Night of the Zombie Healthcare Assistant – Day 5

And so here we are, 5 days into my story (the fourth post) but a long, long way from full recovery.  I guess this is the pay-off post given the title, but I’ll continue writing articles after this one covering the rest of the process (I promise, I’ll condense them).  This one though is a smörgåsbord of pain, failure, morphine, bodily fluids and wide eyed terror.  Welcome aboard, I hope the journey was worth it.

NB: Hardly any pictures in this post, I wasn’t in much condition to lift the phone up.

NB: This is a long, long, long post with a lot of text.  Sorry.

Also NB: Day 1 & 2 here, day 3 here, day 4 here.

Day 5

Early start, I don't look impressed.
Early start, I don’t look impressed.

This post might jump around a bit, and first off, I wanted to talk about Alan.  Alan had done nothing wrong other than fall down some stairs.  He’d done nothing wrong other than make it into his 70’s with a mind as sharp as a tack.  He deserved respect and dignity, and more than that, he deserved the best standard of care that you can find in the world.  What Alan got was a crap shoot where one minute he was being dealt with sensitively by someone who truly cared and the next he was being managed like a problematic child you wish you’d never had.  It all depended entirely on which nurse or healthcare assistant he got at the time.  We all experienced this in the ward, some of the staff were fantastic, and some were pretty rubbish and ineffective, but in some ways, we were able to fend for ourselves a little more than Alan.

He’d been lying flat for a few days by the time I was admitted, and along with incessant hiccups (which were sadly a source of amusement for most of the staff) he was beginning to get a bit wheezy (day 4).  I watched as Alan basically picked up a chest infection in slow motion (day 5).  Nurses could tell it was coming.  Healthcare assistants commented on it.  Yet it felt like the plan was wait until it took hold and then pump Alan full of antibiotics to get rid of it again (day 6).  It was like watching paint run down a wall and only when it spilled onto the floor take action mopping it up.  Could they have prevented the infection, would antibiotics a day earlier have held off the worst of it?  I don’t know, but it was tragic watching it take hold (you’ll see, later).

Alan told everyone who dealt with him that he was deaf in one ear, and hard of hearing in the other.  The best of the staff remembered and stood on his good side and spoke loudly and clearly.  The worst of the staff ignored his hearing and just talked to him like a child when he failed to hear what they said.  I started saying ‘he’s deaf in that ear’ when Alan struggled to hear what they were saying.  I was in a bed, on the other side of the ward, and I could hold a fucking conversation with Alan, deaf and hard of hearing, better than some of the staff did while standing next to his head.  He wasn’t stupid, he wasn’t tired, he was just hard of hearing.  He deserved to be spoken to like an intelligent human being, not like a baby.

There were three shift rotations a day for the nurses and healthcare assistants, and during each rotation the new and old groups would do a round discussing all the patients.  That was the handover, and it relied on short conversations, the memories of the people involved, whatever notes had been written into our folders and the words written above our beds on the white boards.  It’s always great to be talked about as if you’re not there, I often chipped in during their discussions of me, but not once did any of them say ‘Alan is a bit deaf, stand on his right side’.  I watched one set of nurses consult with a doctor when Alan was deteriorating, and they limited his water intake to 1 litre a day.  But they didn’t write it clearly above his head, nor did they explain to Alan why.  So when the tea lady came around for the rest of that day, she quite happily re-filled Alan’s jug and gave him full cups of tea.  Later that day, the nurse complained at Alan about this.  It wasn’t fucking Alan’s fault – he’s a patient, he’s not meant to be in charge of his own care.  The communication between the staff was just terrible.  Eventually one of the nurses told the lady who did the tea about the fluid limit, but the next day, it was a different tea lady … and so Alan got too much fluid again.  Eventually, myself and Alan had to keep reminding the people serving him water that he wasn’t allowed it.

Friday morning had arrived, I woke up early having had a pretty fitful night.  I’d used up a few more cardboard urine bottles overnight, but the feeling had come back in my lower body and I was able to wiggle the toes in my left foot.  While I’d been ignorant of the seriousness of my foot injury, and had been wearing the moon-boot, I’d been able to hobble around quite quickly.  Now though I was in a light-weight cast which I wasn’t allowed to bear any weight on, in any way.  I couldn’t hop because my left arm was too painful, so I was reduced to pivoting between the bed and the chair next to it if I wanted to move.

Nurses arrived with a fresh gown and a fresh pair of paper pants, along with a bowl of hot water, some more antiseptic scrub and some towels.  They left me to get cleaned, saying if I needed help just to buzz with the alarm.  That was the most painful washing experience in my life.  My left arm was still almost entirely immobile and very swollen.  I couldn’t bear even the weight of my own forearm and I couldn’t voluntarily move the arm more than 1cm away from my body.  Even getting the gown off was extremely difficult and painful, but I managed.  I changed my paper pants, washed as much of my arm as I could in preparation for the surgery and then got the gown back on (but not done up).  I buzzed for the nurse, and waited.

And waited.

So I buzzed again.

And waited.

After about 20 minutes and my 6th buzz, the nurse arrived, irritated.  Luckily, I hadn’t been choking to death, or hadn’t fallen to the floor, or hadn’t been suffering from any breathing issues or actually anything serious.  I was just in pain, unable to get dressed, unable to walk, sitting on a bed waiting for someone to come and help me.

We got the gown tied up and then the nurse tried to put the foam sling back on my arm.  She failed, getting the strap in the wrong place, despite me having explained how it needed to go.  So I explained again how it needed to go over my shoulder, and she tried again, and failed.  Both attempts were excruciating painful.  I told her, rather angrily, that I’d sort it out myself thank you very much and she cleared away the water and towels and left me to it.  The gent with the motorcycle injury looked over and said, “She’s rubbish”.  And she was.  I got to know her and her shift quite well over the small number of days I was there, and she was indeed, rubbish.  She didn’t communicate, she didn’t listen, she didn’t care and she turned up at her own pace.

I got into trouble once on Facebook when I said something like 20% of people are shit.  That includes hospital staff, the police, the army, the clergy, bin men, gravediggers, chefs, teachers, shop keepers, etc.  Someone told me that people in the NHS deserve our respect.  It’s true, they do.  But equally, people are crap.  Great people have crap days, and some people are crap all the time.  Some people start out great and then get worse over time.  Some people are great on day one and great on the day they retire.  But the truth is, people are fallible, they have shit days due to regular issues we all suffer.  When I have a bad day and go to work, the worst that happens is I write a snotty e-mail and have to apologise for it later.  If you work as a nurse and you take your frustrations or stress in to work with you – people can suffer.  I wouldn’t ask anyone to do it – I have the utmost respect for anyone that does.  There are more good people than bad, more good people in the NHS than bad, but that doesn’t detract from the truth.  Some people are rubbish and shouldn’t work in a role which requires them to help people.

This nurse was one of them, or she needed a holiday, or she needed more support from her own management, or something, but whatever the problem was, it impacted my health, and the health of the other people in that ward.

And, she wasn’t even the worst health care professional I was going to experience that day.  That was to come much later.

When the nurse with the drug trolley came around that morning, I still wasn’t listed for any drugs, but I explained how much pain I was in and she gave me some codeine after much pleading on my part that paracetamol really wasn’t going to cut it.  Then I got a visit from a surgeon.  She wasn’t the lead surgeon or consultant doing my shoulder, but she’d come to do the pre-surgery assessment.  She asked me how I was feeling, and I was pretty angry at that stage.  I explained I was in pain.  She asked if I’d been offered any pain relief and I explained I’d pretty much had to beg for codeine.  She asked why I hadn’t had any morphine and I told her I hadn’t exactly been given a list of what I was allowed to ask for.

At which point she stood up, and said to the nurse team which were currently doing hand-overs, “Mr Evans doesn’t seem to be happy with his pain relief”.  After which, I was fitted pretty quickly for subcut morphine (morphine administered via a subcutaneous line).  Hilariously, the dose of morphine I got was delivered to me as I was lying on the bed on my way for a shoulder surgery and a general anaesthetic (GA) but you can’t have everything.

You have to consent to surgery, and they’re very serious about it.  Before I got the morphine, we did that little dance with the surgeon explaining the risks and me trying to explain I’d already consented to shoulder surgery on Wednesday during my first appointment with the fracture clinic.  But no one could find that paper work so we had to go through it all again.  I got a visit from a new anaesthetist, and we discussed options, but given the location of the surgery and the intrusive nature, the only real option was general anaesthetic for this one.  Then I was onto the trolley and getting some morphine.  I did ask if there was any point and if it would interfere with the GA, but was pretty much dismissed by the nurse administering the dose.

I waved to Alan as I was pushed out of the ward and down to theatre.  It was 9:42am and my day had already been a bit challenging.

I texted Greté around 4pm when I woke up, back in the bed.  My arm was back in the sling, the only difference being the presence of some pretty big wound dressings.  The surgeon I saw that morning would be the last time I spoke to a consultant or surgeon until after I was discharged.  At no point did anyone come and tell me if either surgery had gone to plan or had issues, at no point did anyone tell me how to manage either of my injuries.  I did, in frustration, explain that to one nurse and the next morning (I told you this would jump around) the on-call doctor came to speak to me, but all she could offer me was “there aren’t any comments on your notes, so I think it all went okay”.  Come on NHS, I’m the patient, where’s the communication?

Anyway, I woke up, I was still groggy, Greté and her mum visited me.  Over the days I was in, Simes and Sarah visited as well, but I’m ashamed to say I can’t remember on what days they visited.  I’m grateful for their visits, but I just can’t piece together when they were!  I stumbled through a conversation with Greté but I was clearly still recovering from the GA.

At some point during this day, I had a visit from the clinical pharmacist and we got my medication sorted out.  I was prescribed codeine, paracetamol and ibuprofen, and my own diabetic medication was documented so I could use those as necessary.  I’d had a couple of visits from the nurse with the drug trolley and one of the questions they and the healthcare assistants ask while doing hourly observations is, are you in pain and can you rate it from 1 to 3.  They use 1, 2 and 3 in Derby because they found with 1-10 most people would just pick 1, 5 or 10 anyway.  Mostly I responded 1 or 2.

