Thursday, 22 March 2012

The 99p Challenge!

Ahh, - the 99p Challenge. A fondly remembered radio 4 show from back in the days when Simon Pegg wasn't immensely famous. And also, coincidentally - and for a limited time only - the new price of my fantasy eBook, the Ancients!

That's right - don't waste your money on a couple of Snickers bars (although they will forever be Marathon bars to me) or a litre of organic milk, when you can get a whole full length fantasy eBook instead. The Ancients is crunchy, nutritious, free of additives is ONLY ONE CALORIE! What more could you ask?

For the Kindle-types amongst you, The Ancients can be procured from your friendly local amazon store, If you are lucky enough to live in the US (at least, for the purposes of this offer) then you can get the Ancients for the EVEN CHEAPER price of $0.99! (I've no idea what your chocolate bars cost over there though, but I can say from bitter experience of attempting to eat a Reece's Pieces bar that confectionary does not translate well across the Atlantic)

If you have a different eReader, or for some reason you like reading your eBooks in a different format every day, head over to smashwords, where your $0.99 will get you 8 different file types - including ePub, PDF and .doc, as well as being available for online reading.

So, don't delay! Join the 99p revolution - the challenge is simple! Merely click on the link, part with the teeny tiny amount of money, and enjoy your new eBook.

(Also, track down the 99p Challenge and listen to it - it's very good)

(PLEASE NOTE - YOU'VE MISSED IT NOW, SORRY. It's back up to £1.99 - but don't let that stop you!)

Monday, 19 March 2012

The Express Diaries - 2

With a clattering of iron wheels, a sinister plume of smoke, and a slightly-less sinister chuff-chuffing noise, The Express Diaries edges closer to it's terrifying final destination - your brain

And so, it's time to tease you a little more with a few glimpses into my new novel. They say a picture paints a thousand words - so here's a whole short-story's worth from Eric's easel...

Ms. Grace Murphy - young spinster, secretary to Betty Sunderland, and good friends with Violet Davenport


"Within ten minutes we found ourselves standing in a quaint, cobbled courtyard, outside an old, glass-fronted shop. The window was filled with all manner of stuffed animals, and a weathered sign hanging above the door proclaimed

‘Wellington Fils
50, Rue St. Etienne’

 Extract from the diary of Mrs Betty Sunderland


‘ on earth are we supposed to find...’ Violet began, but at that moment we heard a great clanking of gears from somewhere above us. Looking up, we saw a campanile, some five stories up, and as we watched a pair of figures jerked in to view in front of the great clock face. A winged angel, sword in hand, and cloaked, hooded Death, holding his scythe, stood before each other. They began a slow, mechanical battle, whilst the chimes for six o’clock pealed across the courtyard. After a brief struggle, the angel retreated. It appeared that Death was victorious.
            ‘Where is more likely to be struck by lightning,’ I suggested, ‘than a clock tower?’
Extract from Milos Valinchek's journal

And finally... another excerpt from the diaries themselves, where our intrepid party discover the tragedy that has struck an old friend...

