Observations From Home.

Wales training squad:
Backs: Morgan Stoddart, Lee Byrne, Jamie Roberts, Shane Williams, Tom James, Sonny Parker, Tom Shanklin, Stephen Jones, James Hook, Andy Williams, Warren Fury.


Forwards: Duncan Jones, Gethin Jenkins, Rhys Thomas, Adam Jones, Matthew Rees, Huw Bennett, Ian Gough, Alun Wyn Jones, Ian Evans, Jonathan Thomas, Martyn Williams, Alix Popham, Ryan Jones.

Who is Warren Fury? (Fantastic name though).

Sonny Parker. Hurrah!

Two tests against South Africa. I wonder if they'll be on New Zealand telly?

New Zealand Observations (2)

1) Rugby rugby rugby Carter Carter Carter Carter Carter

2) Netball, far from being a sport solely played by schoolgirls is MASSIVE here. It's on TV and everything. I think this is a bit... odd, but haven't said anything yet in case I get yelled at.

3) Watching TV news is a bit like watching an extended Wales Today, in terms of the sheer 'localness' of it all.

4) All the trees look like something out of prehistoric times.

5) It's bloody beautiful.

6) I might have a ticket to see New Zealand play England in June, thanks to a nice girl who has a rather unhealthy obsession with Nick Evans ("He's the back up first five, you know?". "Er, you mean fly-half?")

New Zealand Observations

1) Buying a phone is tricky. I went into the shop, naively assuming that phones came with SIM cards. Not so. You have to buy a separate SIM card. I have been to five shops so far, and they are all out of SIM cards. Is there a great telecommunications crisis in this country that I am unaware of?

2) Shortland Street (crappy daytime program that used to be on at the same time as Neighbours) is MASSIVE here.

3) It is really, really hot and really, really humid. This makes me really, really uncomfortable.

4) Petrol prices hitting $2 a litre is front page news here. This made me giggle, compared to prices back home.

5) Los Angeles is a fucking shitpit that I am never setting foot in again.

VISA!

Finally got my visa for New Zealand after a long and protracted battle that made the Wars of the Roses seem like a genteel game of cricket on the village green. Unfortunately, I've off on what promises to be a rather rambunctious stag weekend thingy in Poland this weekend, so if I lose my passport, I'm buggered. I'm thinking about sewing it under my skin, like that sadistic bloke in The Invisibles who kept razor blades under his skin...

Anyway, it should be a good weekend, and no doubt gallons of beer shall be drunk by all.

Also, the new Wisden is out, and everyone should go and buy it. I haven't had the chance to do more than scan through it, but there's a fair amount on Bradman, which is always interesting to read about. 99.94. Incredible. Surely the most dominant sportsman of any sport, anywhere, anytime.

Fuck the Welsh...

...Assembly.

Because those cunts are directly responsible for this exchange I had today.

"WHY SHOULD I PAY FOR MY INHALER WHEN IT'S FREE?"

Let's think about that for a moment.

Serevent inhalers cost about £30 a pop. The packaging costs money. The raw materials cost money. The plastic the inhaler is made out of costs money. The factory it was made in has heating and lighting bills to pay. The poor sod of a doctor who had to speak to you and prescribe for you does not work out of the goodness of his heart. Neither do I.

Funny how it doesn't become an emergency when I tell you the trade price, isn't it?

Nine hours left.

Nine hours left in the retail grindhouse (5.30 finish today, 9-5.30 tomorrow). Unless me and the New Zealand visa people have another falling-out, that will be it.

I can't wait.

Off to Hay-on-Wye for the weekend, to look at books.

Also, best luck to Portsmouth (Hi, Stu!) and Cardiff in the cup this weekend.

Also, FUCK OFF MK DONS!

Crimes Against Humanity

Fake Plastic Team 2

Grimsby 0

There is no more depressing sight in football than seeing MK Dons win. This abortion of a team are a fake, a charade, a tacky abomination.

http://www.afcwimbledon.co.uk/

The Quack's Back!!