A bourbon biscuit!
A bourbon biscuit!

Greté left, I had some food and dozed for a bit.

Then around 8 or 9pm Alan started having trouble.  He was clearly running a fever and was beginning to get very confused.  He hadn’t been diagnosed with his chest infection at this stage, and wasn’t on antibiotics.  Twice I watched him try and get out of bed, thinking it was time to go home.  It was heart breaking.  We’d had the evening nurse shift change and had a male nurse, a female healthcare assistant and another member of staff (not sure if she was a nurse or an HCA).  I’d never see any of them before.

Alan was considered a high risk patient.  He needed the compression on his feet, and he needed to be turned a couple of times a day and he was on hourly observations.  I’d just come out of surgery on GA, and needed hourly observations.  I was also in an increasing amount of pain.

Between 8pm and 11pm, I noticed the HCA walk into the ward a few times and stand in the middle, and then look confused and walk back out.  She kept looking at a piece of paper in her hand, but would then simply leave the ward.  Alan was restless, trying to get out of bed.  My pain was increasing but I was still very groggy.

At around 11pm I watched the HCA, and she looked stoned; I’m sure she wasn’t, but she looked it.  Maybe stoned, or in shock, or suffering from PTSD, or lost, or she could have been a zombie.  Whatever it was, she was clearly out of her depth in a major way.  Neither myself nor Alan had had any observations done for over 3 hours, no one had asked me about my pain, Alan had tried to get out of bed twice.  He was singing, talking, thrashing and clearly distressed.  I was starting to breath heavily to try and deal with the pain in my arm.

The Zombie HCA walked in, looked at her bit of paper, hung around, and then left.

I think I called out saying I needed something for the pain and she mumbled something.

A while later, I was hyper-ventilating and groaning involuntarily.

Alan was singing.

Zombie HCA walked in and straight out.

I started sobbing.

Alan sounded like he was coughing up a lung.

Eventually the male nurse came in.  I don’t really remember much about the conversation, but he was irritated at the Zombie HCA, he was irritated at me, he wasn’t happy that I wanted some pain relief, but eventually, after another 50 minutes, he came back with some subcut morphine.  I’d been in pain from 8pm, in serious pain from 10pm and in almost unbearable pain from 11pm, but around 12:30am I finally got some pain relief.

I say relief, but by them it was too late.  Essentially, whatever they used to block the pain as part of the GA wore off in one go between 10pm and 11pm, so I went from being uncomfortable, to being in all the pain having your arm cut open and metal plates screwed into the bone can induce in the space of 60 minutes.  The morphine just took the edge off and made me dozy, it didn’t kill the pain.  Not long after this, the HCA spoke to me for the first time all evening, she said, “Can you rate your pain level between 1-3?”.  I asked her if she was fucking joking, given she’d just watched me go from normal to sobbing in the space of an hour and beg for morphine, but she didn’t really show any signs of understanding what I was saying.  I told the male nurse that “I didn’t trust the other nurses”, and he very angrily pointed out they weren’t nurses, they were healthcare assistants.  I guess he was having a bad day.

I dozed in and out of sleep for a while, and when I woke up in pain, I buzzed and got more morphine.  That happened another couple of times overnight, each time I’d wake up, buzz, and get more morphine.

Finally the night of the zombie healthcare assistant was over, and day 6 (Saturday) had begun.

Before day 6 however, here’s a section of other stuff that happened on day 5, but which I can’t place in the timeline because it’s all so fuzzy.

  • During one of the drug rounds, after my surgery, a nurse pulled out a large needle and said ‘I need to inject this into your stomach’.  It was pretty abrupt, and I said, ‘Why?’  She just said, ‘I need to’.  So I told her no.  I wasn’t prepared to accept some random medication that she couldn’t explain to me.  She looked a bit confused but just left.  Here’s a top tip, if you want patients to take medication, then you should explain to them what it is.  I know that not all people are the same, some don’t care, some don’t understand, but some are intelligent, articulate, interested and aware, and when you have one of those patients you really need to do more than say ‘I am going to stick this in you’.  Tune in on day 6 to see if I ever accept my heparin or heparin equivalent.
  • Despite not being nil by mouth any more, they left that phrase written on my whiteboard and I had to explain it away every time the tea lady came by.
  • While Zombie Healthcare Assistant was failing to do her observations properly (she did eventually take some, but she wrote them up wrongly on the system, mixing up the numbers) both the male nurse and the other female member of staff had conversations with her, explaining she was screwing up and trying to get her to correct the issues.  But it didn’t help.  I didn’t get any proper observations until the next shift change, and Alan was pretty much ignored all night.  I assume the ward was understaffed, and I hope Zombie HCA gets the help she needs in whatever form it takes, but someone needs to manage their staff better.
  • There had been a trainee nurse on the ward earlier – she was doing the HCA role.  She was the only one who actually wrote everything in the folders, and she was constantly aghast at how little information there was.  She took care of Alan before the shift change to Zombie HCA.
  • The next day, the regular nurses complained amongst themselves at how much the trainee nurse had done.  They were pissed off that she’d done lots of nurse stuff, not just HCA stuff, even though she was supposed to be doing HCA training.  I think they were mostly pissed off that she made them look bad.  Which of course, they were.  I don’t know the relationship between nurses and HCAs or how the training works, or what role everyone was doing.  I just know she was a nurse in some capacity, but was only covering, or learning, or supposed to be doing the HCA role in that ward, but because she saw holes in the care of the patients she just covered where she could and I appreciate that.
  • Alan finally got some sleep, although he spent much of it mumbling and unhappy.

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Night of the Zombie Healthcare Assistant – Day 4

Welcome to day 4, being the third post in a series of posts about my recent injury and recovery.  This post contains bodily fluids, pictures of cannula and a lack of dignity.  You can read part 1 here and part 2 here.  They don’t contain any bodily fluids.

Day 4

Post-surgery cast and bandage.
Post-surgery cast and bandage.

We never got a chance to call the trauma nurse on the morning of Thursday 25th August to check if I was on any surgery lists, because she rang us first.  The shoulder specialist had found his foot specialist the day before, and I had a serious lisfranc fracture of the foot – which needed urgent surgery and fixation (again, plates).   I really should not have been putting any weight on it all, and the misdiagnosis in Carlisle had put my ability to ever walk properly at risk.  Untreated lisfranc injuries can result in instability of the foot and serious issues with mobility.  So I was being admitted at 11am, and despite expecting to be going in for shoulder surgery – I was going for foot surgery at round 2pm.  We’d prepared a little overnight stay bag the night before when we got home so we were ready to go when the call arrived but it was still pretty fucking scary.  I’ve had a broken arm (in my teens) and I knew I could get through the day only being able to use one of them, but foot surgery inevitably meant being off my feet for some time.  I had no idea how long for.  Also, with both the arm and foot injury being on the left side, I knew I wasn’t going to be using a crutch to get around – it was starting to look a little bleak.

We headed in, found our way to Ward 311 and on Thursday 25th, I’d gone from falling over playing tennis to being hospitalised four days later.

It’s around this point that my dignity became a victim of necessity.  It’s also around this point that I started taking a lot more codeine a lot more regularly – and as a result, my memory is shit.  All of the things I’m going to write about happened, but lets say that the order in which they took place or the exact sequence is more fluid.

Look how pretty it is.
Look how pretty it is.

Admission was pretty swift, they had the details from the previous day and the team were very efficient.  With the surgery deadline in place, there wasn’t much time to get used to my new surroundings.  I had to have conversations with the anaesthetist, the surgeon and the rest of the team.  Before all of that though, I had to get ready.  And by getting ready, I mean I had to shed my dignity.  If hospital gowns are the worst invention of the modern age, then paper surgery pants are the worst invention of any age.  Greté helped me get changed into both gown and pants, after washing down my leg with hibiscrub (or something similar), and I lay back in the hospital bed, feeling a bit like a turkey ready for basting.  Do you know how easy it is for pubic hair to get trapped in paper underwear?  Very easy.

I’ve only had surgery as an adult once, and I found that the person who seemed to care most about my well-being during the whole process was the anaesthetist.  That was matched this time (although the surgeon was nice, to be fair).  I had a long conversation about the style of anaesthetic I wanted.  On offer were full general or, essentially, a spinal injection which would kill any sensation from below the waist and an injection freezing my foot in place.  I never realised that general anaesthetics don’t come with any pain relief as such, where-as the other option was all about the lack of pain.  However, if I went for the spinal injection, I’d be conscious for the operation – and I’d get something to help me relax without putting me to sleep.  The anaesthetist asked which one I would prefer – I think I said, well, I’ll defer to you given it’s your job.  He was insistent that I choose though – which I still find weird.  In the end, I opted for the spinal injection because I quite liked the idea of being awake during the surgery.  It was an excellent decision as my shoulder surgery later would prove.  It wasn’t until much later that I realised the reason anaesthetists care so much, is because they’re basically holding your life in their hands, and in most surgeries, have more control over your well-being than the surgeon or anyone else in the theatre.  If they fuck up, you don’t wake up.

The surgeon then paid a visit – and explained for the first time what the foot injury was and how it showed up on the x-rays.  He also said that the bruising on the bottom of my foot was a classic symptom of fractures, if your foot bruises like that, it’s almost certainly broken.  He explained the surgery, and drew three marks on my leg and foot.  A massive arrow on my left calf, a dotted line on my foot where he said he was going to make his incision, and then another line on the inside of my foot with a question mark, because he wasn’t sure if he’d need two incisions or not.  I finally got to wash those marks off my leg on the 18th of October, 54 days later.  I spent some of those 54 days wondering if the ink was toxic when absorbed by the skin.

