Tales of a Tall Med Student

In the house of God

2010-08-14T21:58:00.002-06:00

I just finished reading 'The House of God.' If you're in medicine, you're supposed to read it at some point, as some kind of right of passage.

To an outsider, the book must seem to present a sick uncaring world. Some things have changed in medicine, since the time the book was written (nobody uses words like 'gomer' anymore, except in reference to the book), but the experience for an intern has remained essentially the same. Coming face-to-face with mortality, and its frightening predecessor of dementia, in the context of withering fatigue and isolation, continues to rip the psyches of interns apart. The book splits the internal responses to it into different characters. The dark humour, the bizarre obsessions, the self-destruction, the intellectual separation from the moment, the suspension of reality; some mixture of these happens to everyone.

Funny enough, I had my appendix out at Beth Israel, the House of God.

Christmas in July

2010-07-29T20:49:00.002-06:00

I'm working in a CCU across the street from a big church these days. The window was open the other day, and you could hear the carillon playing. It took me a couple of minutes to realize that they were playing Christmas music!

Perhaps under the subliminal influence of the church bells, I've found myself listening to Joni Mitchell, on repeat.

It's coming on Christmas
They're cutting down trees
They're putting up reindeer
And singing songs of joy and peace
I wish I had a river
I could skate away on

The other explanation is that maybe I want to skate away from this place.

Code Blue

2010-04-03T20:49:00.005-06:00

"See, there's a big difference between mostly dead, and all dead. Now, mostly dead: he's slightly alive." -- Miracle Max, The Princess Bride

Apparently, Max had studied ACLS.

Carousel

2009-08-28T17:50:00.002-06:00

Randomly, we came across the carousel. She bought a ticket immediately. Most of the riders were kids, but there were a few more like her. She found a horse, and got on. I found a park bench. The carousel started up, and began to spin, much faster than I expected. She put her arms out and arched her head back, like she was in a movie, riding into the wind on some southern beach. I looked at my watch; we were running late.

Even Rainbows are Poisoned with Damnation

2009-02-07T13:41:00.006-07:00

When someone asks what there is to do,
light the candle in his hand.

Like this.

-- Rumi

I hate going to half-days. To explain: we get half a day a week off from work, to go for teaching. Don't get me wrong, I love teaching, but somehow, half-days just aren't what they're supposed to be. People spend half of the time going for coffee, or sitting around complaining about inappropriate consults. My half-day is Friday morning, and as I sit at half-day, inside I'm burning with the need to get back to patients. Every second spent listening to complaints makes me think about how my patients are losing out because of this waste of time.

I'm unhappy to be there. Meanwhile, everyone else calls it "protected time" (a phrase I hate, obviously) that is their right by contract to take off from work.

Incredibly to me, I finally found support for my position in the writings of Rumi:

The intellectual is always showing off;
the lover is always getting lost.
The intellectual runs away, afraid of drowning;
the whole business of love is to drown in the sea.
Intellectuals plan their repose;
lovers are ashamed to rest.
-- Rumi

Waitin' for my Odometer to Roll Straight Sevens

2009-02-03T18:20:00.002-07:00

Screw rehab, I love my addiction
No sleep, no sleep, I am always on a mission.
-- J. Dupri

I was the only car on the 278, the only car on the Triborough, as I drove into Manhattan at 1:45 in the morning. Who knew that was possible, to be alone on the road into NYC. I found a parking spot at the entrance to the Museum of Natural Sciences, and made my way along the west side of central park to my hotel. The city was abandoned.

Meds has absorbed me into its lifestyle. One night, I'm asleep by 8:30; the next, I'm waiting for the sunrise so I can leave work and head into town. This pattern has creeped into my vacations as well.

December

2008-11-22T19:05:00.005-07:00

It's December again. Summer is long over; short days, long nights, and a reminder that we're all dying, and not that slowly. Haruki wrote:

The bloom of summer came home to me after all these years. The tidewater smell, the cry of distant steam whistles, the touch of girls' skin, the lemon scent of hair rinse, the evening breeze, fond hopes, summer dreams... Even so, everything was ever so slightly off, as if little by little the tracing paper had slipped irretrievably from the lines of summers past.

Anyways, 10 p.m., and I'm off to work, trying to put the tracing paper back in place for one more night.

Snow

2008-10-21T20:51:00.002-06:00

It's back, and I'm actually happy about it. My schedule for November looks great.

My luck is turning

2008-10-18T10:14:00.002-06:00

I stopped for a post-call café con leche on Queen West. Not bad, but not Seville. Reaching the bottom of the cup, I felt something odd in my mouth, mixed in with the coffee grounds: a shard of glass. Great.

Returning to the car, I was greeted with a $30 parking ticket.

Smurf

2008-10-03T18:52:00.003-06:00

Another 14-hour day, and I was walking home. My feet hurt, the tie around my neck a constant irritation. I was preoccupied, thinking about what it means to exist.

Two white guys stumbled out of a bar and into my path. They're in their early twenties, dressed as b-ballers, and drunk or high or both. "Can you spare some change?" one asked me. "Sorry, no." I tried to be nice.

"You FAKER! You and your... BLUE SHIRT!"

Seriously? Is this my life?

I walked into a street sign.

"HA HA! That's the funniest thing I've ever seen! Hey look! Look!" His friend was now vomiting into the flowers in front of Just Desserts.

"FAKER!" I heard in the distance, as I disappeared into the darkness.

The Good Life

2008-07-23T20:26:00.003-06:00

She asked, "Did you move back into your old apartment?"

My friend answered for me. "Yeah, he moved right back into the same rut he was in when he left."

I've told people before that I sometimes feel like I'm living in stasis. Now I find that it is true. I'm walking the same streets as before, going to the same restaurants as before. Often it's the same employees as before. Eight years have passed.

The only difference is that now my hair is a bit longer, my beard scragglier, and there are lines at the corners of my eyes. And I had a future back then. Now there's just the present. Is that the improvement?

Oh Happy Day

2008-04-06T19:03:00.002-06:00

Medical school finished on Friday.

Yunus said:

I haven't come here to settle down;
I've come here to depart.

De Omnibus Dubitandum

2008-03-16T17:08:00.005-06:00

The dream was beautiful. He was helping the poor, the repressed, the innocent. Justice: it was happening, he was working hard, he'd do it, he'd change the world. And, the million dollars, oh the million dollars every day, just out of reach, but he'd get it.

Now, cracks started to appear. He had trouble remembering his plans, his ideas, and the people he had told them to had not written them down. His own notes didn't make sense, he had so many ideas. If only they'd written them down, if only he'd had a secretary writing down everything he had said.

A profound sadness was settling into his soul. Now, how could he achieve his goals? He knew who to blame: that medical student. The student had stabbed him in the back, said that he was not thinking straight, that he was sick. He had told the committee not about his wonderful dream, but about his mistakes. He wasn't sick! Now, the student was experimenting on him with his drugs, just to play doctor. His dream, his dream was dying.