Well, fuck me sideways, the Quack has got a nice new shiny website. She still hasn't got round to answering my question though.

Let's have a look.

"Christine Glover is a very well known pharmacist with
homeopathic training offering an holistic integrated approach to healthcare. She
neither rejects conventional medicine nor accepts alternative medicine
uncritically. She believes that emotional happiness is a fundamental part of
physical health for an all round sense of balanced wellbeing."

Firstly, I think it's fair to say that "very well known pharmacist" is a bit of an oxymoron. I'd never heard of her until a couple of months ago, and would frankly struggle to name any pharmacists. Well, apart from people I was in university with, which doesn't really count. Physicists, we are not. Also, I am not sure what an all round sense of balanced wellbeing is. I guess it has something to do with not wafting at balls pitched outside off stump. Or not.

But wait! There's more! The Quack has managed to write a second paragraph. Fuck me, if only I had homeopathic training! I could also write two paragraphs!

"Christine Glover worked for fifteen years in her own community pharmacy in the
West End of Edinburgh, with a wide range of clientele ranging from bishops to
drug addicts. Since then she has spent the past seven years focusing on an
holistic approach to health issues through homeopathy. She was President of the Royal Pharmaceutical Society of
Great Britain from 1998 to 2001."

Well whoop-de-fucking woo. I also slog through the retail trenches, although I would bet my right elbow that I see a lot more drug addicts than any fucking quack. This is why:

HOMEOPATHY DOES NOT WORK. IT IS A CUNT'S TRICK, FOR THE SOLE PURPOSE OF RIPPING OFF THE GULLIBLE AND DESPERATE AND STUPID. FOR FUCK'S SAKE, HOW THE FUCK CAN YOU HAVE A SCIENTIFIC DEGREE AND BELIEVE THAT A FUCKING MAGIC WATER POTION WILL CURE CANCER? ARE YOU THAT FUCKING BRAIN-DEAD OR DO YOU JUST HAVE NO FUCKING MORALS WHATSO-FUCKING-EVER?

Oddly enough, all the drug addicts I see are treated with evidence-based medicine. Also, drug addicts are, in the main, poor. Poor people cannot afford homeopathic "consultations".

Also, how the fuck the Royal Pharmaceutical Society of Great Britain can continue to let this woman peddle her crap while still being a practicing pharmacist, and proudly advertising herself as a former President of the Society is beyond me. How the flying fuck a known homeopath got elected as president is completely beyond me. I blame the voters...

Edit: Point and laugh at the Quack here http://www.glovers-health.co.uk/index.htm

Fucking Easter (2)

You have no job and, in fact, very little to fill your days with. Well, apart from getting on my wick, that is.

So do you

a) think to yourself "My word, my friendly local chemist will be closed for a day over Easter. I should prepare for this apocalyptic event by TAKING RESPONSIBILITY for MY MEDICATION, and making sure I order a script from the GP because it is MY MEDICATION and it is MY RESPONSIBILITY to take care for MYSELF"

b) Walk into your pissed-off tamping chemist at five to six the day before Good Friday and kick up a stink because you forgot to order YOUR OWN MEDICATION, and it is, apparently, my fault.

Fucking Easter.

I would like to thank the fucking moronic pharmacist who has been sitting on a Meff script that has not been adjusted to take account of the Easter bank holiday. I just love the way it has been sitting in the pharmacy for three weeks, and then you leave it for me to deal with on Saturday morning. You fucking shithouse little twat.

Thaat aside mind, I had a cracking weekend.

"ALL THESE WORLDS ARE YOURS, EXCEPT EUROPA. ATTEMPT NO LANDINGS THERE"

A truly great man died today.