The surgeon also tossed in a throw away comment, that after the plate goes in, sometimes they take it back out after the swelling goes down, a couple of years down the line.  Yep, two years of swelling around the plate.

Post-surgery selfie, complete with oxygen line.
Post-surgery selfie, complete with oxygen line.

What didn’t happen during all these conversations, was a proper discussion with the clinical pharmacist or anyone about medication or pain relief.  Likely because I was being admitted quite late and going straight to surgery – but it would prove frustrating later on.

Eventually it was time to head out – and I hopped across onto the surgery trolley and told Greté to go home rather than wait since we didn’t know how long it would take.  Off I went, paper pants and all toward the operating theatre.  I had another conversation with the anaesthetist, we reviewed all the questions again about loose teeth, and then it was time for the injections.  Leaning forward was pretty painful (see: fractured humerus) but once the various cocktails were in me it was a lot easier.  I was in surgery and looking up at some bright lights.  My memory of the surgery is strange.  Time was really compressed, and I must have been dozing on and off, but I do remember talking to the surgeon and other people in the room.  I remember seeing an x-ray of my foot with the plate and pins in it.  I listened to the surgeon discuss where to put the next pins and how to lock the plate in place.  I never felt a thing.

I woke up back in the ward, in bed, thankfully with my paper pants still in place.  I could not feel my legs, or my back, but my leg had a half cast on it and a lot of bandage, so I knew something had happened.  Luckily it was the correct leg as well!  I’m piecing a lot of the rest of the day through a mixture of SMS and Facebook messages.  Thanks to technology, I never felt far from Greté and friends, and most of the photographs in this post I took to send to Greté to let her know I was okay.  I woke up around 7pm and texted Greté as soon as I could reach my phone.  There wasn’t much point her coming back in that night so we just spent the time talking on SMS or FB.  This is my favourite part of the whole conversation, Greté’s text is in grey, mine is blue.

Facebook messenger chat
Facebook messenger chat

I hope you appreciate that.

Flapping cannula.
Flapping cannula.

So far, other than some confusion early on, the experience with Derby hospital had been pretty good.  I can’t fault the consultant, the anaesthetist or the admission team.  However, it was all about to start going downhill.  I’d not eaten anything or had anything to drink since midnight and it was now 7pm, long after they serve evening meals.  A lovely nurse1 checked with me and asked if I was hungry and wanted a sandwich.  She brought two sandwiches back with a drink, and said I looked like I had an appetite.  I was then informed that it would be nil by mouth again from midnight, because I was going in for shoulder surgery the following morning, at 10am.

I had a chance for the first time to get to know the other patients in the small ward I was in.  Alan was in the bed opposite mine.  Alan was in his 70’s, deaf in one ear but mentally sharp as a tack.  He wasn’t from Nottingham or Derby, but had fallen down some marble stairs in a building somewhere in the region and broken his hip in three places.  He was pretty immobile in the bed, had been in for a few days and had some kind of air-powered compression slippers on to keep the blood flowing in his legs.  There was a gent on my far right who’d been in a motorcycle accident, broken both arms quite badly.  He’d already been in surgery a few times, metalwork sticking out of his arms.  His legs worked though so he spent a lot of time out of the room walking around.  In between them was another guy, who I didn’t get to know, he was pretty much asleep and then discharged the next morning.

I had a bit of a chat with Alan which wasn’t easy, we were both drugged up and he was half deaf, but at least it was some conversation.  The pain in my arm was getting worse, I hadn’t had any pain killers since the night before but I checked with the healthcare assistant (HCA) while she was doing my observations and she said the nurse would be doing her rounds with the drug cart in a little while.  I also mentioned that my cannula appeared to be coming loose, but she didn’t seem very worried.  Eventually the nurse with the drug trolley arrived, and we spoke about pain relief.

“There’s nothing down next to your name, I can give you some paracetamol.”

I was a bit frustrated by that.  I explained calmly that I was in quite a bit of pain and really could do with something stronger than paracetamol.  It turns out that because I was admitted and moved into surgery so quickly, I hadn’t had the review that happens when they work out what drugs you’re going to be prescribed.  I told her I had a bag full of ibuprofen, codeine and paracetamol all prescribed to me the day before by the consultant.  She said, “you’re not supposed to take your own tablets, but if I don’t see you taken them ….”

So I took them.  Along with my diabetic medication.

While I was calming down from that (and enduring ‘hourly observations’) I noticed that Alan’s pressured foot things weren’t on his feet.  I was just about to mention it to someone when one of the nurses / HCA’s noticed and replaced them, making concerned sounds about how long they’d been left off for.

#dignityI finished the day off with a massive wee; into two cardboard urine receptacles.  I’d taken on board a lot of fluids during the surgery, and despite not having anything to drink since the previous night, I’d also not been to the loo since around 11am, so there was plenty of water to get rid of.  When the nurse came to collect the used bottle, I had to let them know they were both full – I don’t think she believed me initially, but she took them both and returned with two empty ones.  That would be a pattern for the next day or so, where I think I passed a volume of liquid equal to Loch Ness.  I can’t quite describe the subtle terror of lying in a bed, not able to feel your own legs or find your own penis by touch, weeing into a carboard bottle which is resting on the bed, trying to work out if you’re holding it at the right angle so that it doesn’t just spill out of the top.

Luckily for everyone concerned, I have great pelvic floor control.

Despite several queries and reminders no one really bothered fixing my cannula, and despite the fact that my arm was seriously painful I eventually just nodded off, ready for day 5.  You’ll be pleased to know that day 5 is finally the Night of the Zombie Healthcare Assistant.

  1. note that I refer to a lot of staff as nurses, they may have specific roles and names, but I don’t know them []

Night of the Zombie Healthcare Assistant – Day 3

This is the second post in a series of posts covering my injury and subsequent recovery.  You can check out the first part here.  This one’s not to bad, but if you don’t like to hear about bodily fluids, you probably want to skip the next one (which I’ve not written yet, but I already know how it goes), and to be fair, most of the ones after that one too.

Day 3

Bruise starting to develop nicely.
Bruise starting to develop nicely.

After an uncomfortable night, muted by a lot of codeine, I was up and hobbling around on Wednesday 24th August ready for my appointment at the fracture clinic.  I prefer the Royal Derby Hospital over Nottingham (we live in a place that lets us choose) for various reasons – so we squeezed me back into the car, padding in place, and got there early.  I’m always early.  Usually, very early.  I was once an entire day early for a medical appointment (I had to go back the next day).  Luckily the fracture clinic isn’t far from the main car park but despite my protests, Greté made sure I was in a wheelchair rather than allowing me to walk.  I’m grateful now, but at the time my pride was a little fractured too.

The fracture clinic system at the hospital is a bit free-form.  You arrive in the main reception, and sit for a bit, then someone calls your name and you go through to an examination room, and then you wait as long as it takes for the consultant to come and see you.  The nurses seem to be just as confused about what is going on as everyone else, and it felt very chaotic.  However we’ve been a few times now and I think what it means is that, because people need x-rays or casts and other procedures during the whole appointment, they can basically manage the list of people without being overly rigid.  If your appointment time is 2pm but you arrive at 1pm, you’re likely to be seen before 2pm, because there’s a gap while a brace of more mature patients are having casts put on, or whatever.  So we were in an examination room pretty quickly, but it took more than half an hour for a consultant to then come and check me over.

Lovely bruise on the base of my left foot.
Lovely bruise on the base of my left foot.

To add to the confusion, we weren’t coming in via a normal route.  Normally, you fall over or suffer a trauma, and either go straight to the clinic or get referred immediately by A&E.  We had kind of self-referred a couple of days after the accident, so they had previous notes to look at from another hospital, but no one had done the normal trauma / fracture questionnaires that Derby usually do.

Lastly, as a patient, you tend to get told nothing until the last minute.  We’d not been to the fracture clinic before and didn’t really know what to expect, so the waiting was even harder (with or without pain) and people would come, ask questions, and leave and we’d not be sure what that all meant.

However, eventually a consultant came to see me and we went through a few basic questions – and then were immediately sent off to x-ray.  X-raying fractured limbs is painful, because you invariably have to get them into positions they do not want to go into.  I was still blithely and happily standing on my foot when required, but moving my arm around was agony.  X-rays done we wheeled back to the reception and went straight back into an examination room.  What followed was one of the most amusing and yet uncomfortable hospital interviews ever.

More bruising
More bruising

Our consultant had a couple of student doctors with him that day.  He sent them in, telling them to do the regular trauma stuff and he’d be along in a minute.  He obviously got delayed, so we spent nearly an hour in a room with two doctors who knew they were out of their depth making small talk.  We filled in the questionnaire, that they’d never seen before, talking about what the injuries were and where they were.  When it came to the physical examination, they took one look at the bruises and my pained face and didn’t bother.  A lot of the questions pertained to serious trauma but they felt they had to ask them anyway.  They were really nice about it, and we had a good chat about lots of non-medical related stuff, but they can’t have been enjoying the experience.

Eventually, the consultant arrived having looked over the new x-rays.  He was a shoulder specialist himself, and the delay had been because he was trying to find a foot specialist to review the foot x-rays.  We were about to get the first full and accurate diagnosis, the fourth of the whole process.  The initial nurses had gotten it wrong (can’t blame them), the GP was close but ultimately not detailed enough, the Carlisle orthopaedic department were plain wrong, and this guy, as you might imagine, was about to be correct.

The arm was clearly fractured, across the top of the humerus just below the actual ball joint (surgical neck fracture), it was also displaced.  So not dislocated, but not properly aligned either.  Had we not taken any action, it wouldn’t have healed correctly, if it healed at all, and I would have been screwed.  The consultant explained I was going to be screwed in a more literal sense, because it needed surgery and fixation (i.e. a plate).  He explained that he wasn’t sure if there were any spaces on the next immediate surgery lists, and also explained he’d been trying to speak to the foot specialist, because he was concerned by the x-ray, but he wanted to get a better diagnosis.  After writing up a sick note and giving me a prescription for some much stronger pain relief, he left to do that, and we started filling in (shoulder) pre-surgery questionnaires with the trauma specialist nurse (not sure of her title, but she was doing the admissions stuff).

