framed as the rights of the woman vs. the rights of the foetus, which in his opinion was overly simplistic. The value of human-life as being determined by society, he said, is an entirely post-modern idea – one which he disagrees with. The value of a life is not simply determined by ‘how much their relatives love them’ – it is an inalienable human right, and all lives are equal.

Furthermore, reproductive decisions are not, in fact, wholly autonomous. The social context of such a decision is predetermined, and a number of social factors will influence its outcome. In his words, there are a variety of ‘malevolent’ factors ‘manipulating’ women into thinking they have no choice but to terminate. Such forces can include wealth, or the opinion or influence of the dominant male in their lives. In many cases, he believes, a woman cannot find adequate support to continue with the pregnancy. Expanding on the latter example, he believes that if the father takes the stance of ‘respecting the woman’s autonomy,’ she will see this as him abandoning her to make the decision alone. He also stated that where the woman’s autonomy takes precedence, the autonomy of the man involved will be infringed upon.

Furedi countered this point by saying that the decision to terminate a child is often taken by a couple together, in the best interests of both parties, not just that of the woman. A couple whose lives are involved with each other will often have similar needs, and hence a single solution will likely be beneficial for both parties. Conflicting interests are not as much a problem as Wyatt made out.

Another counterpoint made by her is that although social context will influence the decision to terminate, many of these social factors e.g. poverty cannot be helped or changed by those involved in the pregnancy. In an ideal world, nobody would find themselves in the situation where they are financially unable to raise a child, but until that day (if it ever comes), what would you have the woman do?

Wyatt makes the point that of the many factors that influence a woman’s decision to terminate, abortion will not solve any of them. There is nearly always another option – shouldn’t we do more to support people in choosing these alternatives?

Of course we should, Furedi agreed. If there are underlying factors that are ‘forcing’ a woman to have an abortion, we should do as much as we can to change these, as no woman takes the decision to terminate lightly, and many would much rather avoid it if there was an easier alternative. However some women, even if other maternal options (that may be appropriate alternatives to others) were made available to them, would still want to terminate.

My feelings are that some social factors are unlikely to ever change, and even if the problems of poverty are somehow solved, there will always be other social factors influencing the decision-making. You can’t possibly divorce the decision-making process from the environment it takes place in – a person’s wants, needs and responsibilities are based on their surroundings, their relationships with individuals and society. Wyatt actually made a similar point sometime later in the debate with regard to moral decision-making – he said that individual autonomy is an ‘enlightenment myth,’ as any decision taken by an individual will affect others. All people are integrated and linked in society, so we should discourage moral decision-making based on the needs of an individual, and instead place the focus on the consequences a decision may have for the wider society.

Wyatt also addressed the issue of foetal screening, saying that many disability lobbyist believe that termination following a positive test result encourages social prejudice towards disability, and de-values the lives of disabled people. He asks, ‘Do people really believe a life with Downs syndrome is not worth living?” Obviously expecting a rhetorical, unanimous ‘no,’ I think perhaps this question is a little naive. Obviously from the perspective of someone who IS living with a disability, they will of course value their own lives as much as the next person values his, and most would still rather be alive than dead. But then again, some wouldn’t. And I’m certain there are some crippling disabilities that many currently healthy people would, if they were unfortunate enough to sustain such disabilities, feel death is a better alternative to. I’m not going to address the issue as to whether all lives are inherently and equally valuable, as it’s way too big an issue, I don’t know a thing about it, and addressing it in the context of disability would make me seem prejudiced, which I’m not. I’ll just say that I think that the value of a person’s life is not intrinsic, but is determined by the regard they themselves, or the people they interact with, hold it in.

Wyatt also addressed the issue of whether the medical sector in today’s society should be a consumerist provider, or an ‘enshrinement’ of society’s moral values (obviously insinuating the latter). This is another interesting topic I would love to expand on at some point – for now, I’ll just say the I believe the role of medicine is somewhere in between these two extremes. I believe people should have the right to free access to healthcare when they need it but not necessarily when they want it – for example, cosmetic procedures. However, people also have the right to refuse intervention or treatment if they don’t want it, even if such treatment would improve their health. It’s a grey area.

The debate was then opened to the floor.