Rest in peace, Arthur C. Clarke, who proved that physics is the sexiest science there is.

http://uk.youtube.com/watch?v=cWnmCu3U09w

Non-vintage Six Nations

Bloody fantastic. Although I feel rough as arseholes now.

MURs

Medicine Use Reviews, apparently. Supposed to be carried out on patients to make sure they are taking their tablets properly.

In practice, this is not the case.

Patient A has fucked lungs, diabetes, depression and would be an excellent candidate for an MUR, that is if I had a spare 30 minutes, which is a whole different story.

Patient B takes 75mg of aspirin every morning and is fairly intelligent. Does he really need an MUR?

The fact is, patient B will always be chosen, because he is easy, and he can be a box ticked, and another step on the ladder towards a target. There is shit-all patient care involved in this.

Fifty thousand ploughshares produced, comrades!

NOOOOOOOOOOOOOO!!!!!!!

Brett Favre, Green Bay Packers (1992-2008)

So long, and farewell. Everything I love turns to dust, in the end.

Most TD passes: 442

Most passing yards: 61,655

Most passing attempts: 8,758

Most wins by a starting QB: 160

Most consecutive starts, quarterback: 253 (275 including playoffs)

Most 3,000-yard passing seasons: 16

Most consecutive 3,000-yard passing seasons: 16

Most pass completions: 5,377

Most seasons with 30-plus TD passes: 8

Most consecutive games with a TD pass, postseason: 18

Most NFL MVP awards: 3

I haven't been this gutted about anything sport-related since Jonathan Davies went to League.

Journal Review.

Some interesting points in this week's Journal (yes, really)!

An interview with Paul Gimson, who taught me a few times in university, and is a thoroughly decent chap. However, he's wrong on this though, I think.

“The fact that patients now do not have to pay means they can appreciate the service pharmacists provide more clearly. That can only be a good thing for patients and for pharmacy.”

Wrong. In fact, giving out paracetamol and ibuprofen for free only serves to make pharmacists seem even more like shopkeepers.

There's also an early April Fool's joke, whereby students at Keele "university" get their own computer generated character to talk to throughout the degree course. Apparently, this will help students counsel patients. Call me old-fashioned, but in my day we, er, talked to patients! It all sounds a bit World of Warcraft to me, and no doubt there will be CGI characters with improbable breasts who go out digging for gold.

Full bizarreness here. http://www.pjonline.com/Editorial/20080301/articles/p249atavars.html

Interesting letter, full of kindness and compassion, from a Mr. Matousek. I rather suspect that he is a better pharmacist than I will ever be. http://www.pjonline.com/Editorial/20080301/comment/lett08.html

Mr. Gush is, once again, too busy trying to makes his sums fit to answer some simple questions. http://www.pjonline.com/Editorial/20080301/comment/lett07.html

Free prescriptions in England? Believe me you do not want it. http://www.pjonline.com/Editorial/20080301/comment/lett03.html

The Society of Quacks is doing something-or-other, I'm not sure what. Though quite why it needs to be reported in a supposedly scientific publication is beyond me. http://www.pjonline.com/Editorial/20080301/news/p237homeopaths.html

Free access to journals! Hurrah! http://www.pjonline.com/Editorial/20080301/news/p238freeaccess.html

Interesting article on extemporaneous dispensing. It claims that "around six extemporaneous preparations were dispensed per pharmacy per month in the UK" . I find that hard to believe, personally. I think I've done two in eighteen months, both for ephedrine nasal drops, and that doesn't really count. In fairness, it's something I'd like to see more of, but it's impractical to carry out in most pharmacies.

Job section: The usual propaganda crap from Boots and Tesco, that Bermuda job's there again, something going in the Orkneys which may be interesting, and something in Queensland.

Scab! Scab! Hang him hang him hang him!!!

Against my better judgement, I did an all-day shift in one of those horrible, soulless, 100 hour supermarket pharmacies the other day. This is something I promised myself that I would never do.