Just a tiny bit of swelling on my elbow.
Just a tiny bit of swelling on my elbow.

After a standing start, things were beginning to move quite quickly.  I’d gone from being suspicious about the first few diagnoses but assuming I’d be in a sling for a few weeks, to being told I needed quite invasive surgery on my arm at the very least, and that I was going to be admitted to hospital.

Shit was getting real.

We talked at length with the trauma nurse, she cursed a lot at the missing information that neither the consultant nor his students had collected, I completed a surgery consent form for the arm (we’ll come back to that later) and we got ready to return home.  The trauma nurse explained that they probably didn’t have any slots free, but that we should go home, do nil by mouth from midnight (standard practice just in case) and then call first thing in the morning (Thursday) to see how things lay.

We left and headed home.  Not really sure of what would happen next.

As it happens, what happened next was that we didn’t need to call them in the morning, because they called us first.

Night of the Zombie Healthcare Assistant – Day 1 & 2

I had intended to write a single blog post, describing a single night in the hospital after my surgery – however, as usual I am unable to write small amounts of text, and so here is part one of what looks like it will be an increasingly wordy description of my injury, my hospitalisation, and my recovery.

Day 1

In the early afternoon of Monday August 22nd I fell over while playing short tennis at Center Parcs in Cumbria during a family holiday.  Let me just give you the dictionary definition of short tennis.

short tennis : noun : tennis played on a small court with a small racket and a soft ball, used especially as an introduction to the game for children.

Jonathan serving
Jonathan serving

That’s right, I fell over playing children’s tennis.  Normally I refrain from sport.  Years of ridicule and humiliation while at school gave me a healthy disrespect for any kind of group sporting activity which involves moving around.  I can often be heard saying, “I don’t run“.  It’s not something I’m proud of, it’s just been a basic fact of my existence for the last 30 odd years.  So I was more surprised than anyone to find myself playing short tennis, even if it is supposed to be a little easier on the body than full length tennis.  It was pretty energetic, although most of the energy was spent with one of us retrieving missed balls from the courts of other players.  We were playing doubles and there were probably only 4 players on our own court for 2% of the match, the other 98% of the game was spent with one or sometimes more than one of us on someone elses court picking up balls.  Inevitably then, I chased another errant ball across our court and towards the net of the court on my left.  I was lumbering at some pace, and then I was falling.  Fate, it seems, is not without a sense of irony.

I don’t really remember what happened.  I don’t know if I tripped, or slipped, or stumbled.  I don’t know if something in my foot snapped causing me to fall, or if falling caused me to snap something in my foot.  If you know me, you know I’ve got pretty good balance, I do not fall over.  Except I had.  I realised I was basically lying flat on my face on the court of an unknown family with two young kids.  There was no way on this earth I was going to stay there, so I stood up, and walked back to the bench near our court.  I was holding my left arm close to my body and bent at the elbow, and I knew something was wrong.  Adrenalin is amazing though, so I made it back to the bench and sat down.  My oldest nephew, Jonathan, asked if I was okay, and I said no.  I think he asked if I wanted him to get someone, and I think I said, yes, get everyone.

I was pretty certain at that stage that I’d either dislocated my shoulder or broken my arm.  I couldn’t use my shoulder muscles to move my arm in any direction, although I could bend it at the elbow.  It hurt, a lot.  I got my left shoe off as well because I could feel my left foot throbbing, and it was swelling, alarmingly, but I was more worried about my arm.  I assumed I had just sprained my foot or ankle.

People from Center Parcs started to arrive.  The local first aid person told me the nurses were busy with a sick child, but would be along as soon as possible.  Until then, she tried to help.  She tried twice to put a sling on me, admitting before she’d even started that she wasn’t very good at it.  She failed both times, and the pain was just too acute for me to let her try again.  She was quite apologetic though and I tried not to be too annoyed, or too passive aggressive.  I probably failed.  Someone brought me some carrier bags with ice in them – I guess from the bar.  They really helped on my foot, although given it was just ice in a plastic carrier bag it was pretty harsh pretty quickly, but didn’t do much for my arm or shoulder.  After about 15 minutes, maybe longer, two nurses arrived, with gas & air!  The next period of time is a little blurry (gas & air)!  I remember the nurse explaining the impact of the gas, and how it might make me feel sick and to tell her if that was the case.  I remember her asking me if I had any other conditions, to which I responded diabetes and chronic sarcasm.  Then I remember everything getting very heavy and woozy and spinney.  My nephew tells me that when they tried to take the breathing mask away from me, I refused, but I don’t remember that.  The gas & air didn’t solve the pain, it just meant I cared less.  They offered me additional pain relief, which meant paracetamol.  I kind of laughed, it’s never done anything for me in terms of pain relief on its own but I took some anyway.  The nurse did manage to get a sling on my arm without any problem at all.

Me in the 4x4 on the way to the car park, an hour after the fall
Me in the 4×4 on the way to the car park, an hour after the fall

The nurse wasn’t convinced I’d dislocated my arm, she said it was probably just a muscle injury and she thought I’d sprained my ankle.  This was the first misdiagnosis of the whole process, and I can’t really blame her, she’s not after all a specialist, but I was pretty sure she was wrong.   Center Parcs had called an ambulance pretty early on in the process, but the nurses had received an update saying it would be 4 hours before it arrived (my advice, never get really sick anywhere in Cumbria).  Since one of them was convinced it wasn’t a bone injury and certainly not life threatening, they asked if I was okay being driven to the hospital as it would be much quicker.  The hospital in this case was the A&E department at Penrith, about 20 minutes away from the Whinfell Center Parcs site.  My brother-in-law Paul offered to drive, so the only issue then was getting me from the sports hall, to Paul’s car.  Center Parcs staff said they’d bring the mini-bus over, until the driver told them on the radio it was full of furniture he was moving around and it would be another hour before it was free.  In the end, they found a 4×4 that was free, wheeled me in a chair to the car, got us to the car park, and after shuffling and hobbling into the vehicle, we set off.

Greté had been in the lodge the whole time – she’d been resting her back after a tough couple of days.  I didn’t want to disturb her when I first fell over, and didn’t want her having to hang around in a hospital waiting for me.  So Paul drove and Jonathan stayed with me so Paul could get back to the kids.  I’m still not sure Greté has truly forgiven me yet.

Me, my sling, and my nephew Jonathan in A&E
Me, my sling, and my nephew Jonathan in A&E

So we arrived at Penrith A&E and honestly, I expected to be there about a hundred hours.  Small A&E, big area, plenty of people already in the place, but they saw us quite quickly.  They had a wheelchair for me and Jonathan kindly pushed me around.  We did, at one point, misplace a boot moving between the main waiting room and x-ray, but we recovered it before it walked away on its own.  Can’t fault the staff at Penrith A&E though.  The nurse who did my assessment was great, the person who did my x-rays was really apologetic about the position I had to get my arm and foot into (that hurt, a lot), and the GP who reviewed it all was thorough and explained everything.  In fact, the GP was really good, because he pretty much diagnosed both injuries.  At one point he said to me, “I’m a GP, I don’t spend a lot of time looking at x-rays ….”  He went on to say I’d fractured my humerus and my foot, and that he was also concerned by a shadow on the arm x-ray, which might have meant it was dislocated as well.

The first of many horrific hospital gown experiences.
The first of many horrific hospital gown experiences.

He tried several times to get hold of the on-call orthopaedic surgeon at Carlisle hospital and failed.  I waited with him while he tried.  I thank him for that – he was serious about trying to get me referred and trying to get me the right help.  Everyone at Penrith were pretty good to be honest.  He eventually gave up trying to get hold of the specialist for a discussion and referred me directly to Carlisle, but said I’d have to go to their A&E since he couldn’t get hold of the person he wanted to speak to.  He sent me to the plaster room where the nurses put a moon-boot on my foot, and a more extensive sling on my arm.

Now I just had to get to Carlisle hospital!  Greté was pretty angry at this stage and suffering quite a lot of panic, and for that I am eternally sorry.  We had quite a fraught conversation on the phone and Paul brought her over so we could all go to Carlisle hospital.  At this stage we didn’t know if I was going to be admitted or just seen by the specialist, but there wasn’t much we could do.  I was conscious that I was starting to interfere with the enjoyment of the holiday for Paul and the kids (and Greté).

My foot.
My foot.

I sat and stared at my new boot, while we waited for Paul to arrive.  A little drive later and we got to Carlisle – a regular hospital.  Greté waited with me this time, and eventually the orthopaedic specialist checked my x-rays.  He didn’t ask me any questions, didn’t really talk to me much, and didn’t examine me.  He glanced at the x-rays.  He confirmed I had a fractured humerus but was disdainful of the GP’s assessment about a ‘shadow’, proclaiming it wasn’t dislocated and simply needed gravity to heal.  Then, and in his own words, “I’m not even sure your foot is fractured”.  I’m not a doctor, I had to trust him.  The GP, after all, had said he didn’t spend all his time looking at x-rays, and this guy did.  So we asked should we head home and speak to the local hospital or continue on holiday?  He said we didn’t need to rush, finish up the holiday if we wanted and make an appointment when we got back to Nottingham a few days later.

This, it turns out, was terrible advice.  Not only was he partially wrong about the arm fracture, he was totally wrong about the foot.  Dangerously so.

I don’t know if he let disdain for the GP who referred us get in the way, or if he was just having a bad day, or if in fact, he was just sick of people from Center Parcs falling over, hurting themselves and coming to him to get fixed, but he misdiagnosed me.  He did at least prescribe some pain killers.

Myself and Greté had a bit of a chat while we waited for Paul to come and get us.  We were uneasy about his manner, and I was clearly in a lot of pain.  However by this time, it was already quite late, and we weren’t going to be driving back to Nottingham without quite a bit of effort packing and the like.  We decided that if I had a comfortable night in the lodge we’d consider staying a few more days, but if I couldn’t get any rest or was in pain, we’d head back in the morning.

