Monday, July 28, 2008

In need of a booty call

I had a good call night last night, with nobody calling me between 01:00 and 08:30. It's a bit of a coincidence that the calls I have without being called in the middle of the night, I'm attached to the same doctor. With that said, my day was busy with me having to certify the death of three patients and taking massive amounts of blood for microbiological work-up. I thought I can take blood well but I've still a long way to go.

********

As a constant horndog, I'm always seem to be looking out for a girlfriend. Unfortunately my options are very limited. I'll start with my largest group - patients. If I liked very old woman this wouldn't be a problem but I still want to stay with my age group. The only lady who came close was somebody who came in for thyroid surgery - she looked like an actress I keep seeing on Hong Kong TV.

There are a couple of cute nurses in my current hospital but most of them are too old for me or too Hongkie for me. I've been teased constantly how my hospital ID photo, which was taken about seven years ago when I was thinner, does not correlate with my present appearance. Probably for this reason I'm ruling out nurses.

So what about doctors? I've always maintained in the long term I don't want to be married to a doctor. I do want to talk about something other than medicine. I have a lot of doctor friends but when they gather, I'm usually bored stiff out of my mind when they start talking about exams, patients or anything else medically related. I know I cannot date somebody who's a medical officer now even though I may be older than her - I don't want to upset the social balance of this conservative society. I don't have many options within the intern pool since everybody seems to be paired up.

What I really need is a f*ck buddy. Somebody I can pay a booty call just for sex and have no intimate relationship or attachment to. Unfortunately the idea of a f*ck buddy in Hong Kong is a farfetched as free elections, so I have to give that up.

Sunday, July 27, 2008

The off-season: Wigan Athletic

If Wigan had been relegated last season, I don't think anybody would have missed them. Like Middlesborough, Bolton and Fulham, they have pitiful attendance records and other bigger teams such as Nottingham Forest or Leeds United or areas where they are no Premier League team like the West Country or Yorkshire would pull in more fans. As it is they managed to stay in the Premier League by getting rid of a bad manager (why did anybody think Chris Hutchings would do a good job?) and getting a dire manager who was struggling with his own team, Steve Bruce.

Regarding Birmingham City who were relegated, Bruce has raided his former club for players but hasn't done really much that would satisfy Wigan fans, if there are any. He still needs a major recruitment drive soon, otherwise it will be another tough season for the Latics.

GK: Chris Kirkland, Mike Politt, Carlo Nash

With Politt recently signing an extension, it will look like Nash going as he has been on loan other a few Championship clubs already and will no doubt interest many.

RB: Mario Melchiot, Ryan Taylor

With Emmerson Boyce more likely to shift to centre-back, Bruce will allow Taylor to revert back to his usual role as right-back but to be second choice to Melchiot's experience.

LB: Erik Edman, Martin Figueroa

If Bruce can tie down FIgueroa to a permanent deal, he won't have any issues in this position.

CB: Emmerson Boyce, Paul Scharner, Titus Bramble

Everybody knows what will happen here - Bramble has to leave. He's the worst player to grace the Premier League. He's the reason why we have so many foreign players in the Premiership. After Bruce has finally got rid of Bramble, his main priority is getting a couple of decent centre-backs.

WG: Luis Antonio Valencia, David Cotterill, Daniel de Ridder, Kevin Kilbane, Jason Koumas, Rachid Bouaouzan

With Bruce bringin in de Ridder, Cotterill's days are numbered at the JJB Stadium. Also Bouaouzan will be looking for a new club after doing sod all. There have been rumours of Kilbane and Koumas leaving but that would be suicide by Bruce. They are two exceptional footballers who can keep Wigan in the Premier League.

CM: Wilson Palacios, Michael Brown, Oliver Kapo

After recruiting more players from his old club, I think Bruce will stop here. He may recruit another central midfielder but he has priorities elsewhere.

FW: Antoine Sibierski, Henri Camara, Emile Heskey, Marlon King, Amr Zaki

Only Heskey and new recruit Zaki are guaranteed to at Wigan come August. King has been shopped around despite being recruited in January whilst Camara and Sibierski have fallen out of favour with Bruce. Expect at least anothe forward coming to Bruce's squad in the next few months.