I'm Only Looking for My Hand in the Snow

2008-03-01T21:28:00.003-07:00

I started my psych rotation last week, and in celebration I put Yoko Ono on repeat in my iTunes. There's a song of hers I love, because it's somewhat strange: Walking on Thin Ice. I've never met another person who liked it; generally, people think you're nuts if you like Ono, and maybe they're right. Anyways, I came across it recently in a listing of remixes, which was a surprise to say the least.

Yesterday, I looked it up in wikipedia. Apparently, the guitar in Walking on Thin Ice is the last musical recording of John Lennon, and when he was shot, he had the final mix of the song in his hands. Hmm. It also appears that a remix of Walking on Thin Ice hit number one on the US dance charts in 2003. Who knew?

Anyways, I'm tired of winter.

Matchless

2008-01-21T20:58:00.000-07:00

The CaRMs process has more or less sucked for me. I applied to internal without having done any electives in it; when I did renal during my core rotations, I realized that internal was my future. Big mistake. A large percentage of the graduating medschool population applies to internal as a backup, and I disappeared in the flood of applications, just another student with 'Pass' as his grade.

Man, I wish we were ranked by grades in class...

Leonard had this to say, slightly edited to fit my situation:

I came so far for medschool
I left so much behind
My patience and my family
My masterpiece unsigned

I thought I'd be rewarded
For such a lonely choice
And surely she would answer
To such a hopeless voice

I practiced on my sainthood
I gave to one and all
But the rumours of my virtue
They moved her not at all

I got a grand total of one interview. Wednesday is the big day.

Time

2008-01-13T20:06:00.000-07:00

The person who picked my name passed away just before Christmas. She was diagnosed with pancreatic cancer in October, while I was out in Drumheller. When I got back to Calgary for internal, the question was, would I take a few days off to see her while she was still healthy enough? Well, the choice was made to delay going until Christmas. I knew, of course, that that was risky.

She passed away 36 hours before I got there. She was looking forward to seeing me, but I didn't take a couple of days off to give her something to be happy about in her last hours.

I spent Christmas cleaning up her apartment. All the things that meant so much to her, now they were being sold off or given away. I found her old photos, back from when she was a medical student and then a resident. Life seemed full of promise back then; not everything worked out. I realized that a generation later, I live a life remarkably like hers.

I left the apartment for the last time. As a kid, that place felt like home to me. Now, there's no going back. Funny, eating at restaurants where my great grandfather liked to go 100 years ago, I wondered, will I one day say, "Your great-great grandfather liked to eat the lüngerl here"?

First Class!

2008-01-02T21:36:00.000-07:00

I ended up getting upgraded to first class for the last part of my flight from London! Sounds great, eh? That was after first being moved up to business with those crazy bed-seat pods!

My secret to getting great upgrades? Fainting, endless vomiting, and plenty of diarrhea. Not pleasant, but very effective. Oh, unfortunately the first-class upgrade was only to the washroom...

I kept thinking that I'd love to be the medical student taking this history. Living it was not so good.

Hockey

2007-11-12T10:03:00.000-07:00

He had walked the razor's edge between life and death, and he knew it; a dozen strangers had formed a human chain to reach into Hell and pull him back into the land of the living. As consciousness returned, he struggled to ask one question of the doctors hovering over him:

"Did the Flames win last night?"

The Carms Revolution

2007-11-04T18:59:00.000-07:00

Even damnation is poisoned with rainbows. (Leonard)

I headed out through the snow this morning to meet up with friends. It was supposed to be just for breakfast, but conversation dragged on through dinnertime, with the snowfall coming down hard outside.

We spoke of carms, the residency match process here in Canada. Where to apply, how many programs, what to put in our applications; these are questions that have no answers. The act of asking is cathartic, though, and so these days we go through this process over and over.

Of course, if we are successful in our applications, then this safe little world we're living in, with its tight friendships, will be destroyed, and we will all head out to begin from scratch, again.

To all of my architects let me be traitor.
Now let me say, I myself gave the order
To sleep and to search and to destroy.

They Come in Threes

2007-10-27T17:04:00.000-06:00

I've been thinking a lot about life and death recently. Sitting in my spider hole in D'heller, my networkless laptop powered on just to keep me warm, put these thoughts about existence into my mind. Was there more to life than perfecting my Zero Wing skills? What was the point of being a Puzzle Bobble god?

My good friends in LA had a baby two weeks ago now; I've been through a lot of births in the past few months, but I still get choked up by them. And, when it's the baby of such good friends, it's especially meaningful. My happiness about the event are, well, inexpressible.

While they were experiencing new life, though, I was forming a new and close relationship with death. A week ago, I answered a code; the poor person passed away, his head in my hands, my face perhaps the last he saw. Will I end up the same, I wondered, alone, a stranger saying goodbye to me as I leave this world?

I continued on my rounds, and ended up at another code, less than twenty minutes later. This time, I had just begun to bag when she revived. The code team arrived, and I left. Is she still around a week later, I don't know.

They come in threes, I was told. And so, the wait for number three began. It happened on Thursday, at the end of a long day. This one turned out well, and everyone there was happy and relieved. Grandma was okay, and the family intact.

So, now that I am in nephro/internal, I find myself with a job opposite to that I had in my obs/gyne rotation. Death is all around, and it's our job to make sure that it doesn't come too early. This is why I'm here...

As Leonard said:

We've been around, we fall, we fly
We mostly fall, we mostly run
And every now and then we try
To mend the damage that we've done

Back to Life

2007-10-11T22:40:00.000-06:00

Last Thursday, I emerged from my spider hole, and returned to so-called civilization, looking much like Saddam. I haven't quite recovered, though. A classmate asked me yesterday why I was walking around stooped over; the contractures will take some time to stretch away.

We had Thanksgiving on Monday up here, which resulted in a nice dinner at a classmate's place. I started nephrology the next day. It's fun so far; maybe I should go into nephro...

800

2007-09-30T19:13:00.000-06:00

Just a quick note to wish everyone a happy Rumi's 800th birthday. Hmm, a trip from Balkh to Konya could be fun.

The BBC had an article on his birthday here.

From the Masnavi:

Sell your cleverness and buy bewilderment.

Claustrophobia Update

2007-09-15T11:19:00.000-06:00

In this world of irony, it is only fitting that I posted about my odd claustrophobic dreams a couple of posts ago. Now, I'm living the dream.

For my placement in the badlands, the school assigned me a room in a basement. Where do those dreams come in? The bathroom: the ceiling is about 6'1", which means that I can't stand up straight. Shaving isn't easy, walking around has to be done doubled over...

But, that's the good part. The shower, well, is about 6'2" tall, and about 2' by 2'. In other words, it would make a cozy coffin for someone 6" shorter than me. The shower head is located a bit below my shoulder height. I can fit in there if I fold myself up a bit like an accordion bellows. To top it off, the shower head pops off once it heats up, giving me a fixed time limit for shower length... showering is a form of comical torture.

No internet access at home either; I have to go to the hospital to (slowly) check my email... and facebook is blocked. I feel like I've been buried in Kill Bill: Volume 2...