I still had the sling (and had no movement in my arm at all) and boot, although I took the boot off to sleep because it was quite uncomfortable.  I slept sitting up in the lodge, and got a few hours mostly thanks to the codeine.  The longer I sat though, the more obvious it was to me that staying was the wrong choice.  I didn’t want the family pushing me around what is quite a hilly Center Parcs, and the three main things I wanted to do while I was there (walk, swim and take photos) were all off the menu.

Day 2

My lovely sling, and a padded neck rest keeping my arm off the door - during the drive back from Cumbria.
My lovely sling, and a padded neck rest keeping my arm off the door – during the drive back from Cumbria.

So early in the morning of Tuesday 23rd August, with the help of everyone else, we packed and started the drive home.  Since I learned to drive a few years ago, I’ve been doing all the long distance driving, and it was pretty hard work for Greté doing the whole trip behind the wheel, but we made it in one piece, and I spent the first of what would turn into many nights sleeping on the sofa in our lounge.  At this stage, although uneasy, we were still working on the assumption that the orthopaedic specialist had been correct – but Greté rang Derby hospital as soon as we got back – and they gave us an appointment on Wednesday 24th to come in for assessment at the Trauma and orthopaedics department.  At this stage, I was still hobbling about on the moon-boot, confident my foot was going to be fine.

To be continued …

An open letter to BioWare: Thank you

I broke my foot (lisfranc fracture) and arm (upper humerus, with displacement) playing short tennis on holiday in late August 2016.  I had surgery on both of them (plates and pins) and have been recovering since the start of September.  The first few weeks of that meant no use of my foot at all, so stuck in one room in the house peeing into a bottle and using a commode.  My arm was in a sling, and I was under strict orders not to bear any load on it.  For the past few weeks, I’ve had a heel-load bearing cast on my foot, which means I can hobble short distances, but I’m still pretty much limited to a single room because I need to keep the foot elevated as much as possible.

When my wife spoke to the occupational therapist (they did a home visit before the hospital would discharge me) they talked about exercises and what I could and couldn’t do, and my wife mentioned the consoles.  The OT was quite happy for me to use the Xbox One controller, because it would exercise my wrist and fingers without putting any load on my arm, and keep some activity in that part of my body.

Mass Effect 2 LogoI was in too much pain for the first few days at home to do anything though – which meant a lot of television.  Eventually I decided to stop the brain rot caused by that and whacked Mass Effect 1 into the Xbox One now that it’s playable under the backwards compatibility feature.  I completed a full play-through with all the DLC.  That led to Mass Effect 2 (360 only, not backwards compatible yet) and some fun and games getting the ME1 saves to import (saved on the Xbox One, but used on the 360).  Another full play-through with all DLC.  Inevitably, I finished ME3 (and all DLC)! after that as well.  It’s not the first time I’ve played them, although I’ve played ME2 most, I’ve completed ME1 and ME3 a couple of times at least.  I think that was around 120 hours of gaming.

I have Dragon Age: Origins, Dragon Age: Origins – Awakenings and Dragon Age II, but only on the 360 (and it was started to smell pretty hot on the days I played ME2 and ME3).  Also, although I absolutely love DA:O & DAOA they do feel a tiny bit tired now.  I’m not as enamoured with DA II overall, although the DLC improves it.  So, I put Dragon Age: Inquisition into the Xbox One and then played that (and all the DLC, which is new to me), and have just finished.  164 hours in total.

One hundred, and sixty four hours of game play.

daI’ve loved BioWare games for a long time, they’re a part of my gaming history on the PC and consoles.  Baldur’s Gate and Neverwinter Nights have special places in my gaming memory.  I loved the dialog, I loved the characters and the phrases.  Hell, myself, my wife and our gaming friends are still using quotes from the Baldur’s Gate series1 , when roleplaying, gaming and sometimes shopping.

Here’s a short list of why I love the games.

  1. Commitment to single player content.  Look I get it, I played Everquest for over 7 years – I was seriously into that MMO, so I know the joy of gaming online with actual real folk, having conversations with real human beings and sitting up until 4 o’clock in the morning with someone you’ve never met to help them win a piece of loot that’s just pixels backed by a database entry.  I understand multi-player fun.  But when I’m playing multi-player games, I want to collaborate.  I don’t play tabletop roleplaying games to fight against the players, and if I play online multi-player games I don’t want PvP to be the whole point, even if it’s team based.  More than that – sometimes I want a single player experience.  Sometimes I want to read a book on my own, not watch a movie with 300 other people, and gaming is no different.  I want to be the protagonist, to drive the story with a supporting cast, at my own pace, using my own imagination and in my own little world.  You guys deliver that, you guys get it, and you guys clearly love it.  Please, never lose that.
  2. Massive games.  Truly huge.  With structure.  Not huge in the Oblivion or Morrowind ‘er where do I go now’ way, but huge in scope and content, with a solid, structured layered story that helps you decide where to go and what to do when you get there.  It’s a truly fine balance and you guys usually tread it perfectly.
  3. Dialog.  You don’t always get it right, but when you do, it’s sublime.  It might be cheesy, it might be corny, it might be sentimental, but man we love it.  I love it.
  4. Complex morality decisions.  I cure the genophage every time, I have to, someone else might get it wrong.  But every time I’m forced to think about it, to think about the nuances and the impact.  I forgave the Wardens.  I unify the quarians and the geth, even though I know it’s futile, because fuck war.  Sometimes, I sit and stare at a single conversation option for 10 minutes, sometimes longer.  Do I save you and condemn the galaxy, or do I condemn you and save the castle.  Yes please.  More.
  5. Characters.  Your characters will stick with me for ever.  No less than some of the best books I’ve ever read.  Minsc, Wrex, Tali (yes, yes, I’m always a Talimancer), Oghren, these are characters I’ll never forget, and the interactions between them all are moments I’ll enjoy like the best form of entertainment in any genre.

You don’t make games.  You make interactive fiction of the highest order, and I salute you.

I have loved your games for a long time, and stuck in one room for weeks has allowed me to enjoy them all over again with an intensity usually disrupted by trivial things like sleep, eating and work.  In a world of expensive entertainment, your games offer some of the best return in pure gaming enjoyment, well before you factor in any of the ongoing conversations, memories and replays.

Long may it continue, long may you continue, and long may you focus on content rich, single player focussed interactive fiction which puts the player in charge of the outcomes.

In summary – thank you for the last 18 years of games, and thank you for keeping me occupied during my recuperation.

NB: This time, I actually didn’t mind the ME3 endings either, I tried all three, I’m sure the blue one is best overall.  No spoilers.

NB2: Now the 360 has cooled down, maybe I should give DA:O and DA:OA another shot.  Tired or not, I think it’s time a lowly dwarf from Orzammar saved the world, again.

  1. Give a man a fish and he can eat for a day, give him a sword and he can chow down on the marrow of evil! []

The Exposure Triangle

Caveat

I’m no expert.  This is my understanding of the topic, but I’ve had no formal education and only a very limited amount of practice.  Hopefully it’s useful, but you should definitely use it with the above caveat in mind and do a lot more research!

I did draw some pictures, including one of the exposure triangle, but then I remembered this is the internet.  If you google for ‘exposure triangle image’ you’ll get loads of them and they’re better than I could create.  Also, if you just search for exposure triangle you’ll find loads of videos and web pages, which probably explain it better than I do.

Introduction

Photography is about many things – but one of them is getting a properly exposed image.   I’ve written properly in italics because before I even start going into my little intro, it’s important to remember that as the photographer you’re the person who chooses what exposure you want.  Exposure is an artistic choice.  You can expose in a way that reflects what you saw, but also, in a way which reflects a mood or some intent that wasn’t there at the time.  So while people will often talk about the correct exposure, remember that correct is an artistic choice.

That aside, there are four things that affect the exposure of an image.

  1. The amount of light
  2. The shutter speed
  3. The lens aperture
  4. The film or sensor sensitivity (ISO)

While you are sometimes in control of the amount of light and sometimes not, you are always in control of the other three.  Those three control points have a tightly coupled relationship, and since changing any one impacts the exposure of the image, to retain the same exposure you must modify one or two of the others.  This is why it’s called the triangle.

Exposure

More light, means brighter exposures.  Wider apertures, slower shutter speeds and higher ISO all result in more light.  Narrower apertures, faster shutter speeds and lower ISO all result in less light.

If we assume for now that the amount of light you have is either intentional or fixed (i.e. it’s not something you can or want to change) then you need to understand how the other three controls affect the exposure, and the secondary effects each of them has.

Before we do that though, a very quick reminder of what exposure is.  Essentially, it’s how much light is absorbed or recorded by the film or sensor; the more absolute light the brighter the resulting image, where-as less light results in a darker image.

With that in mind, let’s look at how the three controls directly impact the exposure of the image.

Shutter Speed

Shutter speed directly controls how long the camera shutter is open for, and hence, how much light streams in and hits the sensor.  The long the shutter is open, the more light the sensor or film is exposed to and so with everything else the same, the brighter the image will be.  This is true regardless of how much overall light there is, so in dark situations, longer shutter speeds (i.e. slower shutter speeds) still allow the film or sensor to gather more light.

Aperture

The lens aperture is literally a measure of how wide the aperture (or iris) of the lens is.  Apertures are referred to in f-stops, and written like f/2, f/2.8, f/4.  How they’re calculated and what they really mean is enough material for a full post, what’s important here is that f/1.4 is wider than f/2, f/2 is wider than f/2.8, f/2.8 is wider than f/4 etc.  So smaller f-stop numbers are wider apertures and hence let in more light.  With all other settings static, wider apertures (e.g. f/4) will allow in more light and lead to brighter exposures than narrower (e.g. f/22) apertures.