Summary

In: 2 x Centre-backs, 1 x Centre-midfielder, 1 x Forward
Out: Nash, Bramble, Cotterill, Bouaouzan, Sibierski, Camara

Friday, July 25, 2008

Movie Review - The Dark Knight

I used to write for a movie site called "The Trades". The writers were a group of amateur enthusiasts covering the world of entertainment, covering box office grossings to TV shows. Whenever I had the chance I would write movie reviews for the site, especially if the film was opening in Hong Kong before it opened in USA, where the website is based. I stopped writing a few years ago - mainly because I didn't have time to go to the cinema to catch the first screening of a movie and then immediately write about the quality of the acting but mostly because I started to become more dispassionate about the quality of films. I would constantly hype myself up about a film only to be disappointed. I should stop watching too many Hollywood films and turn my attention to other world areas but it is difficult to find these films.

On Wednesday I finally found a film that lived up to its hype - "The Dark Knight". You may have heard it broke all box-office records but it doesn't say anything about the quality of the film. It is one of those films I would go back to see in the cinema again. Christopher Nolan has broken all the rules - he's made an action film with intelligence, a sequel far superior than its predecessors and a summer blockbuster which could vie for best movie of the year. Forget about Oscar nominations for Heath Ledger, you could start dishing out nominations for the film itself as Best Picture and Christopher Nolan as Best Director.

Much has been lauded about Heather Ledger's performance as the Joker. A very deep psychotic performance compared to the wacky, insane approach by Jack Nicholson, Heath Ledger totally dominates the movie. Forget Best Supporting Actor, Warner Bros. could seriously push him for Best Actor. It's a good thing they didn't try to explain the Joker's origins, which helps with the mystery.

That's not to say the other actors performances were poor. In any other film, Aaron Eckhart would be lauded as Harvey Dent whilst Maggie Gyllenhaal was radiant as Rachel Dawes. Christian Bale continues to represent Bruce Wayne/Batman well whilst you cannot fault Morgan Freeman and Michael Caine when they were on screen.

With "The Dark Knight", Christopher Nolan has truly flexed his muscles and shown he can direct and write well. The plot and storyline are intelligent down to the finest details whilst the dialogue and directing are spot on, with nothing too cliched.

See this movie, because it is the only good movie out there.

Tuesday, July 22, 2008

The off-season: West Ham United

Last season West Ham United were the most average team in the Premier League and probably in the world. Too good to go down but too crap to vie for European places, there season petered out by February. With the recent takeover Hammer fans should be expect to challenge for Europe. Yet the money has been tighten and Alan Curbishley needs to sell before he can, which has lead him to shed some excess weight already.

GK: Robert Green, James Walker

After Richard Wright was sold back to old club Ipswich Town, it will be just two keepers battling it out. I don't know why Green has been ignored by McClaren and now Capello in the England reckoning. He clearly is better than most English keepers around.

RB: Lucas Neill

Now with Pantsil having gone to Fulham, Curbishley will probably need another right-back but he still has the option of playing Spector here.

LB: George McCartney

West Ham United seems to be lacking full backs, with only McCartney being the only left-back. And he's not that good either. There has been rumours of Nicky Shorey at six million pounds but with purse strings being tighten, Curbishley has to look elsewhere.

CB: Danny Gabbidon, Anton Ferdinand, Matthew Upson, Jonathan Spector, James Collins, Calum Davenport

Probably a well packed area but with too many inferior players. Gabbidon, Collins & Davenport are surplus to requirements whilst Ferdinand has been shopped around since his off-the-field behaviour has been overshadowing his performances. It only leaves Upson & Spector as the real centre-backs likely to keep their places.

WG: Fredrik Ljungberg, Julien Faubert, Kieron Dyer, Matthew Etherington, Luis Boa Morte

At one point Curbishley had too many right-wingers but after getting rid of Norberto Solano and most likely to payout Ljunberg to go somewhere else the number and quality of wingers is just right.

CM: Scott Parker, Mark Noble, Hayden Mullins, Lee Bowyer, Nigel Quashie

After hopefully getting his worst buy in the form of Quashie, it is most likely Curbishley will just consolidate in this area.

FW: Dean Ashton, Craig Bellamy, Carlton Cole

After selling Zamora (which I think is a bad idea) and not keep Henri Camara, there is a need for a striker, especially with the injury problems of Bellamy and Cole's uncertain future. There haven't been any names flouted around, since it will require a considerable amount to pay for somebody decent.

Summary

In: 1 x Right-back, 1 x Left-back, 1 x Forward
Out: Collins, Davenport, Ljungberg, Quashie

Post-call + taking it on the chin

I'm currently post-call. I don't know why doctors have to differentiate between pre-call, call & post-call but they just do. My call last night was relatively good. Only had to be waken in the middle of the night once at 03:00 for fever which I should have dealt with early at midnight. That's all part of the learning process.