Bones

2007-09-09T22:55:00.000-06:00

My rotation in therapy is done, so I've left behind the hermeneutic circles I'd weaved myself into, and I'm moving on to family medicine. I have a rural placement, in a town famous for its dinosaur bones; it's in what is called the badlands of Alberta. I may not have net access there... not sure how I'll cope with that. If that's the case, I guess I'll be doing a lot of studying and reading, and perhaps a lot of running as well. I'll have to pack my Nietzsche and Freud books... I almost bought a couple of Dostoyevski books on Saturday, but held off...

Changes

2007-09-05T19:17:00.000-06:00

I'm one and a half weeks into my current rotation, and it seems to have had a pretty profound effect on my thought patterns.

Some thoughts I had today:

"Hmm, this reminds me of the conflict between Hegelian and Marxist dialectics."

"He's caught in a classic Batesonian double bind!"

Neither of those sentences would have meant anything to me two weeks ago. I bought a six-pack of beer on the way home.

Psych

2007-09-02T22:23:00.000-06:00

I've never considered myself claustrophobic before, but how else can I explain my recent dreams? Over the past couple of months, I've repeatedly had dreams about being uncomfortably squished into tight spaces.

The last one was about two weeks ago, and I remember parts of it very clearly. I was leaving my office; the door was tiny, just small enough for me to crawl through, with quite a bit of trouble squeezing myself through. The door led into an antechamber, a small room perhaps three feet by three feet, with a second door on the wall to my right, leading to a larger room. The second door was the same size as the first, and I had to work my way through that one, while my lower body was still in the first doorway. As I was worming my way to the second door, someone came to talk to me through the second doorway; they mentioned something about increased budgets, and I was happy because it meant that I could get a bigger doorway for my office.

I eventually made it out into the larger room, but the ceiling there was about six feet high, and I kept hitting my head on the metal light fixtures as I walked around doubled over.

I wonder if being in my obstetrics rotation for the past six weeks had anything to do with it.

Now I'm thinking about going into psych; I'm in the middle of a two-week elective in family therapy, and it's great.

Ahem

2007-08-12T23:02:00.000-06:00

Another weekend without call. The result: nothing. The highlight of the weekend was listening to 'Cough Piece' by Yoko Ono, all the way through, and contemplating its meaning to the artist and its meaning to me.

I tried to get a haircut, but failed. Didn't have a reservation...

Yoko's thought for the day:

Kyoko, don't worry
Don't worry, Kyoko
Mum's only looking for
Her hand in the snow

Which kind of makes you worry about Mum.

Leonard's thought for the day:

Four o'clock and the fog comes in
We all remember the sea
For several seconds our sins are forgiven
Mine against you, yours against me

Survival of the Fittest

2007-07-29T20:37:00.000-06:00

Obstetrics is going well; of the surgical specialties, this is by far my favourite so far. Did I already say that?

I just survived a week with three 24 hour shifts in it, so I'm a bit tired. One of the things with long shifts, is that you end up eating a lot in the hospital cafeteria. Options there are... limited, to say the least. However, the result has been an improvement in my diet, I think, as I have been consuming vegetarian sushi almost exclusively. Getting home, I'm too tired to go get take-out, so I'm eating mostly yogurt, Ensure, and chocolate. Yes, chocolate, thanks to my total life disorganization.

Recently, I bought a big box of chocolates from Bernard Callebaut for the nurses in one of the units I'd been working in. Unfortunately, I never got around to going back to drop it off. So... I opened it up and started eating it myself. And man, it's good stuff, bringing a bit of joy into my life every night (every night I'm home, that is). I'm sitting here with the taste of chocolate in my mouth as I type this; it's not just a moment of pleasure that it brings, but it also evokes memories of previous times and places, involving chocolate from various sources, like Burdick's, Serenade, or the chocolate of my youth: Rottenhöfer.

Anyways, I'm sure that right now there's an accountant at the head office of Wendy's, who's staring at some balance sheets, and thinking: "What's gone wrong in Calgary?"

The Gates to the Garden

2007-07-23T19:09:00.000-06:00

Okay, I've enjoyed a lot of medicine before, for various reasons, but I have to say that the biggest rush you can get in meds may be obstetrics. I have three 24-hour shifts this week, and finished the first one this a.m.; it was my first completely sleepless call shift.

And it was good. I felt like the opposite of St. Peter, standing outside the gates of the womb, receiving the sinless into life, and cradling them in my size nine hands as their cords were cut and they took in their first breaths.

Potterless

2007-07-21T19:09:00.000-06:00

As everyone knows, today saw the release of the final Harry Potter book. I preordered from Amazon months and months ago. Well, today is the day... and they have yet to ship it, those jerks. They sent an email a while back saying that if you wanted it shipped on time, you'd have to pay extra. I'm pretty angry at Amazon right now... I wish I hadn't ordered $270 worth of textbooks from them last week; they haven't shipped those yet either, those jerks!

'Chapters' all the way from now on!!!

Anyways, so here I am without Harry Potter to read. I had the entire plot worked out in my mind, based on the final few chapters of the last book, and now I can't confirm my predictions.

To make up for this fiasco, I picked up some light reading at the local used book shop: 'A General Introduction to Psychoanalysis' by Sigmund Freud.

I was thinking this week that I have been mostly successful at eliminating all fun from my life. Almost all reading I do these days is textbooks. I don't have a TV; I gave up renting movies. However, I unfortunately still listen to music, and have a remaining hobby. I ordered up a bunch of Towa Tei and Haroumi Hosono CDs a few weeks ago (Motivation Five, Future Listening/Future Recall 3, Sound Museum, and Hosono House), along with a disk I was missing from Faye Wong (天空), and they arrived this week; I drove to the courier office today to pick them up. I'm enjoying GBI (German Bold Italic) right now. Augh! It's fun! Darn, must stop!

Anyways, I should really be studying obstetrics now. I need to know how to deliver babies by 8 a.m. tomorrow morning.

High contrast. It's cool!

Direction

2007-07-10T22:23:00.000-06:00

Well, I've enjoyed paeds neuro so much for the past week and a half, that I am thinking this may be it. I will decide over the weekend if I should just go for it. If I find I'm not so crazy about it after another rotation, I can always take a year off.

Cases are very complex, and come to the clinic typically undiagnosed. After spending time in surgery, where the cases were mostly 'done' by the time they got to you, it's a refreshing change, and more or less provides me with the main thing I wanted out of meds.

Funny, surgery seems to be about black and white: he has this, we do this, in this way. Things that fall into grey areas make surgical people nervous... and sometimes angry. That attitude is pretty desirable in the OR, but ultimately fails to satisfy me. I like the greyness of uncertainty that you find in the most complex cases. Heck, my life is spent living in grey, so it's what I'm good at.

Anyways, how can't you enjoy a profession where you get to test for the Moro reflex every time you meet a baby?

As an aside, the number 9.51 keeps coming up for me. What is the significance, I wonder?

Nada

2007-07-02T20:05:00.000-06:00

Well, I have very little to report. Anaesthesia is over; it had its rough moments, notably in the first week, but things pulled together more-or-less in the second week. One more week, and I would have been competent.