ISO

Lastly, we have ISO (it’s not an acronym).  ISO describes how sensitive to light the film or sensor is.  The higher the ISO rating, the more sensitive the sensor is, and hence less light is needed for any given exposure than for a lower ISO.  At ISO 100, you need more light to give the same exposure as you do at ISO 200.  At ISO 6400 you need hardly any light compared to ISO 100 to get the same resulting image.  As ISO increases, with all other settings the same, the resulting exposure will be brighter.

Secondary Effects

Shutter speed affects motion blur (slower shutter speeds give more blur), aperture affects depth of field (how much of the image is in focus), and ISO affects noise (pixels which are too bright, dark or the wrong colour).

You might ask, why then do these things matter if you can change them in various combinations to get the amount of exposure you want?  You’d be right, you can.  ISO 100, f/2.8 and a shutter speed of 1/250th of a second, will give you an overall exposure the same as ISO 100, f/4 and 1/125th of a second.  By narrowing the aperture (from f/2.8 to f/4) we reduced the light entering the lens, so we had to decrease the shutter speed to compensate (from 1/250th of a second to 1/125th of a second).  Likewise, if we expose an image at ISO 800, f/5.6 with a shutter speed of 1/60th of a second, and then increase the ISO to 1600, we double the amount of light hitting the sensor.  In order to keep the same exposure, we have to either speed up the shutter (from 1/60th to 1/125th) or we have to narrow the aperture (from f/5.6 to f/8).

We worry because each of the controls also has at least one secondary effect.

  • Shutter speed also affects how much the subject of the photograph will be blurred (either caused by the camera or the subjects moving).
  • Aperture also affects the depth of field, or how much of the image is acceptably in focus (or out of focus, if you want that effect).
  • ISO also affects the amount of noise in the image.

Motion Blur

While the camera shutter is open, light streams in from the scene in front of it.  If the camera moves, or the subjects in the scene move before the shutter closes again, then they will be smeared or blurred in the resulting image.  How much movement blur you want of the subject is an artistic choice (again).  If you take photographs of a fast moving car with a very fast shutter speed (to remove all blur), you’ll end up with a picture of a car that looks like it was stationary.  Our brain needs to see some of the blur to feel the movement.  That’s why pictures of fast cars often include some blur of the wheels, for example, to give us that sense of motion.  However, if you want to freeze the action, maybe a picture of your dog catching a ball, then high shutter speeds are the way to go.  Also, when taking pictures, the camera is often supported by only our hands, and so is prone to moving a little (camera shake).  Reducing shake means speeding up the shutter so it’s open and closed before the camera can move very far.  Therefore choosing a shutter speed to give you the artistic effect you want or prevent hand shake determines one part of the exposure triangle, which means you have to manage aperture and ISO to get the image exposed as you wish.

Depth of Field

Apertures affect depth of field, which again, deserves a full post of its own.  But essentially depth of field can be thought of as the area inside which your content is sharp and in focus, and outside of which it isn’t.  The effect is gradual, so the centre of the area (the spot your camera has focussed on) is fully sharp and the edges are still acceptably sharp, but only just.  Beyond that, the subjects will be less sharp, eventually blurred beyond recognition.  Several things affect the depth of field (i.e. how deep the acceptably in focus parts are), and it’s important to remember aperture is only one of them.  However, keeping the other depth of field factors the same, aperture has a large impact.  The wider the aperture is, the shallower the depth of field is as a result.  At very wide apertures the depth of field might be very shallow; taking a close-up portrait at f/1.4 and focussing on the person’s eye might mean their ears are already starting to get out of focus, switching to f/2 or f/4 might result in their whole head being in focus.  Depth of field is useful for several artistic reasons, one of which is blurring backgrounds such that the primary subject of your photograph is much more obvious.  Landscape photographers usually want as much as possible in their photos to be crisp and in focus, and so tend to work at narrower apertures, such as f/11 or f/16 to get a deeper depth of field.

Noise

Last, but absolutely by no means least is ISO and noise.  Some people describe noise as the digital equivalent of film grain, but they’re not absolutely identical.  Film grain was caused by the chemical composition of the materials used to make up the film and for many people, it had a pleasing quality even when it was visible.  Digital noise is more random and affects the image in a different way and rarely looks pleasant.  However, it is true to say that higher ISO values result in either more noise or more visible grain, and if it’s not wanted then that’s a problem.  In digital photography, higher ISO ratings effectively mean the sensor is prepared to say ‘yes this pixel is lit’ with a lower level of certainty than in lower ISO ratings.  This means that it is prone to saying ‘yes’ when in fact, no photons landed on the pixel and instead it was triggered by nearby electrical noise.  It is, as always, more complex than that, but the summary stands.  If you use high ISO ratings, there will be lit pixels that don’t actually reflect the true colour or luminosity of the subject and so will show up as noise, and the higher the ISO, the worse this will be.

Early digital sensors were very noisy even at relatively low ISO ratings (like 800), these days, high end DSLR sensors can produce reasonably noise free pictures at much higher ISO ratings like 6400 or above.  While noise can be reduced in post processing, the effect of noise is to distort colours and to reduce sharpness in the resulting image.

How much noise you can deal with is a personal choice, and is also impacted by how large you view the images (or whether you print them).  Most photographers have a primary aim of keeping noise (and hence ISO) as low as possible.  So, while picking apertures or shutter speeds to provide an artistic effect, the ISO is usually picked to be as low as possible while still achieving the desired exposure.

Choosing a low ISO to avoid noise (and so reducing the brightness of the image), and hence forcing yourself to use a slower shutter speed to properly expose it, might introduce blur that you don’t want.  ISO therefore is a constant compromise of artistic look vs. digital noise.

Camera Exposure Control

All camera modes are valuable.  Each offer different levels of control and hence different levels of support for the photographer.  Which mode to use depends on the situation in which you are taking the photographer, the photographer’s preferences, and the desired creative result.

So now we know that to control the exposure of an image, we have to pick a combination of the available light, aperture, shutter speed and ISO.  We have to make those choices with the desired creative look in mind and to control the light arriving on the sensor to properly expose the image.  How then, do we get the camera to support us in doing that?

Most modern cameras (other than point-and-shoot) offer different modes for controlling the exposure.  The common ones are fully automatic, programme AE (often marked as P), aperture priority (A or Av), shutter priority (S or Tv) and fully manual (M).

Fully Automatic

In this mode, the camera picks shutter speed, aperture and ISO to expose the image properly (outside of creative choice of exposure, what the camera thinks is a proper exposure is enough for another post).  The photographer has no control of any of the exposure related settings.  On some cameras, this mode also includes other features like face recognition, automatic flash, automatic low light exposure, etc.

Pick this mode when you want to grab pictures in a range of lighting situations, and you’re interested in just pointing the camera and clicking, and then getting back to your beer.

Programme AE

In this mode, the camera if left alone will behave like automatic.  However, the photographer can if they want override some of the choices (e.g. shutter speed) and the camera will then manipulate the other settings to expose properly, if it can.  For many, this is a first step into controlling the exposure.  This mode usually includes the option to dial in exposure compensation, which I’ll cover later.

Pick programme AE when you want an element of control sometimes, but you’re not worried about the creative content so much as you are about capturing a moment quickly without having to think about exposure.

Aperture Priority

In this mode, the photographer always has to choose an aperture.  The camera will never override that setting, and instead will change shutter speed and potentially ISO to properly expose the image.  This setting also usually allows for exposure compensation.

Use aperture priority when you want to pick a specific aperture for creative reasons (depth of field, primarily), but the lighting conditions are variable and you want the camera to quickly work out shutter speed and ISO to properly expose the image.  Or you just don’t want to have to think about shutter speed and ISO.

Shutter Priority

The partner to aperture priority, in this mode, the photographer chooses the shutter speed they need for the creative look they want to achieve, and the camera changes aperture and ISO to then expose the image.  Again, exposure compensation can be applied if desired.

Shutter priority is useful when you know you want to freeze or blur movement for creative reasons and that is more important than the depth of field of the resulting image.  This is often the case with sports or action photography, but is equally important in other situations where movement blur is a creative choice.

Manual

In manual, the camera software does not change any of the settings.  The photographer must pick aperture, shutter speed and ISO and the camera will then simply use them.  If that results in too much or too little light reaching the sensor, the image will be over or under-exposed.  Contrary to some views, fully manual isn’t always the best option used by professional or proper camera users.  Fully manual has its place, but so do the other modes.

Use manual when you want complete control over the exposure of each image.  This is especially useful in situations where you are in control of the light (such as a studio, or inside a building with a regular lighting situation).

Auto ISO

Many cameras offer automatic ISO in combination with aperture and shutter priority – the descriptions above assumed fixed ISO chosen by the photographer.  Some cameras also offer auto-ISO with manual (you could argue, it’s not fully manual in this instance).  The ability to set the ISO, or allow the camera to vary it within another mode doesn’t significantly change the purpose of that mode, but gives the camera more flexibility to expose the image accurately.  Often, automatic ISO is ideal in situations where the lighting conditions are changing rapidly and are extreme enough that just changing aperture or shutter speed might not give you the ability to cope.  For example outdoors on a bright day with some clouds; as the clouds pass in front of the sun the lighting change can be dramatic potentially preventing the camera from exposing the image correctly by just changing aperture of shutter speed.  Allowing it to also change the ISO provides more flexibility.

Ultimately the choice of automatic of fixed ISO is again about deciding how much control to give to the camera.  If you find that the range of light you’re dealing with is so variable that it results in dramatic shifts of aperture or shutter speed, you might introduce automatic ISO to allow the camera more subtle control.

Additional Points

It’s important to remember that in automatic, programme AE, aperture priority and shutter priority that the camera’s primary goal is to expose the image in a way it considers acceptable.  To do that it will pick apertures, shutter speeds and ISOs and it doesn’t know what you had in mind creatively.  It won’t know that you wanted or didn’t want movement blur, it won’t know that you wanted or didn’t want a large depth of field, etc.  The only difference in the settings is how much the photographer controls versus how much the camera controls.