********

I had a relatively long weekend. When I write 'relatively' it means that - doctors don't have long weekends like other professions. My long weekend was from Saturday afternoon to Sunday night, meaning I could go home and sleep overnight. I do what I normally do at home - eat, drink & sleep plus bake. Since my dad is away on business, I can get to cook dinner which I'm not normally entrusted with, despite being quite good at. I enjoy the cooking process - creating something that other people get pleasure out of. Whether it is baking carrot muffins or baking fish in lemongrass & curry leaves, I enjoy the end result. Also it was nice seeing my dogs around and playing with them.

********

I was in the lift the other day with my supervising MO, a doctor friend of mine, when this obnoxious couple started commenting about her appearance. To give you a background I live in the most conservative society in the world where burns patients have more skin exposed than girls/ladies. This ignorant couple started commenting on my friend's dyed hair, dress sense, stockings & high heels. They regarded it as "inappropriate" for a doctor

Let me just say she was not provocatively dressed at all. My friend was not wearing a see-through low-cut top or a short skirt. She was not wearing red, three-inch, f*ck-me heels. She wears her make-up beautifully (unlike most Hong Kong ladies) and she has dyed her hair. She was dressed smartly But does this has nothing to do with her performance, her attitude or her professionalism as a doctor.

We could talk back since we don't a dreaded visit from the public relations officer, so she had to take it on the chin and just stand there whilst this couple continued their inappropriate barrage on her, just half metre away. There is always this phrase that the customer is always rights but it is wrong. Most of the time the customer is ignorant and doesn't know what he truly wants, whereas the business/service has a much better understanding of the customer needs. The customer is blinded by hearsay, rumours and dodgy advertising, so his/her view of perspective is clearly distorted.

We don't doctors in flip-flops, shorts and a tank top. But calling somebody inappropriately dressed when she clearly isn't may say something more about the caller than the target.

Wednesday, July 16, 2008

A good on-call day/night

I had a nice call day yesterday, what is described in my profession as "complete bed rest". You need to be a doctor to understand that type of humour.

The day didn't start off that well. I was admitted patients when I heard one of the health care assistants shouting one of the patients had collapsed. Since I was the only doctor around, I raced over to check what was going on. The patient became unconscious whilst walking to the toilet and fell forwards, banging her head & cutting her lip. I checked to see if she was responsive (no) but if she was still breathing & had a pulse (yes to both). I didn't know the patient that well since she's not on my team but had to do a quick assessment. It felt unnecessary since one of the medical officers was going to document her condition anyway but I felt as the first doctor there that I at least should write something.

In the end it didn't really matter. Three hours later the patient passed away. Her condition deteriorated very rapidly. I'm just surprised at how patients can go from being good & walking around to being comatose and near death.

********

The medical officer that I was on-call with last night was a good friend of mine. Whatever people say about her, she's a nice girl. It is slightly awkward having a friend as your senior. In the presence of other people I would call her "Dr. Chow" but if nobody is around I would call her by her first name. I know it aggravates a lot of people but in this situation she's not my pal but my superior. She's the one who tells me to do things, whether to write up discharge summaries or consultations. I just have to remind myself she's doing her job and so am I.

Tuesday, July 15, 2008

The off-season: Tottenham Hotspurs

We knew Ramos will do a clearout of some of the players in his squad. It is surprising that only a few players have left so far, with Cerny only the one that springs to mind. By August most of the peripheral players and even some stars will have left White Hart Lane with new players joining in.

GK: Paul Robinson, Ben Alnwick, Heurelho Gomes

With Robinson culpable of many mistakes last season, Ramos needed a more reliable goalkeeper. In stepped Gomes Gomez from PSV but will he be enough to propel Spurs to a top four finish?

RB: Alan Hutton, Pascal Chimbonda, Paul Stalteri, Chris Gunter

We all know Chimbonda is an arse and wants to leave to greener (i.e. richer) pastures. With Stalteri also likely to go, it will lave Hutton and Gunter fighting out for the number two shirt.

LB: Gareth Bale, Gilberto, Lee Young-Pyo, Benoit Assou-Ekotto

With far too many inadequate left backs, surely a few must leave during this summer. Players from the former regime such as Lee & Assou-Ekotto are set to depart White Hart Lane whilst Gilberto may stick around for another season. Ramos will want to use Bale more in his most ideal position of left-back

CB: Ledley King, Jonathan Woodgate, Michael Dawson, Ricardo Rocha, Younes Kaboul, Anthony Gardner

There have been rumours of King leaving Spurs this summer due to his constant injury plights but it will be difficult to replace his quality. More likely to go are Rocha, Kaboul (who maybe going to Portsmouth) and Gardner. That leaves a slot free to fill.