So why did I do it? Essentially, because I can see the light at the end of the dank, grey, newspeak existence that is the tunnel of retail pharmacy. And I figure I may as well earn as much money as I can before I escape.

I can't wait to leave. I'm fed up of hearing brain-dead bigots complaining about Muslims taking over. I'm fed up of having to deal with 3000 different types of cough mixture, none of which work. I resent the way that Tesco and Boots seem to be taking over the entire world. I absolutely, positively cannot stand the ever-increasing tide of ridiculous legislation that does nothing but prevent me from doing my job properly.

Honestly, what is the point of having a pharmacy open for 100 hours? Anything after, say, 7pm should be for emergencies only, by which I mean things like diamorphine, antibiotics for kids and the elderly and anything else that absolutely, positively can't wait until the next morning.

They should not be used so that I can see invisible skin complaints at 9pm, or trying to persuade people to stop wasting their money on Nurofen in a shiny box when the bog-standard stuff does the same job for tuppence.

Bear Shits In Woods Shock.

A soldier has been in a war. For some reason this took up a fair chunk of the six o'clock news last night.

http://news.bbc.co.uk/1/hi/uk/7270743.stm

Quack update, again.

Her website's been down for the last couple of days. Wonder why?

http://www.glovers-health.co.uk/

Further Proof That Australians Are Not Like Us.

I discovered an astounding fact today while slogging through the Australian Medicines Handbook.


There. Is. No. Bendrofluazide. In. Australia.

Imagine that! In the Ghetto we order in bendrofluazide by the shipload. It's one of the most popular, cheapest drugs around. If I could be bothered, I'd look up the interwebs to find out how much of it was prescribed last year.

In Australia, they still use hydrochlorothiazide. Which is one benzene ring, and three fluorines away from being bendrofluazide.

Freaks.

CAOP exam.

Holy Batman, I'm bored.

Thing is, there's not a whole lot of genuine revision you can do for this exam what with it being an open-book multiple choice thingy. So I've just written down a big list of drugs and looked them up in the AMH. I suppose knowing your way round the books will be more important than anything, because you would go fucking spare if you attempted to learn the entire BNF. Although I'm sure a pharmacist I worked with in the hospital had Martindale plugged directly into his brain.

Anyway, revising for this is incredibly boring. It's not helped that, by a chain of unfortunate events, I ended up "sleeping" in my car last night. When I say "sleeping", I mean "shivering and listening to Test Match Special".

Roll on March.

Quack update, again.

Still no reply.

I wonder if she believes in the Tooth Fairy as well?

Exubera?

Did anyone out there ever see a prescription for this then? For something that arrived on the market as the best thing since Brett Favre, it sort of sunk without trace.

Daily Heil At It Again.

Yet more proof, if it was ever needed, that the Daily Mail is written by thick bigoted twats for thick bigoted twats.

The Daily Mail has a reputation for insidious racism and xenophobic propaganda, however, this leaked email from features writer Diana Appleyard illustrates the extent of the Mail’s cynicism.


—–Original Message—–
From: rsreply@dwpub.com [mailto:rsreply@dwpub.com]
Sent: 13 February 2008 15:57
To:xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Subject: Response Source - Diana Appleyard , Daily Mail (Request for personal case study)

PUBLICATION: Daily Mail (Request for personal case study)
JOURNALIST: Diana Appleyard (staff)
DEADLINE: 14-February-2008 16:00
QUERY: I am urgently looking for anonymous horror stories of people who have employed Eastern European staff, only for them to steal from them, disappear, or have lied about their resident status. We can pay you £100 for taking part, and I promise it will be anonymous, just a quick phone call. Could you email me asap? Many thanks, Diana


HOW TO REPLY:
Email: mailto:dianaappleyard@aol.com

Phone: not provided for use

Fax: 01296 738083 (preferred)

How very unsurprising. Unfortunately, there's enough morons out there to keep vacant windbags like this "writer" in business.

