Murphy's Law

Having been born in Norn Iron, an understanding is entered into that, from day 1, one is blessed with all the privileges of origin in the Emerald Isle (half the world claims to be Irish and the other half want to be), but also adherence to the various laws of Murphy. Most of you will already be aware of Murphy's cardinal law which states "If anything can go wrong, it will go wrong". However, unless you studied the Norn Irish Primary (Elementary) School curriculum, you may be blissfully unaware of his other laws. Along with conjugating Latin verbs (which I can still do in my head), we would recite the laws of Murphy like American children pledge allegiance to the Flag. Imagine if you will, small children in matching dark green sweaters, grey trousers or a checkered green dress, all with poorly tied ties chanting with a broad Norn Irish brogue...

"1,If anything can go wrong, it will go wrong

2.Everything takes longer than you think

3.If everything seems to be going well, you've overlooked something

4.Nothing is truly foolproof, because fools are surprisingly resourceful.

5.Objects will be damaged in direct proportion to their importance or value"

For some reason, probably due to one of Murphy's long-lost cororallies, these laws have always applied more dramatically during family holidays-for our family, at least. As a doctor, I have worked hard my whole adult life. In the British system, I went straight from high school to medical school at 18 and by the age of 24, was regularly working up to 120 hours in one week. At least once a month I would arrive at the hospital on a Friday morning and not leave until Monday evening and brief periods of sleep during that shift would be broken by the crash-team pager going off. I would find myself bouncing up and down on some unfortunate person's chest, daydreaming about getting back to bed.

I would get home on Monday evening to be greeted by my new bride, eager to see me after a weekend spent alone, barely able to stand, let alone engage in conversation - and that was on a good day. I would pass out and then be up early on Tuesday to head back to work again. Holidays, short breaks, long weekends, then, quickly became important times to rest, relax and recuperate, as they are for anyone who works hard. Murphy, therefore had to intervene and ensure that, for a variety of reasons(flat tires, tornados, sick children, sharks, lost luggage, expired passports etc), we would return from vacations sorely in need of another one. Obviously the summer of 2019 tour d'hospital was no exception.

As a family doctor, taking time off is viewed as a major inconvenience by many patients, and downright unacceptable by others. The result of this is that, when you get back to work, the schedule is packed, mostly with patients who are half dead because "I didn't want to see anyone else, so I thought I'd wait until you get back, doc". My reception staff are second to none and they have a system fine-tuned to avoid massive overload on my return from holiday. Nonetheless, recovering from this holiday with another one was not really an option and so Monday morning came around fast and despite the grumbling in my belly and the intermittent cramping, back to work I went.

I wasn't completely better, but in the Canadian medical system, I only get paid if I actually see patients and I had a vacation to pay off and so I tried to put my abdominal pain to the back of my mind. It wasn't long until it pushed its way forward. I had intermittent fever, tachycardia(rapid heart rate) and felt very fatigued - all of which I had experienced on and off since this sorry episode began. Before long, I was back on antibiotics - orally to begin with and then, having seen no improvement, intravenously. I had the IVs twice a day as an outpatient, but my wife, who is more sensible than I could ever hope to be, suggested gently that if I didn't rest whilst on the course, that she would put water from the dugout through my cannula and hasten the inevitable. She has 21 years of experience of me turning up to work no matter how I'm feeling. I went to work with migraines, colds and for 2 weeks carrying around a vacuum pump attached to a poorly healing wound on my leg. When she felt really unwell 33 weeks into her second pregnancy, I went to work-"It'll be alright" I did turn up for the premature birth of our son later that day, so, lots of Brownie Points, right?

On the day we were packing up our house to move-June 1st, 2017-I had a sudden onset of vertigo - later diagnosed as vestibular neuronitis - a viral middle ear infection. One minute I was packing a box, the next I was on my back and the ceiling was spinning. I'd already taken time off work to facilitate the move and so Murphy clearly classed it as a holiday. I spent the "vacation" unable to walk or see straight, and calling for Huey down the big white telephone. I was therefore especially helpful in our house move. Thankfully, most people recover quickly and fully from vestibular neuronitis. It turns out I'm not most people. At first the vertigo was rotatory. It was quite trippy to sit in a parked car and watch the building in front of me slowly spinning. If you've seen Dr. Strange then you've got a pretty good idea, but with a spinning Safeway Liquor store instead of beautiful Georgian buildings or New York skyline. The rotation eventually subsided, somewhat, but a constant movement remained. It had become difficult to focus on anything and simple everyday tasks became 10 times more difficult. In the early stages I had to consciously tell my brain that things weren't really moving. Tests revealed that my right vestibular nerve (responsible for sending signals from my balance centre in my right ear to my brain to tell me which way up I am) has been destroyed by this nasty little virus. A specialist neurologist diagnosed me with Persistent Perceptual Postural Dizziness or 3PD. This was a brand new experience for me. I've had my share of medical problems over the years, but this was the first time I'd been given a diagnosis I'd never even heard of.

Wrong, Indira, just wrong.

There were treatments available, however. Pills that might make everything steady again. After the eighth different medication, with several side effects along the away, we gave up. I saw physiotherapists, psychologists, tried a tailored online course from down under, nothing helped. I returned to work, part time at first, then gradually worked up to full time again, but I would return home every night feeling like I did after those monster weekend shifts as a junior doctor. I had to sell my motorbike, which I had dubbed "My therapist". Although I had learned to drive a car safely again, the effort to balance and questions about how well I'd be able to get myself out of trouble on two wheels meant it was pointless keeping it. I gradually figured out that things my body had muscle memory for, for the most part, I could still do, but learning new skills that involved dexterity, balance or focus had become a thing of the past. I found I could still surf - at least until a Great White Shark (let's call him Murphy) came along and ruined the party, but I can't hit a croquet ball with a croquet mallet. After two years of 24/7 dizziness, along with the fatigue and frustration that came with it, I was ready for a nice relaxing family holiday. Little did I know that Murphy was lying in wait.

But I digress. After that "nice, relaxing" holiday, I was back at work, having had one outpatient and one inpatient course of IV antibiotics. The pain continued however, as did prolonged and frequent trips to the bathroom as well as my constant companion, fatigue. In the few days I did manage to show up to work, not a lot was done.

September 17th was my youngest child's birthday and after our traditional pancake and bacon breakfast, she got on the bus for school and I set off for work.

As I moved from my office to the exam room for the third patient of the morning, I felt a sudden stab of pain low down in my abdomen, the same area I'd been experiencing cramping for almost 2 months by now. This pain was different. More intense, it made me grab my belly, but then it eased a little. Not a lot, but a little. During that consultation (which I do not remember at all, even though it was to be my last for some time), the pain came in waves. I made it the few steps back to my office and waited, sweating like a stuck pig, for my colleague to finish with his patient.

"Something's happened" I told him.

Later that day, I was back in the CT scanner, this time to reveal there was a small perforation in my bowel. It was small enough that there was an equally small chance it might close up by itself. So another course of antibiotics followed, what we in the business call "watchful waiting". As I started to think about when I could get back to work, I heard my wife asking the surgeon,

"So he needs to rest, he shouldn't be working, right?"

He must have seen that look in her eyes that I know so well, because he was very quick to reply.

"Absolutely, rest, no work, give it a week and we'll follow up"

Leonardo was Italian, not Irish

I can't say I was hugely optimistic that the umpteenth course of antibiotics was going to be "the one", but as I have always told my patients,

"Every day without surgery is a good day"