In manual, the camera is no longer trying to expose the image, it will report the exposure (based on the built in metering), but the camera will trust the photographer that the resulting image is what they want.

Exposure Compensation

Cameras think the whole world is 18% grey.  Sometimes they get it wrong.

A camera has no idea what is in front of it, nor what your artistic intent was.  When the camera exposes the image in any mode other than fully manual, it has made some decisions about how bright the overall image should be (i.e. how bright the highlights should be, and how dark the shadows should be).  It doesn’t always get it right.  If you photograph a building outside on a bright day, you might find the building looks quite dark, or if you photograph people against a dark background it might over expose the people you’re trying to take pictures of.  You’ve got three choices in situations like that.

  1. You can change one or more of the control points you’re already managing (for example, you could change the aperture if you’re in aperture priority mode), but you may have to accept compromise on your creative choice
  2. You can switch to manual and change any of the control points (this allows you to retain your creative intent, but negates the benefit of using semi-automatic modes).
  3. You can dial in exposure compensation if you are in a mode which supports it (fully automatic modes do not tend to support this feature).

Exposure compensation tells the camera that it needs to make the image brighter (expose it more) or make it darker (expose it less) than the metering suggests.  It achieves that in various ways depending on which mode it is in.  If the camera is in shutter priority mode (so you have selected a shutter speed), but you want to add exposure compensation (to brighten the image), the camera will widen the aperture, letting in more light and making it brighter.  If you are in aperture priority and the image is too bright, adding negative exposure compensation will shorten the shutter speed, resulting in a darker image.

Obviously, if you’re already at the limits of the control points, for example in shutter priority mode, you want the picture to be brighter but the camera is already at the widest aperture, then the image still won’t be exposed in the way you want it, and you’ll need to switch to another mode or use manual to get the exposure you desire.

Exposure compensation allows you to override the cameras chosen exposure without having to switch to a fully manual mode, and lets you quickly change between lighting situations without giving up the creative elements you have chosen.

Other Stuff

There’s clearly a ton of stuff I’ve not covered.  Adding your own lights, flash or strobes allows you to change the amount of light yourself, impacting how you choose the other controlling factors.  Your camera meters the light in front of you in different ways (phrases like spot, evaluative, weighted, matrix, etc.) and that in turn affects the elements of the image that are exposed at different levels.  Your camera has no real clue what is in front of it, and so is generally trying to expose the overall image as if it was grey (middle grey, reflecting about 18% of the light landing on it); that’s okay in many cases, but equally not okay in many others.  I’ve not covered dynamic range (the range of light from the deepest shadow to the brightest highlight), nor colour balance or any number of other elements that will affect the overall image.  I’ve also not covered stops or exposure value (EV), how to know what changes to make to shutter speed to compensate for changing aperture from f/1.4 to f/8 and vice versa.

Summary (tl;dr)

  • Aperture – wider gives more light and shallower depth of field.  Narrower gives less light and deeper depth of field.  Smaller numbers are wider (f/1.4 is wider than f/2, and f/22 is narrower than f/8).
  • Shutter Speed – slower gives more light and more motion blur, faster gives less light and less motion blur (frozen action).  Shutter speeds are given in seconds or fractions of a second.  Most cameras show 60, 125, 250, 500 etc. when they mean 1/60th, 1/125th, 1/250th.  So bigger numbers usually means faster (shorter) shutter speeds and hence less light.
  • ISO – lower is less sensitive and needs more light to expose but has less noise, and higher is more sensitive, needs less light to expose, but is noisier.
  • Exposure – it’s a creative choice, affected by the amount of light present, and the combination of aperture, shutter speed and ISO.
  • Camera modes – every mode has a purpose, and there’s plenty of overlap.  The more control you give the camera, the less control you have over the creative elements of the picture, the more control you take from the camera, the more you have to think about exposure yourself.
  • Exposure Compensation – the world is 22% grey, but only when you blend it all together.  Sometimes you want parts of your image exposed differently, and exposure compensation allows you to quickly add or remove light from the overall exposure (the camera will have to change one or more of ISO, Aperture or Shutter Speed to achieve it).
  • Lastly – this is only an overview, it’s a summary or approximation, and there’s a lot more depth.

Other Resources

Parking Charge Notice

I recently had the misfortune to receive a PCN (Parking Charge Notice) for using the car park at a retail park in Nottingham.  The PCN was left on the windscreen of my car, claiming I had been observed ‘leaving the site’ and was therefore in breach of a contract.  After I got the notice, I went looking and found the signs on site which explained how long you could stay, and other restrictions, including a very small set of text saying you weren’t allowed to leave the site.

Let’s get a few things straight.  I’m not a lawyer and this is not advice.  This is  a description of my understanding and a description of what happened to me.

I’d heard about PCNs before.  They are not fines, nor are they penalties.  They are invoices.  Invoices based on the assumption that you agreed to a contract by parking your car, and that the terms of the contract are clearly published somewhere you can read them.  Essentially, when you park, you read the signs, and that’s you agreeing to the contract.  The contract will state that there’s a charge for not complying with the terms or something similar.  Private companies, paid to manage the car parking space, will then place a PCN on your vehicle if they believe you’ve broken the terms, and will pursue the invoice.

The advice a few years ago was ignore them, don’t respond and don’t pay them.  However, I believe that advice has changed recently to be appeal, object and complain, but still don’t pay.  The car parking companies have started taking people to court, and they have won some cases.  So it’s no longer safe to assume they’ll never take you to court.  There are also added complications since the law changed in 2012 which allows them to pursue the registered car owner if the driver doesn’t respond to the PCN.

Given I was driving, and I didn’t want Grete being chased, I opted to appeal and complain making it clear I was the driver.  I wrote to the PCN company, to the manager of the shop I had spent money at on the day in question, and to the owners of the retail park.  I wrote some letters by post, sent a few e-mails, and some tweets.

The way it works is that if you pay within 14 days, the charge is reduced (by at least 40%, according to the law), so I was facing either £60 for paying early, or £100 for paying within the 28 days.  I decided I’d rather pay £100 after complaining and appealing than simply rolling over and paying the lower of the costs.  I’m lucky that it would have been a financial pain, but not the end of the world.

Yesterday, I was advised by the owners of the retail park (by e-mail) that they spoken to the car park management company and had the PCN cancelled.  They also made it clear they were doing me a favour, and that they felt the charges were appropriate.

I haven’t yet heard back from the car parking company.  I got a response from the shop (by e-mail) saying they couldn’t do anything, to which I replied and said they could advise the people they rent from that the behaviour of the car park management company may result in them losing trade, to which they’ve not replied yet.

When I used the car park, it was less than 40% full, and there were hundreds of free spaces.  I shopped in one of the shops at the retail park.  I left within the 3 hour window (although until after I got the PCN, I didn’t even know there was a 3 hour limit).  I wasn’t parked across any bays or outside of the white lines.  Without giving the location away it’s adjacent to, and arguably part of, an area where lots of people take breaks and enjoy the wild life and a walk.  There are no signs on the site indicating where the car park ends (so I don’t believe it would be possible to enforce a ‘don’t leave’ contract, since you can’t tell when you’re leaving).

The car park management companies clearly undercut each other for their services and then supplement their income using the speculative invoicing scheme.  If I was ‘observed leaving the site’ and the aim is to reduce losses to the shops, then the best bet would have been to alert me at the time, or clearly indicate the start and end of the site in question.

Anyway, it’s done now (assuming the owners are right and the car park management company do cancel the invoice).

I am considering whether it’s worth the hassle of writing to the car parking company in a couple of months and asking what data they hold on me under the DPA, and asking for them to remove it.  I’ll see if I can be bothered.

MCM Comic Con – Birmingham – March 2016

Picture of a Raider and Moxxi from Borderlands
This is not us.

We went to the MCM Comic Con, in Birmingham on Saturday just gone (19th March).  Here are some various random observations.

Getting to the NEC Birmingham is quite easy for us – we drive over, it’s between 45 and 55 minutes depending on traffic and this time it was pretty good.  There was a queue leaving the M42, which took up about 10 minutes of the journey, but it was always flowing.  On the way back however, we noticed a pretty bad car fire on the A42, which looks like it had closed that road for some time.  Not sure by how long we missed that, but glad we did, and hope everyone involved was okay.

We parked in East 5, having pre-paid for our parking the night before.  I can’t stress enough how useful this is if you intend to go to an event at the NEC.  The queue for car parking tickets was about 100 meters long, and I suspect was roughly a 10-20 minute wait in temperatures hovering around 4C.  Car parking was £12, which is high, but it’s a captive audience.  We couldn’t book reserved / priority parking which puts you outside the event halls, I guess there wasn’t any close enough for the Comic Con event, but we’ll check again next time.

We had priority tickets for the event, it’s £5 more, but you can go in from 9am rather than 11am.  We never intended to get there for 9am (and if you do, you’ll queue even with a priority ticket), but we got there around 10:15am-ish, and walked straight in, past the 11am queuers.  I recommend this approach!

The event was in an L shaped hall and quite big; bigger than November last year which felt very cramped.  It was a little more open this time, although still quite cramped in the main section.  There were the usual selection of vendors and guests, but since that’s not why I went, I won’t comment.  We didn’t go to any of the events either, although there was an inflatable theatre in which they were taking place.  Greté was there to shop, and I was there to take photographs.