Fuck off and get a real job, Appleyard.

LINK:http://www.recessmonkey.com/2008/02/16/incitement-to-hate-foreigners/#comment-198307

Revision.

Today, I have been mostly Procrastinating. This happens whenever exam time comes around, when I get the books out and start looking at stuff, and sitting round in my pants all day, and drinking tea all day, and re-reading The Invisibles instead of doing real work, and leaning back on my chair bouncing a table tennis ball off the wall.

The exam I will be sitting is a multiple-choice open book thingy. In theory, it should be easy. Word on the street, however, is that it is not. It is not a re-run of the pre-registration exam, which was not difficult at all. It is an ambigous race against the clock that will determine my success or failure.

It's struck me just now much I've forgotten since I left the hospital, where I had the sanctity of a billion different books, and Google to use if I needed to look something up, and where patients were, generally, more interesting.

Unfortunately, this time I'm doing it on my own, and have no-one else to ring up for pep talks and crisis management. I will not, for example, be benefitting from The Farmer's Selective Revision Guide for Neuropharmacology. Instead, I will be reading the BNF and the AMH from cover to cover, going back through my notes from the Hospital, sitting around scratching, and hoping that something sticks.

Some traditions still hold however, and I intend to have a pint in my hand within ten minutes of the exam finishing.

Where The RPSGB Produces A Shotgun, And Shoots Itself In The Foot.

I am not a big fan of the RPSGB. I think that their entire raison d'etre is to make money out of the membership. I think that the financial management of their rather large funds has been nothing less than criminal. They have offered me no support whatsoever, apart from a phone call couched in vague terms of menace. Their treasurer is useless. In any other form of business, there would be some accountability to their membership for fucking up the finances to this degree.

However.

It seems that they are not content with raising the membership fee by almost 50%. Bernard Kelly, who is something called a "finance and resources director" at the RPSGB has been quoted as saying

"I don't like putting up fees one year and putting them down the next.

"I don't think you'll see us putting up fees by 40 per cent again in the next few years, but I don't think you'll see us saying: 'things are great so we won't put things up'."

Mr. Kelly's name does not appear on Our Beloved Society's Register of Pharmacists. I suppose this means that Mr. Kelly is too stupid to go to university and pass a few exams. No-one should have a problem with that, Mr. Kelly can't help being a bit thick. However, what really rankles is that Mr Kelly is now in a position to have the power to tell people with a real degree, in a real science, what to do.

This just goes to show that the RPSGB have zero interest in anyone other than themselves. I can't wait until they become obsolete, and will gladly piss on their metaphorical grave.

Perhaps we will see Mr. Kelly justifying his statement. Perhaps pigs will fly. Perhaps all homeopaths will throw themselves off a cliff. And if my aunty had bollocks she'd be my uncle.

Nexphase

If a thousand monkeys typed for a thousand years, one of them would eventually produce the complete works of Shakespeare.

The other nine hundred and ninety nine monkeys would produce Nexphase.

Interesting article.

http://www.usatoday.com/money/industries/health/2008-02-11-prescription-errors_N.htm

Some quotes from it:

In its responses to USA TODAY, Walgreens said, "Errors don't occur more often at a busy pharmacy than a slow pharmacy."

Philip Burgess, national director of pharmacy affairs for Walgreens, testified in a 2007 deposition for a different case that he saw no link between pharmacist workload and errors. He said mistakes were "more related to lack of focus."

This is complete and utter dishonest bullshit from a man who has completely forgotten what it is like to be a real pharmacist. If, indeed, he was ever bright enough to be one.

USA TODAY found Walgreens and CVS have policies that seem to stress speed in filling prescriptions.

Walgreens' budget guidelines for work hours, never previously publicized, say a pharmacist at a typical store might have as little as two minutes to verify the accuracy of a drug, its dosage and directions.