WG: Aaron Lennon, Steed Malbranque, Teemo Tainio

This is where Ramos might consider investing a lot of time and money in. He really doesn't have many natural wingers. Malbranque and Tainio are wide attacking midfielders, leaving only Lennon as the only out and out winger. He may consider playing Modric or dos Santos in the wide areas though.

CM: Didier Zokora, Jermaine Jenas, Kevin-Prince Boateng, Adel Taarabt, Tom Huddlestone, Jamie O'Hara, Luka Modric, Hossam Ghaly

We all know Ghaly was expected to leave and maybe followed by Boateng but I'm surprised that O'Hara and Taarabt might be on their way. They are both technically gifted playmakers who will do well in any Premier League team. That said there are far too many midfielders at Tottenham and to make room some have to go.

FW: Dimitar Berbatov, Robbie Keane, Darren Bent, Giovani dos Santos

Even though Bent was worthless last year, it will be difficult for Spurs to shift him to any other team if they want to recoup any of the 16 million pounds they paid for him last summer. But they did get a good bargain on dos Santos, For just 5 million pounds, he has got to be bargain of the season already.

Summary:

In: 1 x Right-back, 1 x Centre-back, 1 x Winger
Out: Robinson, Chimbonda, Stalteri, Lee, Assou-Ekotto, Rocha, Kaboul, Gardner, Tainio, Boateng, Taarabt, O'Hara, Ghaly

Monday, July 14, 2008

Settling in...

I'm finally settling into my job as a lowly intern. 90% of my job involves paperwork - filling up the drug chart or writing a discharge prescription; writing up admission management orders; booking follow-ups; writing admission notes or discharge summaries. The only thing that differentiates me from a nurse is my signature. Most nurses I know are experienced enough to know the bureaucracy of our health care system and how to navigate through it but require my signature for the authorization to do anything. I get through 90% of my paperwork without any mistakes but it is nice there is somebody like a nurse to correct me. Unfortunately none of the nurses at my current hospital are sexy.

All this mind-numbing copying of previous notes and orders has left my brain dull. Most of my clinical sense has gone out the window and I'm afraid without it I might kill a patient. I nearly did on Sunday. A patient developed a fever at 6 am. I diagnosed it as pneumonia and did what I normally would do - take blood for culture and laboratory tests plus gave her oral antibiotics. At 9 am she developed a low blood pressure. I ordered IV fluids & antibiotics for her and basically was about to leave before somebody reminded me what her blood pressure actually was. After looking at her blood pressure and nearly freaking out, I eventually called the medical officer on call. Before long the patient was sent to the Special Care Unit because of septic shock. I just hope I develop back my clinical sense so I don't kill another patient.

Doing procedures is starting to become much easier for me now. I almost proficient in venous blood sampling but my arterial blood sampling is still in need of practise. I had to take an arterial blood sample from a patient today. I'm fortunate the patient was in a state of stupor, since I had to poke her a few times before I could take enough to perform an arterial blood gas. I'm also relieved I could catheterise a patient's bladder without any major hitches, even though the last time I performed an urinary catheterisation was a year ago... on a dummy.

What surprises me most is the number of deaths I had to certify. In a convalescent hospital , we don't get many emergency cases. However we do get a number of terminal patients with "Do Not Resuscitate" orders. Yet it seems my luck that I had to certify three deaths in a four day spell, all of them when I was on call. Compare this to the other interns in the hospital, who haven't had any, and you start to think you have a black cloud following you.

I'm not looking forward to my next call on Friday if this keeps happening.

********

Yesterday I had afternoon tea with two of my best friends at the Peninsula. I was quite surprised that we had to queue for something like this. The food was actually very good. I loved the scones with clotted cream and strawberry jam. How I miss English food! And the tea was very good - it didn't need milk to be enjoyed. I was disappointed they didn't have any cup cakes or french fancies but you can't have everything.

Of course I'm going to whine that I could all that at home - serve tea with scones and everything else. But I have to realize not everybody could do that and sometimes the experience is more important than the food itself.

Saturday, July 12, 2008

The off-season: Sunderland

I'm in the middle of my lunch break right now, so excuse me if this entry seems a little truncated.