When asked if rising abortion rates were a concern, Furedi replied in the positive – because even if a woman feels a termination is the right thing to do for her, it is still a distressing experience. We would ALL like fewer abortions to take place, but only by preventing unwanted pregnancies by increasing use and reliability of contraception, rather than by limiting access to termination. When the 28-week limit was brought into law in England and Wales, there were no more third trimester abortions in Scotland, where there was no legal limit.  Hence, there is no need for an external regulator of abortion use – women are responsible enough to make the decision for themselves. The increase in the number of abortions does not necessarily reflect the decreased value placed on human life by society – the society in which legalised abortion came into place was one where women were not expected to have sex outside of marriage (and, if they did, they were expected to become married) or make their own living – these days, where women have more rights and a more independent role consisting of more than just motherhood and home-making, there is a greater need for abortions.

A member of the audience challenged Furedi’s view that all women are morally responsible enough to make such a decision, citing a recent newspaper article about a girl who had ‘6 abortions before age 18.’ Furedi maintained that the number of abortions an individual is allowed to have should not be limited, as a person who isn’t even responsible enough to use contraception will likely not be in an ideal position to raise and care for a child.

Another member of the floor was employed in her working life as a helpline telephonist specialising in post-traumatic stress resulting from having an abortion. She said that many of the women she spoke to said that they felt abandoned by the healthcare service in their time of need, that they would never have had the termination if they had been told they were going to feel so bad afterwards, and that many of them were pressured into having one by their partners who had threatened to leave, but that the relationship dissolved even after the procedure. The speaker felt that abortion clinics did not do enough to provide support to their patients after the termination. Furedi replied that the women at her clinic receive as much or as little counselling as they feel they need, and that you ‘can’t force counselling’ on a person. Very few woman actually do suffer from post-abortion trauma. Wyatt replied to the issue of the quality of informed consent by explaining that many practitioners feel that offering information about the adverse effects of the procedure is insensitive while the woman is making such a difficult and emotional decision. Furedi made the point that abortion is not a ‘miracle cure’ and that it should be made clear that it cannot fix your relationship. Personally, I think that if you’re in a relationship with a man who is pressurising you in a situation as sensitive as the decision to terminate, the relationship’s not going to work anyway, whatever you do. It would be difficult to maintain a happy relationship with a person like that.

The speakers were asked by a member of the audience to address the ‘underlying issue’ in the abortion debate – whether they believe society needs to have a more responsible view of sex? i.e. should people consider sex with childbirth as an end? Furedi replied that sex was not without purpose, even if divorced from the aim of having children – she doesn’t believe it to be dysfunctional to have sex just on the merits of having sex. The pleasure derived from making love to a partner is meaningful enough. Wyatt then argued that not all sex has this value – promiscuity, casual sex, one-night-stands and all the rest of it are not healthy ways in which to behave.

To be honest, I’d have to disagree with him here. It’s true that many women will have promiscuous sex due to self-esteem issues, and I agree that this is NOT healthy, but not all sex outside of a relationship is for these reasons. I think even one-night-stands can be a mutually beneficial experience, even if it’s not the same experience as sex within a relationship (or sex to procreate, for that matter).

Inevitably, the issue of termination in the case of rape was brought up. Wyatt made the point that he personally knows a woman who was raped, and who eventually decided to have the child. He said that the situation eventually ended happily, even if it wasn’t a pain-free ending.

Sure, it’s a lovely story, but you can’t just say that because one woman was happier to go ahead with the pregnancy, all other raped women would be as well. In fact, I’m fairly sure this woman is in the minority. Surely the ‘happy ending’ for most rape victims would be not being forced to have their rapist’s child.

The weekend that didn’t go to plan, part 2

The majority of Saturday night was spent at work, after which Adam had promised to take me to an engagement party.

Which he then decided was shite. He took me to the studios (a metal club) instead. Much drink was imbibed (this seems to be a common theme to my entries as of late…) and a good time was had by all until Adam, being the twat that he is, injured his leg trying to climb onto the stage. After we were turfed out of the club around 3am, we decided to go back to the flat of a guy we had met (which, fortunately for me, was about a 5-minute walk from my own flat. Hurray!). We didn’t stay there long, though, as one of Adam’s friends, who was out-her-face on E’s, hysterically declared that we HAD to take Adam to A&E on account of his leg (which was beginning to look rather swollen and nasty).