There were some really good things.Picture of Stormtroopers behind a Comic Con sign

  • There were a lot of Rey’s.  It’s great to see another interesting and dynamic character for female cosplayers to play.  Of course, gender is irrelevant (I saw at least one female Kylo Ren), but for women who want to play women, it’s great that there’s more choice, and with costumes that aren’t revealing or sexualised.  There were, as always, the usual collection of Lara Crofts, Harley Quinns, female manga characters I never recognise and Black Widows (among lots of other female characters, don’t get me wrong).  I just thought it was nice that popular media has presented another strong female role model, with any-age appropriate dress, and hope we get many more in future.  Which reminds me, there were quite a few Dana Scully’s as well come to think of it – always handy to break out a smart suit and wear an ID badge.
  • There were a lot of families all in costume, many of them with very young kids who seemed to be having a great time.  I don’t remember previous Comic Cons being quite so kid friendly.  I guess for the kids it’s normal – get dressed up as your favourite character, it’s just as we get older it becomes more nerdy and weird.  We should learn from that – nothing wrong with it at all.  I think it’s great that people felt comfortable enough to bring their kids along.
  • Lots of excellent costumes in general and clearly a lot of effort had gone into them.  There’s always the regular semi-pros, the 501st Legion, that company who pays cosplayers to dress up (can’t remember what they’re called), the guys in the Batman suits that look like they just walked off the set, etc.  I do wonder if they can be off-putting at times.  But then there were the regular broad range of almost-semi-pros, amateurs, last-minuters, threw-on-a-fezzers, wore-my-tardis-dressers, and came-dressed-as-Jessica-Rabbit-in-my-7-inch-heels-and-bearders.  It was really a great collection of people.

The not so great.

  • There was an unnecessary amount of body odour.  I know, everyone’s wearing Lycra, or vinyl, or rubber, or fur, or leather, or whatever.  But if you know you’re going to be in close proximity to a lot of people just use some antiperspirant or deodorant that day, even if you don’t normally.  I know, some folk have medical conditions, and I respect that, and I absolutely have no desire to stop those folk attending or having fun, but there are just some guys who can not be bothered to make the basic effort of wearing deodorant, and there’s no excuse for it.
  • I go to the convention to take photographs of costumes.  There are people wearing those costumes, and the costumes range in quality.  I want to capture people who’ve put in some effort and are enjoying themselves, and I work hard mentally not to judge the people I’m looking at outside of those parameters.  Clearly, I’m also human, so I naturally find some people more attractive than others, or more interesting, or whatever.  I work hard to ensure I’m not just there taking pictures of attractive women in revealing outfits – that’s not why I or they are there.  However, there are clearly some people only taking pictures of people they fancy.  I stopped a pair of ladies and asked if I could take a picture, and one of the pair stepped sideways out of the shot.  They were both in costume (the lady who stepped sideways was in a less revealing outfit than her friend).  I had to drop the camera and ask her to step back in to the frame, at the same time as her friend was encouraging her back in as well.  I don’t know if she was just shy and didn’t want to be in the shot, but I got the feeling they’d been stopped by other people who just wanted a picture of the lady in the more revealing outfit and it made me a little bit sad and somewhat angry.
  • I felt a bit sad for the two of three rows of signing tables.  Pairs of people behind a desk – ageing actor + agent, all the way along, waiting for someone to turn up so they could earn another bit of cash.  I know, it must be lucrative, and I’m being hugely hugely disrespectful.  Fans love to meet their heroes, their heroes love to meet their fans, and if you’ve got a fan base then you should turn up and everyone’s a winner, but the two times I walked through that area it just felt devoid of soul.  Sorry.

Other things

  • May the tiny kitten of joy vomit forth happiness upon you
    GenkiGear t-shirt

    Lots of vendors, the usual range of stuff, not really why I go, but it kept my wife occupied for the four hours we were there.  Shout out to GenkiGear which is where my wife spent the bulk of her cash.  She does love their stuff.  There seemed to be about a thousand versions of Monopoly on sale, one for every fandom and universe, including Firefly.  There was quite a nice little Steampunk area, although it didn’t seem to be getting a lot of attention, one guy with some amazing art there though (who’s name I didn’t take down – aha, just remembered, I think it was this guy).

  • Getting into the venue from the car park was amusing.  If you’ve been to the NEC you know they run a shuttle bus service from the car parks.  We were on a side of the NEC we’ve not been to before, and we walked from the car park down towards the road (past all the people queueing for car parking tickets, see above).  As we got to the road, we could see the bus stop to our left, but everyone was streaming over the road crossing and not far in front of us we could see some buildings.  So, sheep-like, we just followed.  Sadly, those folk were more optimistic and younger than we were – the buildings we could see weren’t the exhibition halls, and so it was the feared long walk from the car park to the entrance.  We got the bus back.  Next time, we’ll be much less sheep-like.
  • There was a mock fight between a Rey, a Kylo Ren and a Finn.  I’m pretty sure if you’ve never seen the film it counted as a spoiler – they didn’t spoil the other thing though.
  • I saw the worst Han Solo ‘look-alike’ ever, even if his costume was authentic looking, he looked like an accountant.

Overall it was a good day out – not the cheapest way to spend four hours if you’re not interested in the events or the star signings, but not the most expensive day out either, and great to see so many excellent costumes and folk enjoying themselves.

Memories are weird

London Comic Con May 2013
London Comic Con May 2013

In 2013 I went to London Comic Con for the first time.  Other than a couple of small gaming conventions years earlier it was my first ‘fandom’ convention.  I took my trusty bridge camera with me and while my wife and her friend shopped, I walked around and took a lot of pictures.

A lot, of pictures.

I got home after an exhausting day and looked through the pictures and I was really pleased.  I had some great shots of some great costumes, and good reminders of the day.  I picked out 80 or so of the best and stuck them on Flickr.

At the back end of 2013 I bought a DSLR (a Canon 600D), and I started taking photographs as a pastime rather than just as a way of remembering events.  Although when I set out, I expected to be taking wildlife pictures, I ended up gravitating towards street portraits / candid street photography and other weird stuff.  Wildlife photography is a lot of work, and I just didn’t have the time to invest or the patience, to be frank.  Of course, all photography is a lot of work, but you can fit that work around doing other things with some types of photography and not others.

I had great memories of my photos from 2013’s Comic Con, so I went back to London in 2015 to take more pictures, with my new camera.  It did not go well.  Firstly, I had a crisis of confidence and just didn’t feel like I could approach people and ask them to take pictures.  Secondly, technically the shots I did get were just terrible.  I couldn’t work out what I was doing wrong, they were blurry or badly exposed.  I got back very unhappy and looking through the results didn’t make me feel any better.  Later that year, I went to Birmingham Comic Con, and tried again, but it was just as bad.  The camera ended up being a dead weight in my hand and despite taking a flash with me, the four of five pictures I did take were terrible.

A couple of days ago, I went back to Comic Con in Birmingham, resolute that I would just take pictures, using the flash and that I would learn from the experience instead of just being unhappy with the results.  I would use it as practice, so when I go to Comic Con in London, in May, I can use what I’ve learned to try and get some better photographs.  I was partly successful – I managed to stop people and ask for pictures, I tried to frame the subjects better (hard at a Con at the best of times), and I just took pictures and tried not to worry.  The results are okay, they’re typical indoor flash style pictures with a lot of people in the background.  They’re not as sharp as I’d like, and not as sharp as I know I can get, but they’re acceptable.  I was still sad though that they weren’t as good as the bridge camera photos from 2013 which I had enjoyed so much.

So I went back to look at those 2013 pictures – and they’re shit.  I mean terrible.  Sure, they capture people and memories, but they’re technically terrible.  Soft, blurry, grainy, badly framed, they’re everything you’d expect from a ‘point and shoot and move on’ style approach to indoor photography.  Great memories, but technically lacking photographs.  The photo’s I took with the DSLR from any of the other cons were technically much better.  Still flawed, but technically superior in just about every way.

Birmingham Comic Con March 2016
Birmingham Comic Con March 2016

So why was I beating myself up?  Why was I being so hard on myself, comparing my new photographs with superb old ones which didn’t even exist?  Because my memory of that day, and those pictures, was all one memory.  I’d gone without expectation or pressure, without any internal critique.  I’d pointed the camera at people I found interesting and took pictures and the pictures I’d taken reminded me of the enjoyment I had.  The pictures were rubbish but the memories were good.

With the other events, I had gone to take pictures and I hadn’t enjoyed the process.  The pictures reminded me of the days I had, and how those days were frustrating because I didn’t feel like I could do what I wanted to do.

Memories are weird, and shit and unhelpful sometimes.  In May, I swear, I’m going to London Comic Con without expectation or pressure.  I’m going, with my camera, as it happens, to look at interesting people in amazing costumes, and if I get some pictures, all the better, but I’m going first to have fun and to get pictures second.

Flu

I’ve been ill.  Although not anywhere near life threatening, it’s probably the most ill I’ve ever been in my adult life.  We suspect flu, and I now whole heartedly regret not getting the jab last year.  I’m on the ‘at risk’ list due to type 2 diabetes, so get the jab for free (and the NHS are not shy in reminding me), but I laughingly say ‘I’ll get it when I’m old’ each time, and decline.  I won’t decline next year.

Normally if I’m ill, I’ll pass the time watching movies or playing on the console or PC.  This time, I was pretty much spaced out the entire two or three weeks, and just stared at the TV for something to occupy my feeble mind.  Between the coughing and the temperature, I was pretty much wasted.  My eating during the illness has been somewhat sporadic, I don’t think I had anything for the first two days, and then it’s been a mixture of bread and other junk.  Can’t imagine my blood sugar results in March are going to be very good.

Frustratingly, during that time, we had some great sunny days and I would have loved to have gotten out with the camera, but I just didn’t have the energy (not withstanding that I was also off work and it would have been a little disingenuous to be well enough to take photographs but not well enough to work).  This morning was the first time in three weeks I’ve been out of the house (other than two trips to the GP), and I’m not sure Tesco counts as a fun destination.  Even doing that has left me knackered.

So I’ve spent a lot of time staring at day time TV, with adverts.  One of the things I noticed is that every second advert during the day on TV is about after 50 life cover, to cover the cost of funerals. And every other advert in between those, is about reclaiming mis-sold PPI, short term loans, or claiming compensation for an injury at work.  What a fucking depressing collection of adverts.

The usual random blogging type stuff, usually ranting.