I reckon Sunderland were fortunate to survive last season. Roy Keane is a good motivator and coach but his prowess in the transfer market is a little less desired than most. He needs to make more astute signings over the next two months to consolidate the Black Cats' position in the Premier League.

GK: Craig Gordon, Darren Ward, Martin Fulop

Even though Gordon had a slippery patch last season, he's still considered the No. 1 at the Stadium of Light and most likely Ward will back him up. Fulop has been courted by many Championship clubs so he is most likely to leave.

RB: Phil Bardsley, Greg Halford

Roy Keane should cut his loss on Halford and just sell him instead of loaning him out. He doesn't need a back-up since he has many players who can also play in the right back role such as Whitehead & Nosworthy.

LB: Danny Collins

After letting Ian Harte go and playing a centre back in this position, Keano will need to get a left-back as one of his priorities.

CB: Nyron Nosworthy, Paul McShane, Danny Higginbotham, Russell Anderson

With Anderson most likely to go, I think Roy Keane should go an experienced centre-back to balance the back line.

WG: Carlos Edwards, Roy O'Donovan, Kieran Richardson, Ross Wallace

Keane has already stated Wallace can go, despite the fact he's not bad and versatile. With Richardson and Edwards spending most of last season in the treatment room, this is another area Keane needs more numbers in.

CM: Dickson Etuhu, Dean Whitehead, Liam Miller, Greg Leadbitter, Dwight Yorke, Andy Reid, Graham Kavanagh, Arnau Riera

Everybody knows Riera, Kavanagh and Miller have fallen out of favour with Keane. So you won't be expecting them to be at Sunderland in August.

FW: Anthony Stokes, Daryl Murphy, Michael Chopra, Kenwyne Jones, David Connolly, Martin Waghorn, Rade Prica

This is where Roy Keane has the most trouble with. He seems to buy hopeless strikers and even his best striker Jones has trouble scoring. I'm sure he will keep everybody apart from Connolly but I still think he needs another striker.

Summary

In: 1 x Centre-back, 1 x Left-back, 1 x Forward
Out: Fulop, Halford, Anderson, Wallace, Miller, Kavanagh, Riera, Connolly

Thursday, July 10, 2008

Many firsts

Everybody seems to remember their first time for everything. The first time they kissed a girl or boy for example. It is suppose to litter your life with memorable events that you look back on when you're older. In my short lifespan as a slave to the Hospital Authority, I've experience quite a number of firsts. Not all of them were great but some where.

I had to deal with my first difficult patient in the General Clinic, who insisted having a colonoscopy despite there was really nothing wrong with him. Yeah, he was a bit constipated and was reliant on medication to take a dump but the guy was in his late fifties and most people are starting to depend on lactulose or senna to prevent constipation at that age. Thankfully the medical officer in charge stepped in to save me from the hassle of dealing with this patient. I was eternally thankful, having been arguing with the patient for more than ten minutes. I'm just grateful these people are a minority.

I've been approached by my first drup rep during my shift in the Breast Centre. I don't know why they put a guy in the Breast Centre but they did. Probably more disappointing was the gender of the drug rep - it was a guy. I know most the drug reps in the industry are women, just to entice the male doctors into buying drugs they don't need to prescribe. Thankfully he was courteous enough to explain the drug trial I knew nothing about, about a drug I knew nothing about and gave me a free gift - a placemat for your car to prevent items like your keys and mobile phone sliding all over the place. I know it must sound daft to some people to think this is your highlight for the day but it just reminds you that you're a doctor and these people are giving you a bit of respect for what you are.

The last 'first' I'm going to write about is one 'first' I didn't expect to be doing. I was on call last night and after having done the night round, I was settling in for an episode of 'Bones' before I got a call from the nurse. I had to certify the death of a patient. My mind thought, "Jesus Christ! Isn't this suppose to be a job of a medical officer!" I was going to ask the nurse to phone the medical officer instead to certify the death. Yet I thought I will eventually have to do this. So after getting changed quicker than an adulterer who hears the partner coming into the house, I whizzed to the ward and at the same time brushed up on my knowledge on how to certify the death of a person. I had seen it done before but I had to make sure since this was somebody's life (or death as it was).

After reaching the ward and asking the patient's sisters to wait outside the room while I conducted the examination. It just dawned at me at that point this was no longer a person but just a body. I know it sounds harsh and cold but it is true. I just had to get this over with, with respect, dignity and professionalism. After making sure I had all the signs to confirm death and double checking just to make sure, I told the relatives that their brother had passed away and I was sorry. I had to get down to the business of writing all my findings and documenting everything. I had to call the medical officer on-call just to inform her what I did.