To A&E we went, then, Adam and I, where we (predictably) waited until around 7am to be told that it was just bruised. You have to love the junior doctors at A&E – fair enough, they’ve been doing a round-the-clock shift on a Saturday night, and at that time in the morning they probably just want to go home - but they make absolutely no effort to hide their contempt if they think you’re wasting their time. I’ll admit that with their experience, they can probably spot bruising from a mile off, but to folk like us with no experience, a bruise is one of those purply-green things that turns up on your skin when you bump it. It is NOT something that swells to the size of a small fist and makes walking extremely painful.

A guy called Jeffrey in 1979 conducted a qualitative study in 3 Accident & Emergency departments in the UK, where he discovered that the staff grouped patients into either ‘good’ or ‘bad’ categories, depending on the extent to which their complaints allowed them to practice and develop the clinical skills necessary to pass their exams, or to practice their chosen specialty. ‘Good’ patients also included those who were acutely ill and hence presented a ‘challenge.’ The bad patients were the drunks, regular overdosers, homeless people and those presenting with trivial complaints (which is a coniditon not due to trauma, nor urgent), which they felt were not legitimate uses of the A&E service.

It’s probably easy to blame the patient for presenting with such inappropriate use of emergency services, but this use primarily occurs in either people who are not registered with a GP, or individuals who feel they are unable to evaluate the seriousness of a condition (which, in this case, was Adam and myself). The choice of A&E over primary care can also be due to the availability it provides in terms of immediate access and out-of-hours service.

I just thought I’d note all this because, at the moment, I’m viewing this from the perspective of an NHS user, whereas in 5 or so years I’ll be seeing it from the point of view of the junior doctor. I’m hoping that in future I’ll remember this and conduct myself accordingly.

A poster on the academic forum regarding people making anonymous posts:

Peer learning is as important as lectures etc. I’d actually rather know who I was talking to or being helped by. If we can’t be accountable for what we write on [the forum], how are we going to be accountable for what we do as doctors?

This is the type of wanker I have to go to school with every day.

Vulgarity, pt. 2

I think my feelings of alienation within my year-group do, in part, stem from the fact that I come from a slightly different background. Despite the fact that my Mum does have a slightly above-average household income, she herself is a self-made woman. She grew up in a rough area, but hasn’t totally forgotten it like my Dad has.

Essentially, what I’m trying to say is that I can definitely appreciate what I’ve got and have the ability to see both sides of the coin – I originally assumed this would work to my advantage, since the poorest in society are naturally the sickest, when I’m qualified I’ll hopefully be able to identify with my patients a little more than my, er… ‘loftier’ colleagues.

It just seems like a lot of people from wealthier or medical backgrounds have this inherent upper-class conservatism, whereas I’m normally a lot more liberal and open-minded (and rather outspoken about it), so I just don’t have anything in common with anyone.

The way I’m regarded makes me feel as though I’m the ignorant one, but other times I’m convinced of the opposite, and I don’t know how deluded either perception is.

There’s no room at med school for my particular brand of vulgarity

Well, it is officially week two of med school, and I’m getting a bit worried that I’m not going to make any friends. I know I can be abrasive but I didn’t think it made me THAT difficult to like… I’ll be the first to admit that my sense of humour is a bit of an acquired taste, and it doesn’t always succeed in actually being humourous, but even so, I’ve never had many problems making friends, despite my awkwardness.

It’s not that I don’t understand social norms and expected behaviour (although with the looks I’ve been getting recently, I kind of feel that IS the case), it’s just that at some point it seems I’ve unconsciously dispensed with all the norms that I don’t agree with, or find unnecessary, so they no longer inhibit my interactions with people. Unfortunately, I’ve not been granted a terrible awful lot of common sense (I’m the ONLY person who’s allowed to say that about me), so I only realise when I’ve said/done something really ridiculous AFTER it’s happened.

To be sure, I’m not being any more ridiculous than I normally am – it’s just that I’m now in a peer group that isn’t so tolerant of it. And I can’t seem to change my behaviour, so I’m feeling a little ostracised. Even the guys I’m friendly with are kind of condescending, which leads me to believe they’re just putting up with me because they don’t want to tell me out-right that they don’t want me about.

