Appendix I: Docklands area, London.

This is an area just east of Central London, right on the river Thames. It used to be an old shipyarding and docks area (hence the name), with lots of old warehouses and narrow streets that wind tortuously through scattered blocks. It's recently undergone a huge refurbishment, so the old run-down brick-and-timber buildings have been converted to spacious (extremely expensive) loft apartments, and the streets are now lined by luxury cars. It's become a very fashonable and desirable area to live in.

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Appendix II: Museum of Contemporary Art

Believe it or not, this place actually exists. Right on the waterfront, with a expansive view of Circular Quay (the ferry terminal) and the Opera House, and the waterside suburbs beyond them. There's also a cafe there, out on the front terrace, and it serves the most amazing scallops I've ever eaten.

For information, try their website at

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Appendix III: Rodgers and Hammerstein

The legendary pairing of the lyricist and the composer, Richard Rodgers and Oscar Hammerstein II. Their musicals have been played out all over the world, and have been transcribed to the big screen. Most memorable offerings include 'The Sound of Music', "The King and I', 'Oklahoma', 'State Fair', and that famous song 'You'll never walk alone (When you walk through a Storm...)'.

In my humble opinion, anyone who's lived in the latter half of this century will have heard at least one of their songs.

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Appendix IV: Grand Rounds

The mainstay of clinical teaching in hospitals (tutorials aside), these are usually given as lectures by specialist doctors / surgeons in their area of expertise. They often include reports and discussions on interesting / unusual patient cases and clinical / surgical demonstrations.

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Appendix V: GCS

GCS stands for Glasgow Coma Scale, a handy point-score system for clinicians to judge the depth of a coma. It is based on three criteria: Verbal response, Motor reflexes and Eye opening, and the response is graded to a number. A GCS of 3 is the lowest score, with no responses. A GCS less that 8 indicates a severe injury, 9-12 moderate and 14 would suggest a minor injury.

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Appendix VI: West End

The West End is the theatre district in Central London, with dozens of playhouses scattered within a few blocks of tightly winding, convoluted streets. The musical Piersen is referring to here is in fact 'Hello Dolly', the Michael Stewart / Jerry Herman musical based on the play 'The Matchmaker' by Thornton Wilder (and subsequently made into a film starring Barbra Streisand, Walter Matthau and Louis Armstrong, and directed by Gene Kelly).

This particular line was when Dolly tries to persuade a reluctant Mr. Vandergelder, a well-to-do businessman, to ask her to marry him - a sight gag involving clever manipulationof salt and pepper shakers, and somewhat independent interpretations by Dolly and Vandergelder of 'your way' and 'mine'.

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Appendix VII: FRCS

FRCS stands for 'Fellow of the Royal College of Surgeons'. In this case it's the college based in England. With specialist medical training, the teaching program and examinations are regulated by a single body, depending on your specialty. In this case, the RCS is responsible for mediating and conducting examinations for doctors training in Surgery, as would the RCPsych do for Psychiatrists, etc. These colleges aren't tertiary education institutions as such, but a board of specialists that, amongst organising teaching programs, also dictate rules of conduct, procedures and have the authority to mete out disciplinary measures.

Following a set period of training, the doctor is awarded a membership of the college (eg. MRCS), and with further demonstration of experience and expertise, an FRCS may be awarded. In this scenario, Laine definitely has a right to be gobsmacked - to meet a twenty-six year old consultant neurosurgeon with an FRCS is pretty much impossible (at least, I've yet to meet one *G*).

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Appendix VIII: Horace, Odes IV

There are three versions of this poem - one is the original Latin version as written by Horace himself. The other is the poem the Kai quotes in Chapter 23, which was written by A E Housman as a translation of the Latin version. A more prosaic translation is at the end of this section.


Diffugere nives, redeunt iam gramina campis 
    arboribusque comae; 
mutat terra vices et decrescentia ripas 
    flumina praetereunt; 

Gratia cum Nymphis geminisque sororibus audet 
    ducere muda choros. 
immortalia ne speres, monet annus et almum 
    quae rapit hora diem. 

frigora mitescunt zephyris, ver proterit aestas 
    interitura, simul 
pomifer autumnus fruge effuderit, et mox 
    bruma recurrit iners. 

damna tamen celeres reparant caelestia lunae; 
    nox ubi decidimus, 
quo pius Aeneas, quo Tullus dives et Ancus, 
    pulvis et umbra sumus. 

quis scit an adiciant hodiernae crastina summae 
    tempora di superi? 
cuncta manus avidas fugient heredis, amico 
    quae dederis animo. 

cum semel occideris et de te splendida Minos 
    fecerit arbitria, 
non, Torquate, genus, non te facundia, non te 
    restituet pietas; 

infernis neque enim tenebris Diana pudicum 
    liberat Hippolytum, 
nec Lethea valet Theseus abrumpere caro 
    vincula Pirithoo.

A E Housman

The snows are fled away, leaves on their shaws 
    And grasses in the mead renew their birth. 
The river to the river-bed withdraws, 
    And altered is the fashion of the earth. 