Probably what scares me most is that I don't know the patient's name - even now after 18 hours post-mortem. I think it is easier for me to not know, to actually detach myself from the event and not to personalize it. The patient (whoever he was) was from a different team which I'm normally attached to during the day. I just so happened to be the house officer on call who had to perform the necessary duties. It just is a fact of life.

I just hope that I don't encounter too many of these incidents in my career.

Tuesday, July 08, 2008

Week 1 out of 52

I'm one week into my intern life and I'm learning quite a lot. I'm not learning much medicine as it is. The life of a house officer is basically to learn the mundane bureaucracy and protocols that come with daily life in a hospital structure or within a health care system. You learn to know which drugs to prescribe, when you can book a follow-up clinic, how to write up discharge summaries and which people to consult for particular patients.

Perhaps I'm being too harsh since I'm based at a convalescent & rehabilitation hospital. Most of the patients I admit into the hospital have already been assessed a number of times by more senior doctors. So when they come into have surgery there is really no point asking them a history or performing a physical examination since it does really help his/her management and more important it wastes my time. Most of the time I feel I'm treating a laboratory result or a finding, which I know I've got to stop. Every time a patient has low potassium levels, I should be stopping myself prescribing potassium chloride syrup and actually go to the patient, assess his/her status and then think about some management. I hate to say it but I think my mind is being numbed. The pay off is that the work is not that taxing and my calls are not that harsh. I will probably miss having a good night's sleep when I'm on call in the admission ward but I think my mental thinking will benefit a lot more.

After this week I know which doctors and nurses are nice and who is a real bastard or bitch. Fortunately those are a minority but it does make your life hell. Thank goodness I've only got five more weeks of this. The doctors and nurses who I don't like expect you to know everything and when you don't they give you a really hard time about it. They don't know about insight or putting themselves into other people's shoes.

For once I'm really glad I have my evening free. I'm glad that I'm not revising my exams and being under pressure. I'm glad that I'm just reading for my benefit and not for the benefit of somebody else. I'm glad I have the evenings to sleep and watch episodes of "House" and "Bones" that I have (illegally) downloaded off the internet before my internship.

Saturday, July 05, 2008

The off-season: Portsmouth


It's been a long time since I did an analysis on a Premier League team. Since the last time there have been many changes and a lot more transfers. I won't be going back to revisit my past analysis despite the movement.

After winning the FA Cup, Portsmouth will be needing to maintain this form otherwise they will be going backwards. This will be dependent on who Redknapp brings in.

GK: David James, Jamie Ashdown

Having the best English goalkeeper, Portsmouth doesn't need to bring in an extra goalkeeper and Ashdown is adequate enough as back-up.

RB: Glen Johnson, Lauren

With Johnson rediscovering his form, there is no need to reinforce in this area.

LB: Hermann Hreidarsson, Djimi Traore

With Traore seeming to go, hopefully Redknapp can keep Aubey to keep two left-backs.

CB: Linvoy Primus, Sylvain Distin, Noe Pamarot, Martin Cranie, Sol Campbell

Distin & Campbell are great and tough to budge, so Redknapp might want to consider getting some young back-ups since Primus and Pamarot are ageing whilst Redknapp doesn't seem to have faith in Cranie. However he won't be doing it this summer.

WG: John Utaka, Glen Little, Franck Songo'o, Sulley Muntari, Niko Krancjar

With Songo'o effectively out of the picture, I still think Redknapp will like to bring another winger. Muntari's best position is in left central midfield rather than an out-right winger. Bringing in Little reinforces the right side.

CM: Lassana Diarra, Papa Bouba Diop, Richard Hughes, Sean Davis, Pedro Mendes, Antonio Mvuemba

The best area for Portsmouth, so much so that many of the players will leave. Only Diarra and Bouba Diop are certain to stay. I think Hughes is the most likely to leave and Davis won't be far behind.

FW: Nwankwo Kanu, David Nugent, Jermaine Defoe, Ben Sahar

By bringing in Sahar, I think Nugent can effectively say goodbye to his career at Portsmouth. I don't know why Redknapp bought him in the first place. I think the leap was too far for the one-cap wonder but he's still young enough to recover.

Summary:

In: 1 x Left-back, 1 x Winger, 1 x Forward
Out: Traore, Songo'o, Hughes, Davis, Nugent