My current study style is a bit of this, a bit of that, what are they going to ask me tomorrow, what did they ask me today. That system really doesn't work at all; I need to formalize some kind of studying regimen, but haven't yet. I had all weekend to study for my next rotation, but felt so far behind, that I didn't even begin.

Anyways, this will be my first rotation outside of the OR since starting clerkship. So far it's been surgery, followed by surgery, followed by surgery, surgery, surgery, and anaesthesia. Now, paediatric neurology. A big shift. Will I cope with going from an action and anatomy orientation to a diagnostic one?

A preceptor told me on Friday that I should pick a discipline where I save the soul of a person, i.e., their mind. A finger, a bit of bowel, none of these are crucial to a person's being. I am taking that into consideration...

To quote the Trashcan Sinatras:

It's a hard road when you know where you're going
And it's harder when you know where you're not

Falling Asleep

2007-06-17T18:51:00.000-06:00

So, as I reported before, I finished surgery on Friday. Before heading off to the exam, me and my size 9 hands closed our last incision for a while, and wrote up our last OR note.

Well, to wrap up our current placements, Atopy, Rococo and I went for sushi on 4 Street on Friday night. Afterwards, we hit some café on 17 Avenue for dessert, which was a nice change from the usual routine.

Anyways, next is anaesthesia. It involves a lot of sitting around and reading, with the occasional IV start or intubation. Quite a change of pace. I can't say I'm looking forward to it much, as I hate that feeling of unpreparedness I always seem to have these days.

Midsummer is this week, and that means that by next weekend, the days will be getting shorter again. Winter is coming.

Sleep on the Horizon

2007-06-14T18:58:00.000-06:00

I was on call three out of the last four weekends. That wears a person down. Tomorrow, I have my final surgery exam, and on Monday I start anaesthesia. So, I won't have any call for two weeks, possibly four. Now I can get some sleep.

Too bad; I've enjoyed being in the OR. Or, should I say, I like being at the table in the OR, since I'll still be physically in the theatre for two weeks, but I won't be doing anything except perhaps some IV starts and some arterial blood draws. On the plus side, I am looking forward to sleeping in until 5:30 every day, instead of getting up at 4:30 like I have been.

I thought about going to Boston for the weekend, but at $1500 for a flight via Chicago, it's a bit too much dough for 48 hours out of town.

Hoo, today was not an easy day. Lucky for me I can fall back on YMO's 'Computer Game -- Theme from The Circus' to get me out of a funk.

Freetime

2007-06-03T17:33:00.000-06:00

I didn't have call this weekend. Whew! I really needed a full weekend off. It's funny how satisfying a simple day of relaxation has become for us clerks. Saturday, I did nothing of import. I met up with Rococo and Magic Pants at Earl's, and we spent the afternoon in the sun on the patio, with margaritas and happy conversation. Then, with coercion employed skillfully on my part, we went to see the latest Pirates of the Caribbean movie. It was supposed to be pretty bad, but Johnny Depp is Johnny Depp. Well, I enjoyed it. I have to say, though, that it was a bit Tranantinoesque, what with all the killing and killing and killing. Also, I was a bit disappointed in Keira's choice.

Today was a quiet day at home with Wa-Wa, Victor Jara, and the other rarely-played artists in my iTunes catalog. Funny, it seems that Tarcy Su and Yuki Hsu have new albums out... I thought they had moved permanently into the realm of memories of my youth.

Anyways, back to the subject of movies, I finally saw Babel. An okay movie; the strongest moment for me was when Ryuichi Sakamoto was used for the final scene. A great song.

We're in the midst of a thunderstorm right now. The windows are wide open...

The Lowest of the Low said:

And some time when your resistance is low
Remember that I know...
Who's your favourite Pogue

There's a place in my soul where no one else can adore you
And like the poet-soldier says, "I would spill my blood for you."

Winter has Arrived

2007-05-24T19:42:00.001-06:00

This morning, I woke up at 4:45, to complete silence. As any Canadian knows, there is no silence like that of a snowfall, so instantly I knew that there was a blanket of snow on the ground outside. When I looked out the window, I was greeted by about three inches of snow. June is in a week, and I still need to get the snow off my car before I head out to the hospital.

Anyways, I was gonna say a bit about my 24 hours of trauma call last weekend. It was pretty crazy. There were some car crashes, a couple of stabbings, etc. But, the big shocker for me was the number of ATV/quad injuries, who made up the majority of cases. In terms of long-term problems, I think that it will probably the quad riders that will end up in the most trouble; those things are dangerous, holy cow.

Good to see, though, how the whole system works. The city has a few good people standing at the ready to save our lives, 24/7.

Well, I got about 30 minutes of sleep during my shift. I was pretty much shot when I got out the door late in the morning on Victoria Day. Oh, it was snowing then too...

Keep Your Pants On

2007-05-18T19:11:00.001-06:00

I just finished my week of urology. Now, it's the Victoria Day long weekend, but unfortunately, I have to do 24 hours of trauma call starting on Sunday at 8 a.m., so my weekend is shot. Tuesday, gen surg begins in the northeast.

I have one little story from the past week. On Wednesday afternoon, I was following my doc for an afternoon of cystoscopy. That's looking inside peoples' bladders with a scope, in case you're wondering. Well, for one patient, we had to use fluoroscopy, so we had to get on our lead aprons. My lead was different from the ones I have become used to for OR work; it closed at the front, with big velcro strips. After we were done, the doc started writing his notes, and the nurses and radiation tech were talking to the patient. I began to remove my lead. Riiiiiipppp, I pulled open the velcro. Unfortunately, the waistband on my scrubs had adhered to the velcro, so zooop, my pants fell down.

Pretty embarrassing. I'm not sure if anyone actually saw, since I was pretty speedy at getting them back up again. However, I can hardly believe that all of the five other people in the room failed to notice me standing there in my underwear...

Very inappropriate behaviour for a med student.

Face Time

2007-05-16T07:55:00.000-06:00

Facebook use has exploded around here. Everyone is doing it. On Monday, I started in urology in a new hospital, a bit more laid back than Foothills. During one of the cases, I looked over to see what the anaesthesiologist was doing so intently; she was facebooking. Walked past the fluoroscopy control nook; the x-ray tech was facebooking.

The only two hold-outs I know of are Magic Pants and Vibe. How do they resist the peer pressure?

Speaking of Magic Pants, I think I've mentioned that we both owned the same crappy phone, a Motorola V220. The worst phone of my life. His phone was crapping out in the same way as mine, with the phone hanging up when you answer it. That's the opposite of what a phone is supposed to do, Motorola; you may want to look into removing that instant-hang up function. Anyways, things reached the breaking point for me on Saturday, when I had a phone conversation with Rococo consisting of about a dozen ten-second individual calls, with the phone crapping out each time.

So, on Sunday, I picked up a W180i. It's good to have a Sony Ericsson again; I feel alive once more.

Geysers

2007-05-09T22:33:00.000-06:00

I think I've been sprayed with more human blood in the past week, than in my entire life up to this point...

