Thursday, 16 August 2018

Night Watch Poem 2018

Night Watch 2018.
He hung out the clothes on the front line, 
& went for a brief walk around the cold dark block.
Coming back, the only way to the front door 
was through the
​translucent ​
He could see, between the clothes, the simple lights inside the house.
Lights, colours, movement, in the soft palette of a breeze 
held together by
​small wooden ​
How easily we are
​made so​

Of the less-cost after shaves I think Tabac is the best. Of the most-cost after shaves Givenchy Gentleman is my favourite. Like Tabac it has that soft background hue of cigar smoke and full ashtrays, and sweat, and in addition, up front is the smell of dirty socks, burnt carpet, kapok rotted by red wine, and the faint redolence of stale semen. Much like an old man's hostel. It amazes me how those French folk got it so right. Olfactory Artistes of the Highest Order.

Tuesday, 14 August 2018

notes from palliative care book, regarding the narcotics... in the absence of heroin, morphine remains the gold standard for pain relief in terminal illness. Codeine is useless and is a bad drug. Oxycodone is very problematic and far less than effective in pain control than morphine in the terminal phase. Hydromorphone is ok, but you should add some methadone to make it more comprehensive. Fentanyl is ok if you like to see happy hairless rabbits in your room...but as time goes by, the rabbits can change into really awful things. Stick with morphine. First choice. Add some midazolam, a tad of haloperidol, a concomitant subset load of methadone for the bones, and you'll be right as rain. If you need far more than 600mg morphine subcut a day, with the additions of methadone, midaz, and haloperidol, then you may need to flush the body IV for a day and start again as the morphine metabolites, in a dying body, tend to eat each other when the concentrations get too much. have a day off, flush the body IV, then come back next day with 300mg morphine, subcut, 5 haloperidol, 30 midaz, 40 methadone...and then titrate up to the need. You can still be sitting in bed doing your crosswords, but you just won't be in massive pain. the human condition...Its not rocket science. if you haven't got good pain control within 3 days, then the people caring for you really don't care, or don't know what they are doing. You could need up to a gram of morphine a day, plus the other stuff, but usually only if you have let the oncologists and surgeons have done too much harm to your receptors by pointless, heroic (for you) and simply cruel interventions.

No one has ever not died, so it is best to be practical about euthanasia...which simply means having a trump card in the pack dealt...and playing it when you choose to. I don't see it as a right or as a moral thing. It's just a human thing. A day or two afterwards, no one cares anyway. Its up to you. No one has never not died. It is as natural as taking a breath, or not taking a breath for 3 minutes.

Friday, 10 August 2018