Today is Queen’s Day in the Netherlands, the day when we celebrate the Queen’s birthday on the date of our previous Queen’s birthday. It is a happy day, with music festivals all over the country, flags everywhere and many people dressed in our national colour orange. To an outsider we must seem like an extremely monarchist and nationalist country, celebrating the Queen’s birthday so exuberantly, but I don’t think that’s really it. The beautiful thing about Queen’s Day is the fact that we can just be happy, together, without any particular reason. The Queen’s birthday is just a good excuse. It is very much like when winning the World Cup, but without the football and crucially, without a losing team. There are no enemies on Queen’s Day, no opposing groups or religious disagreements. In a time when worries about economic crisis, swine flu and terrorist attacks dominate our lives, this day of careless celebration seems all the more important.
And that’s why today’s events have been so shocking: a man drove his car at high speed through the celebrating crowds, presumably en route to attack the royal family who at that moment were passing through. Four people are dead, five severely injured and the nation is in mourning.
Like so many public events, Queen’s Day has now also lost its careless innocence and will probably never be the same again.

With so many changes in my life, buying a house, settling down in Rotterdam (yes, after almost 9 years I’m finally out of denial) it’s domestication all ’round. So I’m cooking… this very tasty and very very simple pumpkin soup:

1. Gently fry 1 large onion and 2 cloves of garlic in olive oil until soft but not coloured.
2. Add 1 pumpkin (cut into smallish bits) and 1 red chili and fry for a few minutes stirring occasionally.
3. Add enough water to cover.
4. Bring to the boil and simmer for about 10 minutes until the pumpkin is soft.
5. Puree with a hand blender.
6. Stirr in 3-4 tbsp of yoghurt and salt to taste.

What an excellent end of the year… last week I was granted a research fellowship by Erasmus University Rotterdam which will allow me to do research for the next four years! Read all about it on the Erasmus University web site (in Dutch).
I will be moving away from head injury and enter the exciting (oh, and very hot and trendy) field of dementia. This may seem like a big step, but really, it’s neurocognition, fMRI and DTI.. nothing new, just patients with cognitive disorders without having hit their head first.
So lots of money for more research time and less clinical work! Oh, and did I mention the huge mortgage for the most beautiful house in Rotterdam we just bought?

I just got back from Valencia, Spain, where the weather was fantastic, the city beautiful and lively, and the food… hmm .
Anyway, there was also a conference: the 25th annual meeting of the European Society for Magnetic Resonance in Medicine and Biology. I like this meeting, because it’s small, there are many people I know whom it is nice to catch up with, and it aims to bridge the gaps between the fundamental sciences and medicine. Unfortunately I’m not really capable of crossing these bridges, as my lack of knowledge and understanding of MRI becomes painfully clear within seconds of the start of most of the sessions…
So I stuck to the clinical sessions mostly, with many talks on MR spectroscopy, diffusion weighted and perfusion imaging.
And I did venture into a few of the physics sessions… not sure it did me any good but maybe repeated exposure will make me at least a little bit less scared of acronyms. I’ll keep trying!

Writing a paper is hard. Submitting a paper is a nightmare. Every journal has its own specific requirements: maximum number of words, reference style, statements to be included in random places in the manuscript, etcetera. Once you’ve done all this, there’s the online submission system to deal with, which demands all kinds of additional, hard to find information, as well as all of your co-authors’ work and home addresses, phone numbers, favourite colour, car they drive… But I’ve gotten used to all this, and am even getting over my submission phobia, which made me press the “no” button time and again when the system asked me “this finalises your submission - are you sure?”.
Anyway, you can imagine my sense of achievement when I pressed the “yes” button after a morning’s preparing the submission of my cost-effectiveness paper for the British Medical Journal. Happy to have it off my desk, I went to lunch… only to return to a message in my inbox from BMJ, regretting to have to reject my paper, sent a mere 85 minutes after submission! (yes, I had a very long lunch break) This is my saddest record ever.
To save the day, I submitted an abstract for the European Congress of Radiology, who will not inform me about their decision until November. Something achieved today after all.

I’ve finally descended from my pink cloud after receiving my PhD with distinction (!) last week and put some pictures online from the defence, dinner, and party (a slightly censored selection - don’t worry..). Some more party pics can be found on Egor’s site for which I deny all responsibility…

With our hospital being an ever-changing building site, it may be tricky to find your way to the site of my PhD defence, so here’s some directions:

1. Take entrance 3 “Sophia/Faculteit” (see map below)
2. Take the elevator to floor 3
3. Follow signs to “Faculteitsgebouw” (over a bridge)
4. Look for (and follow!) red signs “Promotie” or “Collegezaal 7″

If you get lost, ring one of my “paranimfs”
Fleur 0628124014
Gavin 0646017283

Please note that the estimated walking time from the entrance to the defence is 10 mins (and that the defence starts 1.45pm sharp).

I am not a very practical person. I am aware of this, but somehow I forget at crucial moments, such as last week when the 900 copies of my thesis arrived from the printer’s.

Having been delivered to the point the furthest away from my office in the hospital possible, they just needed to be loaded on a trolley and wheeled to my office. Doesn’t seem too complicated, right? That’s why I felt fairly stupid checking there were any brakes on the wheels of the trolley I just loaded the 40+ boxes on (there weren’t), but even more stupid realising I was not going to be able to move the trolley, especially not wearing my high-heeled, smooth-soled shoes… At least I provided some entertainment for the people in the corridors I passed (well, who passed me and my trolley, really). A pleading and very desperate phone call for help was required…

But now the thesis has been sent off, the misery is easily forgotten with compliments pouring in . This is what it’s all about then - lots and lots of positive attention, yum!

I am going to be a better doctor, I have decided. A bit late for my New Year’s resolution, I agree, but better late then never.
Two things have led to this decision. One, I’ve just had a week’s holiday, so I can finally think a bit more clearly. (I’ve also just noticed that it’s spring and that there are leaves on trees; when did that happen?) Two, I read the book “Better” by Atul Gawande. At the risk of sounding really pathetic and promoting self-help books (which this isn’t, by the way), I have to say that this book is a real inspiration, and I strongly recommend it to anyone, particularly those working in health care. It is a collection of stories about doctors achieving more than usual. And not because they’re bettter at the politics and dirty tricks to get ahead in the ultra-hierarchical world of medicine, but just because they’re fighting, trying as hard as they can, and a bit more.
Lately, I have become really frustrated with working in a (university) hospital. The masses of paperwork and thick walls of bureaucracy make it seemingly impossible to change even the smallest things. Not to mention the beeper that never stops beeping, interrupting my work every ten minutes or more. It is then very easy to forget that we’re working with people, sick people, who are worried about their health, future, the pain they’re having or expecting to have. For most of us, the easiest way of dealing with our frustrations, constant pressure and chronic lack of sleep is by ignoring our patients’ human aspect and by denying any additional responsibilities towards them. Although we’d like to believe otherwise, this makes us just fairly average at our jobs. Not good.
So, I will work harder, despite the difficulties of system I’m working in, to be a better doctor. Because if patients can’t even trust us to have their best interest in mind, who can they? Certainly not the billions of hospital managers. And I will not complain about the health care system anymore… although I’m not quite sure how long I’ll be able to keep that one up.
Oh, how will I do all this? Well, read the book. And I’ll also need more holidays, obviously.