Dreams

Someone told me today that 29 was too young to give up on your dreams. The particular dream she was referring to was writing a novel. But that has never been a big dream. The real childhood dream was an odd one. It was to be a Consultant, or a GP, doing a worthwhile job. I wanted to be able to have  a nice life, have a large house in the suburbs or country, to drive a 4×4 and have 4 children in private schools. I would have a wife who didn’t work and an Aga, she would bake cakes and throw dinner parties.  I am currently coming to terms with the fact that this dream won’t come true. They job probably will, but the rest of it won’t. I’ve never had to come to terms with the fact that a dream won’t come true before. All my dreams have come true, but not through luck, They’ve come true because I’ve worked fucking hard to make them come true.

There is no point doing something just because it was your childhood dream. There is certainly no point ruining your marriage because your life doesn’t quiet match your childhood dream.

The bizarre thing is that I have no idea where this dream came from. I was raised by hippies on a council estate. There was no one there who lived that sort of life. I suppose I must have seen it in colour supplements or on TV. Maybe it was in a Joanna Trollope novel. But it was a dream. And a dream I’m trying to let go of.

But at the moment holding onto a dream is likely to ruin my marriage, so actually a dream isn’t making my life better at all. It’s making it considerably worse. I need to give up on the dream to get my life better.

It’s not what you say that’s offensive, it’s what you think

Someone, somewhere on the internet someone made an offensive joke – :

A – ‘ I went to a lovely gay guesthouse in X, they did the most wonderful breakfasts’

B – ‘And no thank-you note between the buttocks in the morning?’

It was a while since I’d seen that particular brand of homophobia  - but of course it is offensive.

There was a swirl of reactions along the line of  ’Hey that’s a bit offensive’. Followed by  the post being pulled by the moderators, and an apology from ‘B’.  It does raise the wider issue of how one should respond to homophobia. I think there are a number of potential responses:

We could censor that post, this was response of the forum moderators. This is certainly the way we dealt with homophobia in the Student Union at University. There was a ‘No Platform to hate’ policy, the student union had decreed that groups proffering certain views would not be able to . Once the post has been removed then the next reader will not be able to see B’s offensive post, so the offense will be minimised.

The other response is to tell B that we find his post offensive, and explain why we do. Yes viewers may see B’s post and be offended, but they can also see how many of the other users of the forum find this offensive.

The risk with simply censoring homophobia, without explaining why it is offensive, is that the homophobic will receive a message that gay people are ‘oversensitive’ and ‘cannot take a joke’. They will continue to have homophobic thoughts, but these wouldn’t be expressed in public. They may even start to resent gay people further and develop further homophobia. However if you leave content on your forum then you may attract other people with unacceptable attitudes to express their views and the forum may be taken over by homophobes.

The real problem with B’s post isn’t that it is mildly offensive and unfunny, it’s the fact that he holds the view that most gay men are sexual predators. Now in this context the view is pretty harmless. But should B be conducting job interviews he may be reluctant to employ gay men as he may be worried that they would sexually harass him and his colleagues.

If we censor his post without providing an explanation we solve the immediate problem: there is nothing offensive on our forum. But we don’t solve the underlying problem. The fact that B has an assumption that all gay men are sexual predators. If we talk to B, and find out where this assumption came from we may be able to  change an attitude, and then solve the underlying problem.

Achievements of a Decade (Warning: Smug Post)

This has been a good decade for me. It has generally been a bad decade for everyone else in the world, but it’s been a good decade for me. I ‘ve gone from the miserable teenage girl, who saw in the millenium watching TV with my parents to a confident, out going and successful married man drinking real ale at the village hall party.

I’ve been a doctor for nearly 5 years now – it’s only in the last year that I’ve been able to deal with the majority of ill adults that pitch up to hospital. I don’t panic around being around very sick people but stay calm, do what I can and ask for an anaesthetist if I need help with specific organ support. I can also recognise when people are dying and provide pretty good palliative care.