To give you an idea of the kind of peer group I’m referring to, I’ll just say that the majority of the students on my course play the violin or some kind of string instrument (but not the viola – apparently, the viola is the laughing stock of the string family. I know this because a group of people I was sitting with were telling VIOLA JOKES). A lot of the Scottish students are in the National Youth Orchestra and things. I’m not saying that if you play the violin it automatically makes you posh, I’m just saying that an interest in the sciences and associated medical subjects doesn’t often correlate with ‘musical genius.’ The violin is an instrument that’s encouraged in the nicer, possibly private, schools. So I’m assuming a lot of the kids here are from middle-to-upper-middle class backgrounds, not necessarily in terms of income (I’m not one to judge someone on something like that), but in terms of attitude. Coupled with that awful medic-superiority complex, and it makes for a fairly arrogant individual.

For example, I was speaking to a guy on the bus to the hospital on Friday. Somehow we got onto the topic of first aid, during which I confessed that I hadn’t had any first aid training. He was inappropriately shocked.

“What, you mean you’ve NEVER done ANY first aid?”

“Yes, that’s what I mean.”

“Really?! You’ve never?!”

“Yes. Really.”

“Well how did you even know you wanted to do this, then, if you don’t know any clinical skills?”

“You don’t have to know how to do chest compressions to know you want to be a medic. Everyone has their own reasons for wanting to do something.”

“Well you must have had REALLY good work experience then.” (He said this in a tone that implied he’s surprised I got into the course at all)

“Um, I went to a couple of GPs.”

“Only GPs?! I spent a week with a surgical team! What did you write as your extra-curricular activities then?”

“Oh, um, just some stuff I did at school, that I’m not doing anymore, since I’m not at school…”

Awkward pause.

(In actual fact, the very few hobbies/interests I DID list were promptly abandoned as soon as the university applications were sent off. The thing about applying to med school is you tend to exaggerate to a ridiculous extent, but just short of where it technically becomes ‘dishonest.’ The only thing I did see through to the end of my sixth year was helping a dyslexic S1 pupil with his reading.)

Me: So what were your extra-curricular things then?

“Oh, do you want the WHOLE list?”

For fucks’ sake. “Just. Abbreviate it.”

Turns out he won the dux award in his school however many years running, is profficient in first aid AND lifeguard training, he won the Duke of Edinburgh award (whatever the fuck that is) and skiis. Among other things. All in all, the conversation left me feeling a little inadequate.

I remembered a little later on that I DID have experience in a clinical skill – when I was watching minor surgeries at the GPs over Christmas, the doctor let me apply local anaesthetic to a wart someone was having removed. I got to load the syringe, and he guided my hand until the needle was in the guy’s arm, and let me inject it. I’m not entirely sure the doctor should have let me do that, but nonetheless, I was fair chuffed with myself. However, when I told this to the guy on the bus, he didn’t believe that I had done it. Such is life.

Gynaecology + porn habit = ?

I attended my first Medical Ethics lecture today, and as an introduction the lecturer asked us to discuss between ourselves a couple of moral quandries related to the practice of medicine – one of the scenarios was, ‘If a gynaecologist regularly looks at (and I’m assuming, although it wasn’t stated, masturbates to) pornography, does this pose an ethical problem for anyone outwith the direct doctor-porn link?’ (It wasn’t written quite like that but you get the idea).

I actually laughed when I read the question. Of course it fucking isn’t! But of course, there were some who thought otherwise. Apparently the patient is at risk of some kind if the gynaecologist derives pleasure from looking at twat.

I’ve two main points to address.

Numero uno. Looking at twat on a porn flick, and looking at twat in the context of a gynaecology examination, are two totally different ball-games, in both aesthetics and attitudes. The clinical setting is one in which you apply medical knowledge, and during a vaginal exam, a practitioner would principally be looking for symptoms or signs which would indicate an illness, or lack thereof. Whereas, most people will beat off to porn in the luxury of their own homes, in private time, and their occupation is probably the last thing on their mind. Porn-pussy is a total different class of snatch – it’s the Ferrari of vaginas (smooth, sleek and will likely take you from nought to infinity in 6.5 seconds). Unless your fetish is thrush and genital warts, even as a gynaecologist, you would never associate one with the other – it’s the difference between eating a fine steak at an expensive restaurant, and trying to pry open a toasted cheese sandwich.