Colonel Neville Goodenough’s Personal Notes, Saturday, October 24th 1925

The cab drove away as I walked towards the door of the bedsit where our friend’s card suggested we would find him.  As the others watched, I knocked on the door, not at all sure what to expect.
            I admit that I was surprised after a few moments the door opened an inch or so, and Beddows peered out into the street, blinking in the grey light of the day.
            Now Beddows is a man fastidious in nature, and respected around town as one of the finest manservants a fellow could ask for. I have never seen him anything other than immaculately turned out, so to see the gaunt, dishevelled figure blink nervously at us without a hint of relief came as almost as much a shock to me as anything I saw in the trenches. I heard Betty and Violet gasp behind me, but he paid them no attention.
            ‘You came,’ he said, flatly, leaving the door open just a crack. He seemed to be waiting for something.
            ‘Now look here, Beddows,’ I said, stepping into the doorway, ‘I understand you’ve had some trouble, but we need to know if your master is inside. Are you going to leave us on the doorway like travelling salesmen?’
            This shook Beddows out of whatever spell had possessed him. He mumbled an apology, and opened the door. Ignoring our questions, and our coats, he ushered us down a short hall into a small room, whereupon the cause of the poor man’s discomfiture became sadly apparent.
            It was a tiny bedroom, grimy and dank. The drapes were pulled closed, shutting out what grey light would otherwise have filtered in from the street outside. As we shuffled into the room, our eyes becoming accustomed to the gloom within, we became aware of a dark figure lying on the bed. As we entered, the figure started, and emitted a peculiar noise, somewhere between a whine and a rasp, which immediately made me think of the field hospitals, and the poor devils who had been gassed by the Hun.
            We crowded around the bed, all eyes upon the figure. The poor man was covered by a thin white sheet to protect his dignity, but sadly there remained little of it left to protect.
            ‘Julius?’ Betty whispered, unbelieving. It was, indeed, difficult to recognise the poor wretch before us as our avuncular host of the previous evening. His hair and famous moustache were gone, as were his eyebrows. The skin of his face and arms was blackened and cracked, except for several large red and weeping sores. One of his eyes was glazed and white, and the other one flitted from one to the other of us, never resting in one place for long. The room stank of smoke and blood. Horrified, it was on my mind to grab Beddows and demand why he had not brought the professor immediately to a hospital, when Julius lifted one of his arms and laid a blackened claw upon Betty’s hand. He smiled, then winced in pain.            ‘My friends,’ he said, in a voice that was barely a whisper, making us crowd around the bed to hear him. ‘Thank God you have come.’
            Written down, Smith’s speech appears clear and rational, but be aware that in reality this was punctuated by numerous coughs, pauses and sighs. Often his voice faded into incoherence and several times he was silent for so long that we feared he had passed into unconsciousness. Despite this, he managed to talk for several minutes, and though his speech made little sense to me, and must surely have been coloured by delirium, I will try and lay down in these notes as sensible a version of his words as I can piece together from his broken voice and my own poor memory.
            ‘I cannot bear to talk for long. Please, for a moment, listen to me, and I shall try and explain how I came to this sorry state.
            ‘You are aware, of course, that I have been on the trail of the Sedefkar Simulacrum – at first, as an archaeological curiosity. Lately, however, I have come to realise it is something much more – a source of great power.
            ‘At the end of the Eighteenth Century it was taken apart and scattered. I initially planned to retrieve the pieces for the museum in the University of Vienna - but now I realise this was arrogant folly. The thing must be destroyed!’
            Betty began to ask Julius a question, but he held up his hand and was overcome by a fit of coughing. Beddows held a handkerchief to his mouth as he did so, and it came away stained with blood and some black substance.
            ‘Last night, as we returned to our home, Beddows and I were attacked by Turkish madmen. I know little of them, save that I believe they seek the Simulacrum themselves, for their own dark purposes. We barricaded ourselves indoors, so they tried to burn us alive. Fortunately, Beddows found a way out. Not before I...’
            He gestured helplessly to his crippled form, and his voice faded into silence. His one good eye looked around the room, and his voice was even hoarser than before when he continued.
            ‘To have come to such a place! To have fallen so far!’
            Betty laid her hand over his to comfort him, but he winced and drew it back from her, though he tried to smile.
            ‘I am afraid, my friends, to come out of hiding. They would stop at nothing, these men!’ He glanced across to his manservant. ‘Beddows has a plan to escape, but the less we speak of it, the better.’
            ‘Most of my notes were destroyed in the fire, or else taken by the Turks, but I managed to rescue something – the summaries of my researches. The Turks will know as well now.’
            He paused, his one eye staring at the ceiling, as if building courage for his next statement.
            ‘And so, my friends,’ he said, looking back at each one of us in turn, ‘It falls to me to pass this burden to someone other than myself. I dare not ask, yet I hope that you will take it for me. The statue must be recovered and destroyed before these men find it.’
            He suddenly sat up in the bed, his eyes wide and staring. ‘I cannot show you what I have seen! You cannot know what I know!’ he cried out. ‘I only hope, and must trust me! The statue must be destroyed!’
            Such strenuous effort had a grave effect upon him, and he fell back to the bed, exhausted. He began muttering under his breath, and it seemed was no longer aware that we were present.
            ‘I am sorry. For them, for me. For all of us. I am the lucky one. I may be spared. I am sorry. So sorry.’
            He voice failed, and his consciousness soon afterwards. His breathing slowed, but did not stop. I think all of us were relieved to see him asleep, and so temporarily released from his agonies. We looked at each other in shock, and then to Beddows, who stood quietly in the corner.
            ‘He is delirious,’ Alfonse said, sadly, ‘to be taken in by such a fairy story. I am sorry for him.’
            I nodded. Betty frowned, but it was Beddows who replied.
            ‘My master is not insane, sir – at least, he did not imagine the attack on the house last night! I saw them with my own eyes.’
            Alfonse fell silent, pondering. Beddows’s eyes met Betty’s, as she seemed the most sympathetic in the room.
            ‘Please consider my master’s words, Madam. He asked me to give you these.’
            He handed Betty a few pieces of paper covered in Julius’s cramped handwriting.
            Grace and Violet were looking at each other, each with a sceptical expression mirrored on the other’s face. Beddows was not slow to see it.
            ‘I do not know if my master speaks truly,’ he said, glancing at the figure in the bed. Julius’s mouth twitched in his sleep and a fearful expression crossed the manservant’s brow as he must have remembered the night of terror the two of them had just experienced. ‘I can only tell you that he believes it to be so. He thinks this statue is of great importance, and he is a far wiser man than I am. I cannot tell you what to do, but who amongst you would refuse the wish of a dying man?’
            The words ‘dying man’ echoed around the small room. Although it had not been spoken of before, it was obvious that Julius did not have much time remaining.
            ‘Please,’ Beddows said, his eyes on Julius’s sleeping form. ‘Read the notes. Consider his words.’
            Betty folded the notes carefully in half, and placed them in her bag. She laid her hand gently upon Beddows’s arm. He jumped, as if struck, but did not remove it. She looked into his eyes.
            ‘What will you do?’ she asked.
            ‘As the professor said,’ Beddows replied, ‘I have...I have an escape plan. There is someone who for him. But I dare not speak of it. Please.’ He broke Betty’s gaze. Not since the war have I seen anyone look so lost, alone and afraid.
            Betty nodded, and turned to the rest of us. ‘We should go,’ she said. It didn’t seem right, leaving a wounded man behind, but there was little else we could do at this point. Both Julius and his manservant had requested we leave them alone now, and they did, as they said, have some sort of plan.
            Betty began to study Julius’s notes on the cab ride back from that dreadful room. I have a horrible feeling that she is taking his mad fantasy seriously.