Murakami

2007-04-30T17:37:00.000-06:00

When I got home from the hospital today, the latest English translation of a Haruki Murakami novel was waiting in my mailbox: 'After Dark'. The first few pages are great; too bad I have to study! :(

Hmm, Amazon says that it isn't out for another week! :)

Come Together

2007-04-29T21:53:00.000-06:00

Things have been slack at school for the past week, but I've been pretty tired nevertheless. Things should get busier again tomorrow, but I am not sure... it looks like my next two weeks won't be what I'd hoped, since my preceptors are out of town for most of it. :(

Anyways, yesterday, Rococo, Magic Pants, and I got together for a late breakfast at Nellie's, with Rococo constantly watching her pager, as she was on call. Our pagers have become central to our lives. Today was almost a repetition of yesterday, as we once again went for breakfast at Nellie's, this time with a bigger crowd of classmates and their spouses. We're kinda starved for contact these days...

I took my motorbike out for a ride this evening. It's been around five months since I last rode... a very long time. It was chilly out; lucky I'm still wearing my winter clothes these days, with my scarf at the ready.

The World is My Oyster

2007-04-20T20:02:00.000-06:00

I survived my last elective, and it was not easy. I'm tired out of my brain, and considering going to bed for the night just after 8 p.m.!

But, I find myself suddenly very excited again about the future. Neurology or neurosurgery, two incredible fields. Ah, what to do? Everything else has been forgotten.

Neuro Calling

2007-04-11T19:36:00.000-06:00

I just finished my first night of call ever, in neurosurgery. I ended up being there for 35 hours. It started and ended well. Yesterday, I saw a live cauda equina for the first time, sitting there in its dural sack; I was assisting in a laminectomy. I was feeling a mixture of elation and awe as I suctioned and retracted away. This afternoon, I scrubbed into a craniotomy, and saw a live brain for the first time. It looked a bit sad at first, but by the end of the procedure was pulsating away happily in its skull. Wow. That's a living skull. That's a living dura. That's a living brain. That's a living person.

I also attended an interesting clinic in the morning. Overnight, though, between 5 p.m. and 6:30 a.m., all I did was write up an admit note and history for one patient. I was expecting to be pushing myself a bit harder...

Well, at the moment I am preparing part of a talk for Friday morning rounds. Fun! :) Suddenly, though, I am missing having a lab to play around in... maybe I should ask someone in neuro here for a project I can work on.

Unexpected Vacation

2007-04-06T15:21:00.000-06:00

Yesterday afternoon, I found out that today would be a holiday... not a bad surprise.

Things started well. I had a comic book and a new CD waiting for me in the mail when I got home. However, I was so tired that I ended up going to bed sometime around 9. So, this morning, I got up bright and early at 4:15.

That's right, it's a holiday, and I slept in until 4:15 a.m..

I guess I should do some neuroanatomy studying... I've already gotten in a full day's worth of wasting time.

Adjust It

2007-03-29T18:21:00.000-06:00

After two weeks of clerkship, I thought that I had made a pretty good transition to the early waking schedule. I was wrong.

On 'Monday morning', I woke up and noted that it was awfully bright outside. Oh no! I'd slept in! I hurriedly put on my glasses, rolled out of bed, and looked at the clock. 12:15.. A.M.. Just after midnight. Okay, so I guess that it wasn't that bright outside. I went back to sleep.

Wednesday morning, something similar. My phone alarm went off, and I got up out of bed, turned it off, and collapsed back on the bed, to wait for my clock radio to go off a minute or two later. As I lay there, I thought, this is good, I managed to sleep soundly since 11 p.m., without waking up at all, so I got a full six hours of sleep. That was an improvement over previous nights. But, I was still quite tired. Very tired. Oh well, gotta live with it. Get up and hit the shower. Why hasn't my clock radio gone off yet? I looked at the time. 11:15 p.m.. Tuesday. I had slept for 15 minutes. The phone alarm turned out to have been the low battery warning. I went back to sleep.

Tomorrow, I get to sleep in, since we will start rounds late, at 7:30.. Maybe I can pop by the pulm rounds at 7, just for fun. :)

Tied Down

2007-03-20T19:39:00.000-06:00

I went tie shopping over the weekend. I basically had four ties in total, and after one week of clerkship, it was pretty clear that I needed to expand that number to add some variability to my wardrobe.

First, I hit all the 'best' stores in town, and boy, was I disappointed. This town is full of ties meant to be loud and make you stand out in an oil-business crowd. To top it off, the salespeople all looked at me with suspicion; I suppose that I look more like a shoplifter than a med student. Anyways, I then backtracked to the cheaper places like The Bay, and found a couple of ties that did the trick.

That's a lot of effort for an outgoing fashion. Ties are losing popularity in healthcare these days, as they tend to help spread infections. However, they haven't been banned outright here yet, and the patients and preceptors still expect you to wear them, to meet society's standards of professional dress. Oh well, it just means more money for the dry cleaners.

In unrelated news, I have managed to acclimatize my body to getting to work by 6:15. Unfortunately, I've overdone it a bit, and now I'm waking up on my own before 4...

Lack of Intellectual Growth

2007-03-15T23:34:00.000-06:00

Skinny Talls goes on elective last summer. Picture an OR, with a surgeon performing a laproscopic cholecystectomy; he uses his instruments to indicate the gall bladder:

Surgeon: "What am I holding?"
Skinny Talls: "A CAMERA!!!"
Surgeon: "Uhh... okay...? (Thinks to self: OMG, how dumb is this guy?)"

Today, Skinny Talls, on elective, assists in a VATS procedure. A full year of medical education has passed:

Surgeon: "What are *you* holding?"
Skinny Talls: "A CAMERA!!!"
Surgeon: "Uhh... okay...?"

A Waking Life

2007-03-14T21:06:00.000-06:00

I've made it three days into clerkship. It has required some adjustments to my schedule. For the past few weeks, I'd generally been going to bed somewhere between 2 and 5 in the morning. This week, I've been getting up at 4:45, to try make it onto the wards at 6:15.

That said, it hasn't been difficult, as the work is interesting, and pretty relaxing. Hmm, what can I say about things...

I have been known to be jealous of people who get to retract. "He/She's probably in the OR right now, holding a retractor!" was one of the phrases I used most often last summer, always accompanied with the voice and face of pure envy. Well, now *I'm* the one who's doing the retracting, people, and let me tell you, retractors come in all kinds of shapes and sizes, including 196 cm. Okay, retraction isn't the only fun I've had; I put in a VATS port on Monday, from incision to insertion, and used a stapler for the first time yesterday.

Anyways, how is it? There is a mix of apprehension and enjoyment inside me. On the one had, it's clear that I'm grossly under-prepared for this. On the other hand, it looks like it will be a wild ride.

The Trashcan Sinatras wrote this about clerkship (I suspect):

But i forget the conversation we had,
i don't remember what you said or did
that made you so attractive.

Yes, attractive. It's the mesmerization that induces amnesia.

Konfusion

2007-03-11T22:35:00.001-06:00

Happily, I was right in thinking that organizing my recyclables was the key to organizing my life. The apartment is almost ship-shape, and I've recovered my joie de vivre just in time for clerkship.