Before I move on to my second point, I need to mention that I am taking into consideration the fact that our theoretical unfortunate doctor may in fact be female. Someone did make that point during the debate, although what she said was, ‘What if it was a female doctor who had got off to a man in porn?’ and I found myself thinking, ‘Well, that would rather diffuse the situation, then, wouldn’t it? Since she would be a GYNAECOLOGIST.’ But still, what I mean to say is I’m not excluding lesbians.

My second point is this. Even if, by some twisted quirk of fate and upbringing, said doctor DID get off on the vaginas presented to him/her during the course of a working day, what should we do to prevent that? Ban everyone that has ever derived sexual pleasure from a vagina from the field of gynaecology? Would you screen people with foot fetishes from working in shoe stores? It’s just not practical, especially considering the chances are even slimmer of a person getting aroused by someone in the work place actually ACTING on it (this is the real issue – actual patient risk).

I did make the point that, to take men as an example, many men (probably over 50%) do, in fact, watch porn. I even asked for a show of hands – it got a few laughs (but no hands). A guy at the other end of the hall argued that I was stereotyping. He asked, ‘Do you go shopping for handbags every weekend?’ And I said, ‘No, I don’t.’ His argument was that then, neither do most men watch porn. What I SHOULD have said was, ‘No, I don’t – I watch porn. It doesn’t mean I can’t be a gynaecologist.’ But hey, c’est la vie. I wish I’d had more of a chance to thrash it out with him though, because I wanted to explain that my point wasn’t based on stereotyping - from what I can gather from bits and pieces on the net, around 70% of men aged 18-34 get off to pornat least once a month. It’s pretty much common knowledge that it’s something people do. Maybe the statistic is the same for women, but I’d guess not – as a woman, I’d venture a guess that we’re a bit less visual, although I’ve read the blogs of dozens of woman who love porn. I personally get off to the occasional image, but it’s mostly all badly-written erotica or my own imagination.

But, even if I’m wrong, and the majority of men DON’T watch porn, it’s still a veritable FACT that any straight man or gay woman will get off on SOMETHING vagina-related, whether it’s dirty videos or not (images, fiction, an actual woman). So any gynaecologist who is attracted to ladies is gonna pleasure themselves to a vag at some point in their lives, if not fairly frequently. Can we screen for this and tell them they can’t be gynaecologists? No. Because nobody in their right mind would pose a threat to their patient like that, vagina-lover or no.

Interestingly, one of the guys I’ve been hanging with turned round at the end of the lecture and said, ‘You just HAVE to be controversial, don’t you?’ I seem to have garnered a reputation in my week on the course for being dirty and foul-mouthed. However, I don’t see porn as a controversial issue, even if I did ask for a show of hands. It’s sad that some of the intellectual elite of the 18-20 age group, tomorrow’s doctors, still view human sexuality as something barbaric.

Stephen Fry -a national treasure

I finally got around to meeting my Director of Studies today – incidentally, he is also director of the whole of Year 1, so I was a bit apprehensive in case he was rather severe and intimidating, but in fact he is quite lovely. He’s one of those old-fashioned, posh, camp academics with more hair than any man of his age has any right to have. And he has a very strong jaw, a bit like Stephen Fry, whom I adore. I think I love him already. But not, as I had to clarify to Z, in a sexual way – I mean in the way that a woman loves a gay man. Or a cat.

Anyway, I’m quite glad for the weekend, as I’ve been at the Infirmary for nine o’clock most mornings this week – it’s only fresher’s week, so at least the lectures haven’t started in earnest, but introductory lectures are lectures all the same. I got a hold of my syllabus for semester one today and spent a few hours just there making it accessible, with colour-coding and subject dividers and things, without actually managing to read any of it, which I thought was quite an achievement. I bought my first textbook on Wednesday afternoon also – I thought that was quite a momentous occasion. It’s called ‘Psychology and Sociology Applied to Medicine,’ and it’s got pictures and stuff.