Then there’s the changing sex business. Thankfully now I can just be a man and don’t look like a transsexual, so I don’t really get discriminated against. I don’t think I could manage to change sex again. I don’t think I would have the courage to stand up at work and say I was a transsexual. I really did change sex at the right time. A lot of people thought I should wait until I was more established in my career before changing sex, but really there’s a lot to be said for changing sex before you have a career worth speaking of.

Getting married has been a big big achievement. Or to be more precise convincing a woman to agree to spend the rest of her life with me. I was worrying if I’d ever manage to find anyone to do that, and now I have.

The other achievement has been loosing weight, but I’m a bit nervous about listing this in a super-smug blog post. Anyone can lose weight with lighter life – but keeping it off is a bit more difficult, most people who lose weight regain most of it unless they have bariatric surgery. Lighter life claim that by ‘addressing the fundamental psychological issues’ then you can lose weight permanently, but until they produce some actual evidence no one takes them seriously.

In the last year I have lost 5 stone, so far I haven’t put it back. If I’m still 11 stone in 2020 then I’ll be smug about it.

If it wasn’t for Press for Change and Stephen Whittle, who have changed the law so dramactically for trans-people I wouldn’t have been able to achieve any of the above, even including the weight loss. If it wasn’t for them it would have been legal for the Medical School to exclude me, I doubt I’d have been together enough to get married or lose weight.

Why Do New Year’s Resolutions Always Fail?

It’s that time of year when you can’t get to the gym for want of love nor money, it’s entirely full of unfit people trying to do ineffective workouts. It’s the time when supermarkets sell out of grapefruit and chemists sell out of nicotine replacement.

I am the sort of person who gets what I want. In the last 10 years I have got into medical school, changed sex, graduated medical school, got onto core medical training, got MRCP, got married, got a number in my first choice speciality, lost six stone in weight and now got funding for a PhD. Oh and brought 2 houses. But as I’m in negative equity I don’t think that is an achievement.

Yet I have never managed to make a New Year’s Resolution stick for more than a few weeks. I think it’s part of the language that we use around them.

If I say ‘I’m going to try and … ‘ that’s what will happen, all I will do is try, I’m unlikely to actually achieve it.

If I say ‘I’m going to do my best to..‘ I will do something, think it’s my best and then stop.

If I say ‘I’m going to…’  then I do, for a while, then I realise that I can not do, just as well, and then give up.

If I say ‘I really really want to, but I don’t know if I can’  I will generally achieve whatever I put my mind to.

If I say ‘I have to do this or some dire consequence will befall me’  It will generally get done if the consequence is both sufficiently dire and immediate enough. I know I will fill in my tax return on time to avoid the £100 fine, but I don’t think that the threat of dying 10 years early is enough to stop me regaining weight.

Another reason why I think New Year’s Resolutions are a bit dumb is that you really, deep down, expect them to fail.  Which becomes a self-fulfilling prophecy doesn’t it. If you know that your Resolutions don’t last beyond February then why will they?

If whatever you need to achieve is something worth achieving then don’t make a new years resolution – just do it! And do it because it’s something you really really really want to do.

Christmas cards in the age of web 2.0

My wife and I wrote our Christmas cards last night, we haven’t posted them yet, but writing is a start. This is a marathon excercise, most of my friends are in their 20s so are moving around fairly regularly. So first one has to send facebook messages, e mails and texts to establish what peoples addresses are.

Then there’s the question of ‘do they celebrate Christmas’. Many of my friends have only recently moved to the UK, often from India or Pakistan. Do they want to be included or not? I’m an atheist anyway – so I always send very secular cards, but it’s still a Christian festival. Actually it’s a pagan festival – but we should move on.

Then one has to establish what ones current title is. In a social circle where nearly everyone is a doctor you cannot assume that their husband or wife will be Mr or Mrs. The chances are they will also be Dr.

Those of us who were hoping to be surgeons may have passed their MRCS exam which changes their title back to ‘Mr or Miss/Mrs/Ms’. Established which title female surgeons wish to be known is another challenge. But how does one establish whether one has passed an exam or not?