I'm still clueless as to what will be happening tomorrow, though. Will I be put straight to work, or will I get to relax and find out how the heck everything works? It's a mystery. I should have watched a chest-tube-insertion video or two today, or memorized surgical instrument names.

Like I've mentioned in earlier posts, I've been listening to the Trashcan Sinatras a lot recently. This verse reminded me of moving on from classrooms to clerkship:

Soothe your fear, we're off where it's warmer
Here's to all of us, I know you are worried
We're leaving here, regret to inform you
Leaving everything, it's just that we've got to
believe in everything, we're leaving everything

Anyways:

Bring it on...

Organized

2007-03-10T22:04:00.000-07:00

My apartment is a disaster area, as is my clerkship preparation. Today, I went out and bought a bunch of containers to organize my recyclables, which is step one in cleaning things up around here. Studying all thoracic surgery and all anatomy tomorrow will fix up my lack of preparation on the clerkship front.

While I am staying here for my first six weeks of electives, like a baby hanging around in the 41st week, most of my comrades have left town. I'm used to being the one that moves on, and leaves everyone behind...

To quote Rivers:

The world has turned and left me here
Just where I was before you appeared
And in your place, an empty space
Has filled the void behind my face

Redemption

2007-03-06T00:28:00.000-07:00

On Saturday, I picked up Magic Pants and Rococo, and we headed downtown for a late breakfast (at 2 p.m.). We went to a place none of us had ever been to before, 1886 Buffalo Café in Eau Claire. We found some parking nearby, and spent about an hour and a half eating, followed by wandering. The café itself was fine, if rather more expensive then Nellie's. Anyways, afterwards, Rococo asked me how much time I'd gotten on the parking meter. "You have to pay on a Saturday?" was my answer; sometimes, I am surprised by how dumb I am.

When we got back to my car, I had no ticket. Whew. However, the car behind me did. Checking my meter, I saw that I had 15 minutes on it. Somebody had come by, seen police ticketing cars, and put at least a quarter into the meter for me.

That's so nice. Good, Calgary, good!

In other news, on Sunday, I finally made it to 'Peters' Drive-In'. I figured that if it was good enough for Hugh Jackman (Wolverine!), then it was good enough for me. I had the double cheeseburger, with small fries and a shake. The burger was okay; it reminded me of a Harvey's hamburger. The fries had a too much oil flavour; I didn't finish them. Finally, the shake. Ah, I chose marshmallow, believe it or not. That was supposedly the flavour that was the culprit in the drive-in's E. coli O157:H7 crisis of '05. Well, it tasted like unflavoured soft-serve, and certainly wasn't worth getting HUS over (haemolytic uremic syndrome).

Okay, Harvey's is probably my favourite burger chain, so the burger was fine. The fries, I'll give another chance to in the future. The shake, I was later informed that I should have gotten strawberry-vanilla or chocolate. I guess I went with expectations set too high...

The sad part of the weekend was that it represented the end of the Triumvirate of Nerds. The other two are headed off to electives out east this week, while I remain in town. Well, we'll see if we end up finding the time to get together again, once we're in clerkship.

Welcome Back, Talls

2007-02-27T20:51:00.000-07:00

I got back into town right around 3 o'clock in the morning on Monday. It took a good 45 minutes for my luggage to show up, so I was pretty tired when I got in my car and headed home. I was the only car on the road as I headed south on 19, cruising (crawling) along at a city standard of 45 km/h (gotta stay under the speed limit). Well, eventually a car pulled up on me very fast, and hugged my bumper. What's up with that, I thought to myself... it's a cop. After a minute and a half, her lights come on. Speeding? No. She ran my plates, basically out of boredom, and I wasn't registered. $115. Welcome home. Be careful, the streets are pretty slick tonight. Thanks.

Earlier that night, in Vancouver, it took me 45 minutes to check the bottle of duty-free vodka I'd bought for a classmate. Lucky the plane was almost two hours late, otherwise I'd have missed it. Well, it gave me something to do. I was surprised that a glass bottle in a plastic bag actually survived being checked.

Happily, Monday was redeemed when Rococo called me to go for a late lunch at Moxie's. The thing is, while the atmosphere there is great for a slow mid-afternoon meal, the menu has become tiresome. A new restaurant to hang in is needed, but none is evident.

Anyways, to (almost) quote Bruce:

Nineteen Street Northwest
Ridin' on a snowy night
'Neath the refinery's glow
Out where the great black rivers flow
License, registration, I ain't got none
But I got a clear conscience
'Bout the things that I done
Mister state trooper, please don't stop me
Please don't stop me, please don't stop me

Shangri-la

2007-02-27T03:25:00.000-07:00

I went to L.A. for the weekend. The Man finally convinced me to come down, and since I had a free weekend, I went for a day and a half. Kind of a short trip... It was good to see The Man and his wife; it's been a few years now. This was my first trip to the US since moving back to Canada in 2005.

Highlights included strolling the beach in Santa Monica and going to In-N-Out Burger, not to mention seeing The Man's CalTech lab, and the Huntington Library and Botanical Gardens.

I am told that 'The Grand Lebowski' (sic) is the quintessential L.A. movie.

Civilization there is very different from here. It's so not Cowboy.

Now, I'm back home in the cold and the snow, back to school. I shall return, though; I still need to meet up with my Enders floppy management partner.

Emulating a Life

2007-02-18T21:04:00.000-07:00

Wednesday we had our last class of the year, and Thursday was our last exam of the year. Technically, we have three more, but they're all 'formative'; id est, they don't count. A bunch of us hit Nellie's post-exam, but considering that we're done with the classroom part of medschool, you may have expected a bit bigger celebration.

Friday, I thought I'd go to ACH for the m&m and a bit of surgery, but found that I needed a break from meds for a few days. So, instead, I got to playing with Virtual PC 7 on my Mac, which I picked up on Wednesday. I managed to install NT 4.0, and more excitingly, DOS 6.22 with Windows for Workgroups 3.11. I then installed Serf City under DOS, and lo and behold, it worked.

Why? Well, I was playing Serf City back in 1995, when I upgraded to win95 and ran into compatibility problems. So, I never finished the game. Fast forward twelve years, and it looks like I will finally get to do that. Who says I never finish anything I start?

Snow

2007-02-14T01:10:00.000-07:00

It's been snowing a lot here recently. I swear, it fell almost continuously between Friday and today; it was always a light snowfall, but it just wouldn't stop. Anyways, since it's Valentine's Day, and I've been listening to the Trashcan Sinatras straight for two weeks, I offer you 'Snow':

snow...fills the fields we used to know
and the little park where we would go
lies far below
in the snow

gone...it's all over and you're gone
but the memory lives on
although our dreams lie buried
in the snow

sometimes the wind blows
through the trees
and i think i hear you calling me
but all i see is snow

everywhere i go
as the cold winter sun sinks low
i walk alone through the snow

I dropped off my car at the local Canadian Tire on Monday afternoon, to have new tyres put on my car. My old ones were worn right down, and two of them had 'slow leaks', and by slow, I mean they would go completely flat over the course of a week or so. Anyways, I ended up walking home from the shop, through the snow, which took about 45 minutes in -20 ˚C weather. Not smart, but it reminded me of my youth. :)

Ah, Good Times

2007-02-11T22:24:00.000-07:00

This was one of those great weekends that make you happy to be alive... and in medschool. With Friday being the peak stress day for medschool so far, it felt great to suddenly have (almost) no worries whatsoever. Saturday was breakfast at Nellie's with Magic Pants and Rococo, at 1:15 p.m.. Today the three of us went to see 'The Queen', followed by dinner and a mile-high mud pie at Montana's.