"That's not enough. They allow no time for counseling" patients about their medications, checking the work of technicians and fulfilling other duties, says Kennedy.

"We have never dictated the time a pharmacist spends on a prescription," Walgreens said. "Pharmacists are licensed professionals; we expect them to exercise good professional judgment." Stores may adjust the guidelines "as needed," the chain said.


Kennedy challenges that assertion: "Walgreens corporate (executives) will tell you … that there is no pressure to increase speed, and that pharmacists are supposed to use their professional judgment and go at a pace where they're not going to make errors. … What filters down to middle management is completely opposite. They're in the stores pushing the volumes."

Quite. All I hear from the overpaid, overpromoted middle management at the Ghetto is that we must cut waiting times, and increase item volume. This is bullshit. It's unsafe bullshit. There are nowhere near enough staff to cope with the Ghetto as it is. Are we going to get any more staff? Are we bollocks! Plus, we have to put up with a Fantastic New Computer System that crashes at hourly intervals.

If pharmacists are being flogged far and away beyond what it is safe for any man to do in a day, it is no wonder that mistakes are being made. If pharmacists have to put up with useless quipment foisted on them by some piston wristed gibbon who is easily impressed by flashing lights and little pictures, then they will make mistakes. If pharmacists have to work in shitty conditions, then they will get pissed off, stressed, and think "Fuck this, I'm off to do something easier".

Why are there precisely zero articles in the Pharmaceutical Journal about this? It's all very well focusing on the 0.001% of pharmacies that have well-trained staff, leaving the pharmacist free to do Other Stuff. Most places are vastly understaffed and with an ever increasing prescription volume there's going to be a very, very serious fuck-up sometime soon. And the supermarket it happens in will wash their hands of the whole affair.

Edit: Should point out that I found this here: http://pharmacygod.blogspot.com/2008/02/usa-today-today.html, which is a better site than mine.

The Ghetto

I've been thinking about this a bit recently, and have decided that there is a strange sense of wrongness about the Ghetto. There's a strange, malevolent evil in the air, an underlying aggression which I have never experienced anywhere else. Driving in the other day, the road was blocked off. Turned out someone had been put in hospital the night before after an "incident" outside the local pub. He was in a critical condition, apparently. A couple of months ago, some young guy was kicked to death outside the pub in what passes for the town centre.

It's manifested in everyday life as well. Mothers screaming at kids in the street, women screaming at men, in the middle of the afternoon, on the public street. People wandering around with cans of Stella. People wanting their tablets now with a furosity unmatched anywhere else.

There's a strange black cloud of depression that hangs over the entire town, with the epicentre being the slough of despond that is the Ghetto Pharmacy. Whatever it is, it is not a healthy environment to be working in.

Quack update.

I emailed the Quackmeister general to ask her what the evidence for homeopathy doing, well, anything was.

Clearly, the Quackmeister general must be preparing a mountain of well-researched evidence, because she hasn't replied yet. That, or she's desperately trying to make something up. It will probably involve the words "emotional", "spiritual" and "laughing all the way to the bank".

Best Rant Ever.

http://militantmedicalnurse.blogspot.com/2008/02/matrons-shoot-them.html

"When do we see Matrons? When there is an inevitable cock up. Then they are down to the ward like flies to a horses ass to ensure that all blame is directed onto the staff nurse and the hospital does not appear negligant or liable. Then the same error happens again with a different nurse because these are SYSTEM errors not NURSE errors. Once again Matron comes down hard on the individual member of staff without troubleshooting the problem. Fucking worthless whores. I saw it happen to too many of my colleagues and I got the hell out before the day came when it was my turn.


As far as I am concerned, most of our so called nursing leadership are traitors to nurses and patients alike. Don't even get me started on the NMC, the RCN or any of the other worthless pieces of crap who refuse to address the real issues. I'd like to see them all lined up and shot*. "

Truly brilliant stuff. And very very worrying. But unsurprising.