We seem to have negotiated it all ok though. Hopefully they’ll be in the post sometime next week.

On teenagers

Tonight I discovered Lamebook - think Regretsy for facebook. Oh? you haven’t discovered regretsy? Oh dear. It would have been such a productive evening if only you’d not checked my blog post.

Lamebook is a website of a screen captures of face book, think Chealsee (14) annoucing she has genital warts, Kasha showing you pictures of her home waterbirth with little Kelsy watching. It’s great. And it’s finally taught me that teenagers are a different species.

I can’t spell very well, but compared to some kids today I am a master of the art. Also I seem to have got the hang of using capital letters. One at the begining of the sentances, and also for abreviations and the word ‘I’. I have a vauge grasp of ‘you’re’ and ‘your’. Though I sometimes get those two mixed up.  I have never felt the need to TyPe CaPiTaLs and LoWeR CaSe LeTtErS alternately. Neither have I felt the need to use L33t speak, I can’t get Leet speak.

I have, for my sins, found the slim notepad I kept a diary in when I was 18 years old. The time when I lost my virginity, got into medical school. Shamefully it was written in long hand, using a pen – yes a pen. The handwritting was neater than my current handwritting, I’d even underlined the important bits using a ruler. I’m amazed at how much of my life was defined during the time I kept that diary. During that time I had sex for the first time (with a woman, I never did the man thing), and got a place at medical school. If I hadn’t got into medical school I’m not sure where I’d be now. I wouldn’t be me anyway. Yes, it is pathetic to be defined by your job, thank you for telling me.

Anyway yes, Teenagers. I have no idea why I have suddenly taken an interest in teenagers. I see teenagers in 2 circumstances.

1. Overdose. Of paracetamol usually. Stupid thing to overdose on.

2. Diabetic keto acidosis. Occassionally they aren’t known to be diabetic. Often they are and have simply not taken any insulin. Or got drunk, or got a STI. Or all three.

Sometimes I also see teenage relatives of older people. These teenagers are usually quitely crying in the corner.

Being a teenager is shite. Your emotions take you over. Your problems are the most important thing in the world. You get dumped you can’t imagine living and want to kill yourself. You have a row with your friend, you can’t go on and wnat to kill yourself. Obviously if the only teenagers you meet are the ones that are admitted when you are on call you imagine that teenagers spend their time flitting from paracetamol overdose to paracetamol overdose. With only a few days in between.

Until recently I had thought of myself as virtually a teenager.  But the last teenager diabetic I saw was a completely alien creature to me. I just couldn’t comprehend why she wouldn’t let me get a line in to treat her entirely self inflicted DKA. That entirely self inflicted DKA that would kill her if I didn’t get a line in and actually treat it.

I’m back, Honestly, no Really.

And I’m still not dead. But it’s going ok. I’m enjoying it and feeling that I’ve made the right career decision. But I’m just that much less anonymous than I was as an SHO. There are hundreds of SHOs in the country so I can easily blog in the background. I could be anyone of them. Hell there could even be another transsexual Medical SHO.

So if for instance I say ‘Yesterday my Consultant was angry’ my consultant is much more likely to put two and two together that maybe his Registrar is a transsexual.

At the moment I love being a Medical Registrar, I’ve got a bit addicted to the adrenaline rush of looking after the very sick, and I can effectively manage a good shift. I’m a bit more unsure about the specalist stuff, I’m ok at the TIA clinic, but the Falls clinic can overwhelm me a bit. My consultant says that I should get out  of my comfort zone, and at the moment my comfort zone involves admitting people to ITU, getting a central line in and starting some inotropes.

Sometimes I wonder if I should continue blogging, I’m hardly a Dr Crippen, syndicated in the Guardian now isn’t he? But this is something valuable. This is a record of my life since I was a House Officer, and now I’m a Registrar. Yesterday my House Officer said that he wondered how he could ever know enough to be a Med Reg. But it’s only been a few years, and it’s possible. And it’s nice looking back at how far I’ve come.