Oddly enough, I'm a bit of a monarchist, so this was a bit of a 'Passion of the Queen' for me.

Anyways, we had a journal club over dinner. I assigned a paper for the group to read, and we discussed it a bit. We didn't read papers like that in science! We then moved on to the subject of the role of orientation week activities in setting expectations for student behaviour throughout medical school, something that Magic Pants has been thinking about a lot recently. At the moment, a frat-boy mentality seems to dominate in this kind of thing, and the times, well, they changed years ago in the rest of Canada.

Sitting around, enjoying some decent food, and having some great conversations, all in a background of pushing your physical and mental abilities to their limits, that is what has made this last year-and-a-half such a pleasure. Meds, there is nothing like it.

And... break

2007-02-09T10:19:00.000-07:00

I just came through the crunch with flying colours. I was up all night writing and making figures, but got my last big project of the year done. Not only did I finish it, but I went totally over the top, with every single figure accompanied by a stereoscopic version. I didn't stop at just sticking in parallel stereographs; no, I went for the full-out cross-eye/parallel triple image combo. Yokochi would be proud.

In other school news, yesterday I also got the electives I was hoping for in March/April. Four weeks of thoracics, then two weeks of neurosurgery.

It's cold here. Last night when I drove to Wendy's to get dinner, the inside of the windows iced up, and I had to keep scraping the windscreen to get some vision. Funny enough, that reminds me of my youth, and gives me a deep feeling of contentment inside...

Textbook Case

2007-01-31T19:18:00.000-07:00

I made it through my exams just fine... hurrah! Unfortunately, yesterday, I was feeling a bit weird all day, then fell very ill right after I got home after dinner. I pulled out a textbook, self-diagnosed myself (a textbook GI case), and proceeded to spend the rest of the evening sick, instead of working on the first of three reports I need to finish by next week.

I should be back at it tomorrow, though. I missed a 'mandatory' small-group class today; I wonder what the repercussions of that will be.

Time Flies

2007-01-23T22:34:00.000-07:00

On Saturday night, I headed over to Big Poppa's for a birthday party. I realized afterwards that it had been a very long time since I'd been to any kind of party. They're fun; maybe I should go out more.

Yes, life is a bit dull these days. I did some online CD shopping over the weekend to try and lively it up. A whole pile of Trashcan Sinatra CDs. A Pizzicato Five DVD. Even an album from The Brilliant Green. Plus, I found a used copy of Mint Sound Greatest Hits, Volume 1. However, online shopping results in a ten-to-fifteen-day delay in satisfaction.

I have OSCEs this Thursday and Friday, with 'culture' and 'ethics' exams on Friday afternoon. Monday is our paeds exam. I should be studying, working, pushing. Instead, time seems to flow by, but I've stepped out of the stream.

Lappy's Back!

2007-01-19T00:14:00.000-07:00

My computer is back from the shop. Phew! After getting it back, I immediately upgraded it to a 160 GB HD. Now I'm happy again.

I immediately ripped the CDs I got over the holidays, including "It's All Gone Pete Tong" and a Tengir-Too album. Good stuff. Then, I cooked up some Kraft dinner, opened up a bottle of wine, and enjoyed a good samurai movie, "Kiru" (aka "Kill!"). Damn, Tatsuya Nakadai was great back in the sixties; I'm glad to see he's still acting.

I'm glad to report that my stomach has adjusted well to my Kraft dinner diet.

Grey's

2007-01-14T22:18:00.000-07:00

Soccergrrrl was out of town this weekend, so I headed over to The Smokehouse to keep Banana company. Yep, just Banana and the Breadfruit, hanging out, watching some TV. I ended up watching the first eight episodes of season one of 'Grey's Anatomy'. Now I get what the fuss is about, and I get the whole 'thing for ferry boats' too.

I need to buy a big swath of land, along with a trailer...

First, though, I have to get my PowerLappy G4 back. :( The local repair place called me on Friday, not to tell me to come pick it up, but rather to tell me that they had 'looked at it' and confirmed that the hard drive was indeed dead, but hadn't ordered a replacement yet. They actually expected me to be happy that they had 'looked at it' within a week! The thing is so integral to my studies, it was a struggle to go a week without it. Never again do I trust Calgarians with my PowerLappy!

Dinner

2007-01-04T21:02:00.000-07:00

Yesterday, I finished the last instant noodle soup I had in my apartment. All told, I think I've had instant noodle 112 times since moving here, and it's time for a change of pace.

I'm now making my way through the 24 packages of Kraft Dinner that I bought back in August of 2005. Thank goodness that Ensure keeps my diet healthy and balanced.

HNY

2006-12-31T22:48:00.000-07:00

Happy New Year, everybody!

I just got back into town. I was quite surprised to see how clean I'd left my apartment.

Anyways, for the New Year, I leave you this quote from Basho:

Another year is gone
a traveller's shade on my head
straw sandals at my feet

Xmas

2006-12-29T22:14:00.000-07:00

Well, merry fifth day of Christmas. I still have two more nights here at home out east. I got my parents hooked up with a cable modem yesterday, so I'm back on the net... phew!

Christmas has been pretty good to me. Two notable things: first of all, my friend M. Tabernac gave me a call, and we got together for the first time in about four years. Recently, he posted his first ever Youtube video:

The other good thing was that my nephews got a book of 'string games' for Christmas. Now, I can do 'cup and saucer', 'Eiffel Tower', 'Cat's Cradle', 'Soldier's Bed', 'Jacob's Ladder'; you name it, I can do it, and I'm awesome.

Night of Union

2006-12-17T20:43:00.001-07:00

It's the Night of Union again, the 733rd anniversary of Rumi's death. I'll offer up a quote from Mevlana:

If you want everlasting glory,
don't go back to sleep.
If you want to burn with love,
don't go back to sleep.
You have wasted so many nights!
Tonight, for the love of God,
meet the dawn,
don't go back to sleep!

That translation is by Maryam Mafi and Azima Melita Kolin in 'Rumi: Hidden Music'.

Break

2006-12-16T21:25:00.000-07:00

The gastroenterology exams yesterday went well. It was interesting stuff; I wish I had studied harder. With that, our Christmas break has begun; we have two weeks off. Our next vacation won't be until Christmas of 2007, so I will have to try and destress as much as possible over the next two weeks. Frankly, there's almost no point, since January will easily be the busiest month of medical school.