Saturday, 10 March 2012

It's what's inside that counts #1 - an idiot's guide to the spleen

'He who smelt it...would forever be the one who DEALT IT!'
It occurs to me that, as I am the author of this post, the title implies that I am, in fact, an idiot. I'll leave you to make your own minds up about that one. Anyway, I've been meaning to do a short series on internal organs for a while - don't ask me why, you may as well question why I write this blog at all - and that is dangerous territory, my friend.

All right, if you insist - I write the blog to vent my spleen about the inanities, injustices and insanities of veterinary life (as well as to plug my books, but I try and keep that to a minimum. BUY MY BOOKS! Ahem) and after several years of venting, I think it's about time I gave something back to the best-named organ in the body.

(It's not the best named part of an organ, however. There are many contenders for that crown. If I ever write another fantasy novel, I'm going to the best internal bits for it. Imagine a party of adventurers trekking through the Crypts of Lieberkuhn and over the dread Islets of Langerhans in search of the fabled Rosette of Furstenburg (it's a part of a cow. If you want to know more, feel free to google it, but it might put you off your tea))

So, lets talk about the spleen (not, incidentally, the intestinally-overactive superhero of the same name from Mystery Men, as shown above. I just couldn't resist reminding you all what a great film it is. And if it doesn't remind you because you haven't seen it, the go and watch it. Now! Really, it's far more entertaining than this blog). The spleen has an air of mystery surrounding over and above other internal bits and pieces, largely because you're quite likely to only have a very vague idea of what it actually does.Something to do with blood, maybe?

Well, don't feel bad. I know what it does, and it still feels vague to me too. This is because the spleen doesn't have any primary functions at all. It's a secondary organ. A middle man. The spleen is the body's equivalent of an estate agent, or a insurance broker, only far less likely to rip you off (though slightly more likely to kill you, so, y'know, swings and roundabouts).