I’m married

‘Gosh,’  I think to myself. ‘ I wonder why I can’t close my fingers, oh yes, it’s because I’m wearing  a ring. But I don’t wear jewelary’

‘Oh!’ I remind myself  ‘Gosh’

‘It’s a wedding ring’

I’m married.

I had a sufficiently unusual wedding to not be comfortable posting about it here. Or at least not in a lot of detail. But it was perfect and we are very happy.

I have to admit being vaguely smug about the fact that my wife’s family don’t know about my past. It’s one of those feats of passing that one shouldn’t be pleased about. But it is a feat of passing.

Another good thing was that the fact I was transsexual wasn’t even mentioned. The Best Man (who happened to be the person who picked me up from hospital after my mastectomy) was under strict instructions Not To Mention it in The Speech.

Even in the legal paperwork bit they didn’t mention it. They asked for my birth certificate, I produced a birth certificate saying I was male.

Simple.

I know churches have the legal right to refuse to marry transsexuals, but I’m wondering how they know?  Do they ask everyone if they are a transsexual? Or do they just ask the people who look like they are transsexuals.

We couldn’t get married in a church anyway.

She’s divorced. Oh and I don’t believe in god. I think they ask about that.

More on Shrinking

This Lighter Life Thingy has been surprisingly effective. I am now 3 stone less than when I started. I am generally pleased about this. Of course I’m missing food, I really could kill a lettuce right now, but it’s worth it for the fact that I’m actually getting results.

For the first time in my life I don’t look like a fat person. I instead look like a thin person who’s put on a bit of weight. I can fit in ‘medium’ clothes instead of Large or XL.

This is good. I’m less self conscious playing sports and swimming now. I was always conscious  of being the ‘fat bloke’ before. I also look more masculine, I didn’t think I would. In fact I was a bit worried that loosing my padding would reveal my bone structure.

There’s still a stone to go though, and by god it’s sticking. There was one week where I stayed exactly the same weight. On 500kcal a day! How is that possible? I have obviously developed nuclear fission.

I think it’s become apparent that I loose weight less quickly than the men at the group who have an XY chromosomal alignment. This is again frustrating, it’s yet another reminder that I am not biologically male,  whatever my driving license says.

I didn’t tell the group leader that I was trans, there was a medical questionnaire, which I refused to give to her because she couldn’t give me a written guarantee of confidentiality. So instead I sent it to the head office. I thought she might get funny about having a trans person in her single sex weight loss group.

Although I’m not biologically male a lot of my issues around food are the same as most of the men in the group. However I did realise that I put on weight as a teenager because calorie counting was what ‘girls did’ so overeating was rebelling against the pressure to be an attractive woman. Also I hated sport because it was gender segregated.

I just hope I can get to my target weight before I move to the Distant Hills, where there isn’t a Lighter Life Group.

I asked her and she said yes.

So it seems I’m getting married.

We’ve been dating for nearly five years. Though I hate the term dating, it makes us seem like Americian Teenagers. We’re not of course.

Three weeks ago we decided to get married. I’m quite stunned by this and delighted. I never thought she’d actually say yes.

 Thankfully I’m of the generation of transsexuals that has always assumed that I would be able to get legally married. It must be awful not to be able to get married.

Marriage, even the thought of it, changes a relationship. I was reading a book on Irrationality by Stuart Sutherland, and it presented a some evidence that making a public committment to a project makes it more likely that it will work. Think weight watchers.

But yes, we’re getting married, I’m losing weight too, and that’s a different matter. We’ve told my parents, my mum is pleased for us, and my Dad is upset we’re not getting married in a church. Even though he never goes to church and isn’t even Christian. My Grandma is delighted, she didn’t know that we could get married. I think this is a sign that they accept me as male – because I don’t think they’d approve of gay  weddings.

So it’s happened. I’m getting married.