The Nymphs and Graces three put off their ear 
    And unapparelled in the woodland play. 
The swift hour and the brief prime of year 
    Say to the soul, Thou wast not born for aye.

Thaw follows frost; hard on the heel of spring 
    Treads summer sure to die, for hard on hers 
Comes autumn, with his apples scattering; 
    Then back to wintertide, when nothing stirs. 

But oh, whate'er the sky-led seasons mar, 
    Moon upon moon rebuilds it with her beams; 
Come we where Tullus and where Ancus are, 
    And good Aeneas, we are dust and dreams. 

Torquatus, if the gods in heaven shall add 
    The morrow to the day, what tongue has told? 
Feast then thy heart, for what thy heart has had 
    The fingers of no heir ever will hold. 

When thou descendest once the shades among, 
    The stern assize and equal judgement o'er, 
Not thy long lineage nor thy golden tongue, 
  No, nor thy righteousness, shall friend thee more. 

Night holds Hippolytus the pure of stains, 
    Diana steads him nothing, he must stay; 
And Theseus leaves Pirithous in the chain 
    The love of comrades cannot take away.

Spring's Return - (English translation by C E Bennet, Loeb Classical Text Library)

The snow has fled; already the grass is returning to the fields and the foliage to the trees. Earth is going through her changes, and with lessening flood the rivers flow past their banks. The Grace, with the Nymphs and her twin sisters, ventures unrobed to lead her hands. The year and the hour that robs us of the gracious day warn thee not to hope for unending joys. The cold give way before the zephyrs' spring is trampled underfoot by summer, destined likewise to pass away so soon as fruitful autumn has poured forth its harvest; and lifeless winter soon returns again.

Yet the swiftly changing moons repair their losses in the sky. We, when we have desceded wither righteous Aeneas, wither rich Tullus and Ancus have gone, are dust and shadow. Who knows whether the gods will add tomorrow's time to the sum of today? All things which thou grantest to thine own dear soul, shall escape the greedy clutches of thine heir.

When once thou hast perished and Minos has pronounced on thee his august judgement, nor family, Torquatus, nor eloquence, nor rightousness shall restore thee to life. For Diana releases not the chaste Hippolytus from the nether darkness, nor has Theseus the power to break the Lethean chains of his beloved Pirithous.

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Appendix IX: Guillain-Barre Syndrome

This neurological syndrome can be described as an Acute Inflammatory Post-infectious Polyneuropathy - that is;

Acute: Onset about 10-20 days after a triggering event
Inflammatory: A reactive response in the nerves to the triggering event
Post-infectious: The triggering agent is usually a respiratory infection, which provokes an allergic inflammation of the peripheral nerves.
Polyneuropathy: The disease affects all of the peripheral nerves, typically in a symmertrical fashion, affecting the most distant nerves first (ie. the toes, tips of fingers) and spreads towards the trunk over time.
Landry's Paralysis is a form of GBS that spreads very quickly. The disease can be very distressing, because it comes on as a spreading paralysis that moves up the body. But since it isn't a destructive process, after the allergic response blows over the recovery is excellent, with all normal function retained.

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Appendix X: Sabrina

A wonderful movie made in the 1950-60s sometime, starring Audrey Hepburn, Humphrey Bogart and William Holden. It's the classic story, really - Sabrina is the daughter of a chauffeur working for the ridiculously rich Larrabee family. She's quite young, pretty gawky - grew up living in the little flat set aside for her and her father above the garages. She loved watching the grand parties the Larrabees held in their gardens as a child, hidden away up in a tree, watching the younger Larrabee son David (the dashing, goodlooking one played by Holden who opted for a life of leisure) charm all the girls while his older brother Linus (Bogart, the not-so-goodlooking workaholic) ran deals and talked finance with the business guests, keeping the family company running.

Sabrina was very much in love with David, though she probably hadn't spoken more than two words to the guy.

As she was growing up, she was sent off to Paris to a finishing school. And having spent a year there, voila, what do we have but a beautiful, sophisticated Sabrina who returns home, surprising everyone (except Linus) with how classy she is now.

I won't give away the story, suffice to say that David was captivated. And he invited her to a big party his mother was throwing. Needless to say it was a dream come true for Sabrina, who had dreamed of being there, dancing with David, being the target of his charms, sitting in the secluded arboreum waiting for him while he ordered the orchestra to play "their" song while fetching champagne and fluted glasses for two. Which he kept in his back pockets as he slipped away from the pain crowd of the party.

Of course, as Sabrina was waiting, there was a nasty accident. How?

LInus caught up to him slipping away and dragged him off to tell him that he had been a philandering and lazy bastard and that he should start pulling his weight around a bit here. To make his point, he makes David sit down. Hard.

Crunch. The sound of glass breaking and a rather loud scream can just be heard over the glorious music the band is playing outside.

Anyway. That was the Sabrina reference. I love that movie, so I just had to put it in there. <G>

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