Where is it?

The spleen is shaped something like a knobbly comma, and it sits (or lies, or does whatever it does when a spleen is relaxing) in your abdomen, on the left side, following the curvature of your stomach. The base (the tip of the tail of the comma) is held relatively tightly to the stomach, but the rest is more or less free to wobble around the abdomen as it sees fit. Sometimes, it sees fit to do this rather more than is good for it, but we'll come on to that.

What does it do?

Ah, the most commonly asked question about the spleen. The short answer is - nothing that the rest of the body can't do, but it helps. It serves a number of functions.

1. The spleen is a haemopoietic organ

(and not, sadly, as I commonly misspell it, a haemopoetic organ, which brings to mind images of it moping around in seedy bars, scribbling sad missives about blood into a tattered notebook)

Haemopoiesis is the production and maturation of blood cells, and although the spleen does a great deal of this whilst we are developing in utero, it sort of gives up about halfway through gestation and thereafter leads most of the hard work to the bone marrow.

2. It mops up old red blood cells

For the SF fans amongst you, imagine red blood cells are living in their own version of Logan's Run, only instead of 30 years, the allotted lifespan is about 120 days, and instead of a Sleepshop you're sent to on your Lastday, it's the spleen.

For everyone else...well, you probably get the idea from the bit in italics.

3. It is part of the immune system

Blood flow through the spleen is really rather complicated, but for brevity imagine that the spleen is like an airport security desk through which all the red blood cells, white blood cells, viruses, bacteria, parasites and other assorted bits and pieces are passed. If the spleen is doing it's job, then the foreign material is quickly grabbed by macrophages (my favourite white blood cell. How can you not like something whose name means 'Big Eater'? A bit like The Blob, only smaller and friendlier) and other white cells, and summarily executed. Okay, perhaps it's not that much like an airport security desk. Maybe it's easier to think of it like a giant lymph node? (I told you I was vague)

4. Blood Storage

The spleen is a reservoir for blood, as any surgeon who has ever accidentally nicked one with a scalpel can readily attest to (er...I imagine. It's never happened to me, naturally). Depending on you species, up to 30% of your red blood cells and a fair proportion (me, vague? Never!) of your white blood cells are waiting in there, ready to pounce. If there is a sudden need for red blood cells or oxygen, the spleen contracts and releases it's payload into the bloodstream. I was taught that contraction of the spleen is what causes the 'stitch' pain in you're abdomen when you're running, but I must admit I remain unconvinced - I'm pretty sure I've had a stitch on the right side of my abdomen, but maybe I'm just wired up wrong.

What can go wrong with it?

Well, here I'm going to talk from a more veterinary perspective. Because I'm a vet. You want to know about humans, go and ask Doctor Mark Porter. I'm going to tell you about the most common problems that I see in practice with the spleen.

The first thing to say is that, as a small animal vet, the majority of spleen pathology I see is in dogs. Possibly because they're smaller, or have less blood flow, or are simply luckier than dogs, cats are rather under-represented in the spleen-gone-wrong stakes. As far as other species - I don't think I've ever seen a spleen problem in a rabbit, and very rarely in small rodents, although ferrets seem to have their fair share of issues with the enigmatic organ.

The second, slightly more depressing thing to say, is that the most common spleen problem I see by far is the big C - splenic cancer. Because of it's functions - all blood-related - when cells go wrong in the spleen, they tend to be blood cells. Or, rather more commonly, blood vessels.

It can be a bit of a challenging diagnosis, because the symptoms of splenic haemgiomas (benign blood vessel tumours, good news) and splenic haemangiosarcomas (malignant blood vessel tumours, very much not good news) can be, like the spleen itself, rather vague and mysterious. The most common presentation would be a middle-aged to elderly dog (often labradors) who just 'aren't right' - quite tired, not exercising well, with not a great deal to see on clinical exam and very little exciting on a standard blood screen. You may be able to feel something in the abdomen, but these are big dogs, sometimes with small tumours, and the spleen is good at moving around, so quite often you won't feel a thing. If you're lucky, or skilled, an x-ray or ultrasound scan will reveal the presence of something that shouldn't be there, but not every time.