Wednesday night was also the medic’s annual fresher’s-week white-coat-adorned pub-crawl, at which I got disgustingly and ferociously drunk. Another guy, Mark, and I had a shot (vodka, sambuca, and – at one point – gin) to accompany every drink we had, and so we were reduced to a state of extreme inebriation about twice as fast as anyone else present. Which, in hindsight, was kind of a good thing, as after a while the bars we went to started asking for ID at the door (which we didn’t have) and consequently a lot of under-agers who were drinking more conservatively than us lost out on the chance to get as spectacularly drunk as we. Also, it meant I was asleep by midnight – I had a lecture at the RI at 9am the next morning (which I turned up at still pretty drunk). The pub crawl terminated at the student union, where I befriended a bouncer who had quite a reputation for being a hardass (it turns out we both love Finntroll), and be-enemied another about 30 seconds later, when I showed him my rubbish fake ID. He said,

“This is fake.”

And I, being fairly drunk at the time, obviously replied, “No it’s not!”

“I’ve never even HEARD of an Age Identification card.”

“…Okay, you win. It’s a fake.”

“Well I’m confiscating this. You can go in, and you can pick this up in the morning from the police station if you want it back.”

I did not, as it was clearly a piece of pish.

I did feel quite bad though – not for losing my rubbish fake ID, as I probably deserved it (imbibing any more alcohol was the LAST thing I needed), but because he seemed rather angry at me, and I still feel a little guilty for making his job that little bit harder. Perhaps I shall apologise if I ever show my face there again.

I do wonder if he did hand it into to the police, though. I’m not entirely bothered – fortunately for me, it was so crap that it wasn’t even a fake of a real thing (a fake of a fake, even), like a passport or driver’s licence, so it doesn’t constitute as fraud, so it’s really not illegal. Unfortunately for me, though, that my date of birth was the ONLY information on that card that WAS fake. So, if they DID want to prosecute me, on the off chance, it would be fairly easy for them to do so.

It was at this point in the evening that I realised that I was a bit of a mess and decided to stumble home. I know when to call it a night.

NEW DIGS!!!

I am now typing to you from my new 5-person university-owned flat in the city, which is (apart from the blocked sink, smelly shower and lack of loo-roll) is very lovely. My four other flat-mates are very tidy, and as a result our kitchen is always beautiful.

I’ve only just got my internet set up, and I’ve been rather busy trying to find cheap cutlery, plates, hygeine products and other essentials that I forgot to buy before I moved. I got here on Saturday afternoon – Z helped me move, although I had to leave half of my things behind because he had forgot to unpack his stuff out the car before he came over. I went on a pub crawl from the rest of the folks from my building on Saturday night, which terminated at the student unions, which was PACKED. You couldn’t get anywhere near the bar, and there wasn’t much room to dance, so it wasn’t as fun as it could have been.

On Sunday I went to a couple of pubs in town with some guys from the block, the Tron and then my new ‘local,’ which is a rock/metal pub, and where I met up with D from back home (he’s now living in a flat that is literally a stone’s throw from mine - what a mad coincidence). I’ve actually had a pretty tame Fresher’s Week so far, mostly due to my avoidance of the unions and the fact that I’m not yet legal to get in anywhere else, so far as clubbing goes.

Z came over to stay on Monday night – we got him sorted out with a parking permit, and made fahitas for dinner, which has got to be the first time I’ve ever made myself a proper meal. I say ‘we’ made it – in fact, it was mostly him, but I did chop some of the vegetables, and the chicken, and helped fry the chicken. Overall I maybe did about a third of the work, but then I washed the dishes so we were even. Anyway, those fahitas were fucking amazing. I had some left over in the fridge and I warmed it up again last night. I honestly can’t get over how awesome they were.

…Moving on. After the fahitas we went out to our local again with D and the two lads from my block.  We went to another pub as well which was very chilled out – it had beds instead of seats. I didn’t stay out long – we were back by about 1. D wanted to stay out, but the lads and I had to be at our respective inductions on Tuesday morning by nine, so we had to cut the night short. I did feel a bit bad for leaving D, as he seemed quite lonely, but he gets very annoying when he’s been drinking so I got over it.

So, on Tuesday morning I got up at 7 and made my way to the hospital to matriculate, then went back to the university buildings and registered with a GP. Had a hot chocolate at the union and went on an organised tour of the main library and medical building, which is shit hot. It has the oldest working lecture theatre in the northern hemisphere, and skeletons of giant Asian elephants, and a medical museum containing the skeleton of Burke. Of Burke and Hare. Irony! I was back at the flat by one in the afternoon, where I had left Z still asleep. We made chicken-mayo baguettes – aesthetically, they were not a success, but we ate them anyway.