Because of this, the case can often grumble on for a little while, sometimes getting a little better on the medicines you prescribe, sometimes not, until it eventually presents collapsed, because that lump on the spleen has finally burst. It's pretty rare to a dog to bleed to death from a splenic tumour - it's bleeding into a closed space, after all, and there's only so much space it can fill up - but it's not going to feel well.

The spleen is also a pretty common site for secondary tumours - with so much blood passing through it, it's a fairly easy organ for cancer to take root. The course of these diseases will depend largely on where the tumour started and what it's doing there.

Because all of these tumours can grumble on for a long time without causing many symptoms at all, they have been responsible for the biggest and most impressive lumps I have ever seen in my career - the largest of which was a seven kilogram tumour removed from the abdomen of a thirty kilogram dog (I do have a piccie of this one, but it is rather bloody, so I'll leave it off the blog in the interests of taste).

A ruptured spleen can occasionally occur after a road traffic incident (I believe I'm not allowed to call them accidents any more, because there's always someone to blame. And where there's blame, there's a solicitor hoping to make money from it), with similar effect to the ruptured tumour above, though often with the added complication of other injuries.

I've already touched upon the third problem. As I said, the spleen is rather mobile, and likes undulating up and down the abdomen like a lumpy Mexican wave. On rare occasions, the spleen can actually spin itself right around, tying it's own blood vessels into a knot and causing the spleen to swell up like a bloody painful ballooon. It's very painful, and often occurs in conjunction with the stomach doing a similar head over heels - the incredibly dangerous and dreaded veterinary emergency GDV (gastric dilatation/volvulus) which we'll have a cheerful chat about when I get around to writing about the stomach.

What on Earth can you do about that lot?

Fortunately, you don't have to be a brain surgeon to sort this lot out, usually. Just an abdominal one. The benefit of the spleen having no primary fuctions is that, whilst it isn't exactly surplus to requirements, you can certainly cope pretty happily without one. Olympic athletes might miss the splenic contraction, and you might be prone to a few more infections (though this does seem to be more of a problem for humans than animal. The same is true of the Olympic thing, now I stop to think about it) but most of the time you can cope without your knobbly comma fine.

The procedure of choice for all the above conditions is a splenectomy - chop the spleen out. (...ectomy, in medical language, means 'to remove', whereas ...otomy means 'to cut a hole into'. ...infamy means something completely different.) Fortunately, the procedure is reasonably straightforward. It's really a matter of tying of blood vessels. And then tying off some more. And sore more. It's very good practice for ligatures, though for big spleens you may need a spare pair of hands and/or a lot of clamps. It can be pretty messy, especially if the damn thing has already burst before you got in there, and you will almost certainly need to give your patient a lot of fluids, or even a blood transfusion, as one way or another a lot of blood is coming out with it.

How successful the splenectomy is depends on the cause of the problem. If you're dealing with a tumour, and it's benign, then there's a fair chance that you've sorted the problem out. If you've got a haemangiosarcoma, then sadly the thing is pretty likely to have spread before you got in there - haemagiosarcomas are really, really good at metastasizing (spreading), especially to the liver, and to the heart. In fact, in a lot of cases the tumour you're removing with the spleen already came from one of those places. It's still a procedure worth doing, because your patient will probably be back to normal within a few days, bright and happy. But one day soon, and often within a couple of months, they'll be back in your consult room again, collapsed as before - for this reason, it's generally a good idea to send your removed spleen off to a pathologist so they can tell you exactly what was wrong with it.

The prognosis for the ruptured spleen and the splenic torsion is generally much happier, so long as you get to them in time. The dreaded GDV (I feel I should write it in capitals to simulate the awe and terror that those three letters can inspire in a new veterinary graduate) is somewhat harder to deal with, but you'll often do a splenectomy at the same time.


So, what have we learned? Amusing in name, confusing in function, slightly challenging to diagnose and relatively easy to treat. If by treat, you mean 'remove entirely' (much in the same way our current Government would like to treat the NHS).

The spleen, ladies and gentlemen. Gratuitous bloody surgical image below Look away now if you're feeling squeamish. (This one's from human medicine)