Anyways, I head back east on Tuesday, so I have three days here to clean up the detritus of my life. I started with some movies. First was 'Magic in the Water', a movie starring a friend of mine from my Boston life. She was very impressive. Next was 'The Million Dollar Hotel', which I rented because it was directed by Wim Wenders. I didn't realize that it starred Mel Gibson, nor Milla Jovovich, neither of which I would have expected to see in a Wenders movie. It was also a surprise to find out that the story was cowritten by Bono.

Anyways, I now have Wender's 'Wings of Desire' in my drive, which I don't think I've seen since 1993 or so.

Oh, the big success of the day was finding a restaurant that serves jajang myeon; it's less than ten minutes drive away from home. Wow, what a relief.

Livin' on a Prayer

2006-12-13T22:39:00.000-07:00

I had two brushes with technological disaster in the past 48 hours.

First story: I sitting in small group yesterday, and was just opening up my notes on my laptop. "Where's that crazy buzzing sound coming from," I asked myself; "How are we supposed to work with kind of noise in the building?" I then noted that my computer was vibrating quite strongly, and that it had actually hung. At that point, I realized that the source of the incredibly disturbing noise and vibration was not construction, but my computer, notably my hard drive. Not good! Rebooting resulted in a few loud clunking noises, like a hammer being dropped onto a metal table. Later attempts resulted in a weird opening-and-closing metallic zipper sounds. I thought I was screwed; naturally, I don't have backups. Well, the happy ending to the story is that when I got home, and I tried again, it just sat there for 15 seconds, then booted up as if nothing had happened. I ran off to buy a spare hard drive, and backed up all my files. Phew. Everything's going to be o-kay.

My other mini-story occured the night before. I got home, after a long day at school, and went to try and wash the formalin smell off of my hands. I turned on the bathroom light, and was greeted with the flash of a bulb burning out. No probs. I had a low-wattage flourescent bulb that I had wanted to install anyways. I screwed out the old bulb, and put in the new bulb. I hit the light switch. Boom! There were some big sparks out of the light fixture, and part of the fixture fell out of the ceiling, smashing the bulb into a million tiny shards on my bathroom floor. Examining it later, there must have been a short circuit inside the thing that you screw the bulb into; it had blown its ceramic shell into two parts, and parts of the metal around it had melted away. Excitement! The happy ending to this story? It forced me to clean my apartment, so that I wouldn't be embarrassed when the landlord came by to fix the fixture. Spotless!

El derecho de vivir en paz

2006-12-11T23:57:00.000-07:00

I thought I'd comment on the death of Augusto Pinochet.

Back when I was in middle school, my sister brought home a record from the local public library; it was 'Pongo En Tus Manos Abiertas' by Victor Jara. I loved it. This was soon followed by the rest of his albums that were available from the library. To this day, I can sing along to 'Preguntas por Puerto Montt'.

I quickly realized that the library didn't have any albums from after 1974. I did some reading, and found the reason (we couldn't just wiki back in those days): he'd been killed in a military coup in 1973. He was taken prisoner, tortured, and murdered. The man responsible for his death: Augusto Pinochet.

Last year, I was happy to find that Victor Jara's work has been rereleased as an eight-disk CD collection.

Almost there...

2006-12-10T22:07:00.000-07:00

I've made it to the last week of school. Exams are Friday. Of course, Darth Vader is right on my tail as I head to the end of the trench, so I must be in top form for the rest of the week.

Last week, we finally finished off the 'Culture, Health, and Wellness' project that had been sucking up so much effort. What a relief that was. Unfortunately, the recent drop in stress levels induced immediate slacking on my part, and I watched a stack of movies. Chief among these were 'Paris, Texas' and 'The Great Yokai War'. Having potential was 'Sympathy for Lady Vengeance', but it got a bit sappy in parts. I also watched 'Slackers', by accident, since I had actually meant to rent 'Slacker'.

Anyways, time to hunker down...

December

2006-12-02T23:42:00.000-07:00

It's been a while since I last posted. December and Advent have arrived (well, Advent arrives tomorrow).

Last weekend, I spent both afternoons in a Starbucks at the local Chapters, just doing some 'Culture, Health, and Wellness' work; they were playing Christmas carols the whole time. Three songs jumped out at me; one was an uninspired cover of 'Happy Xmas (War is Over)'. I kept thinking, is that Sarah McLaughlin? She's killed this song. Well, it was her, and she did kill it. The second song that jumped out at me (a personal favourite): 'Hallelujah' by LC. Of course, besides use of the word 'Hallelujah', it is in no way whatsoever a Christmas song. Anyways, the third song was 'Reggae Christmas' by Bryan Adams. I actually have the 72-rpm 'Christmas Time' single from 1985 back home, printed in glorious translucent green vinyl. Ah, that took me back to happy days.

Unfortunately, this weekend, I've been too busy to make it to Chapters. Instead, I've had a couple of Christmas parties to go to. I can't get into the mood, though. We're so busy at school; it sucks, really. Oh well, two more weeks, and it'll be vacation time. January will be ugly too, but February should be nice and relaxing. I can't say that I've ever looked forward to February so much in my life.

From the news, it's interesting to see that Stéphane Dion has been elected as the head of the Liberal party. Looks like Ignatieff was viewed as being too soft on the Iraq war back in his Harvard days. This should heat things up this winter...

Apathy

2006-11-23T22:21:00.000-07:00

Lately, I've been pretty apathetic, about everything. For example, eating has been tedious. I don't want to eat anything in my cupboard, so I hop in my car and start to drive. KFC? No. The Bell? No. Wendy's? No. Arby's? No. Chicken on the Way? No. Not even Timmy's! Two weekends ago, I ended up deep in the southwest part of town, before finally eating some popcorn.

Fortunately, GI class has turned things around for me. Weird that the vagaries of the intestinal tract would get a person excited about life again. Plus, classes reminded me of the pleasures of a fibre-containing diet, and so I have hit a local sub shop for the last two nights, for a tasty vegetarian sub. Mmm!

Funny enough, when I went in to the sub shop for dinner last night, I recognized Helena Paparizou playing on their radio; it was a song I'd never heard before. As I ordered, I thought to myself, "This is destiny. How many people in this city could instantly recognize Helena Paparizou's voice?"

Educational Reading

2006-11-15T00:40:00.000-07:00

I didn't get very far in my GI text this weekend; just a few pages.

Instead, I finished reading the story of Buddha... in comic book form. Made me want to go to India.

I wish that we had textbooks in comic book form.

Down and Out

2006-11-11T09:23:00.000-07:00

The repro/obs/gyne exam yesterday was not an easy one. GI starts on Tuesday, and will hopefully catch my attention better. Textbook reading has begun, although once again, I find that the text is an inappropriate length for the amount of time we have. 815 pages in one month? Hmmm... at least so far it looks better organized than either of my obs/gyne textbooks.

It turns out that this is the Remembrance Day long weekend over here in AB, so we have Monday off. Rococo, Magic Pants, Bejeweled! and I are starting things off right, by heading to Nellie's to work on a skool project over breakfast, dealing with the influence of socioeconomic status on choice of medical specialty.

In other news, Stephen Lewis came to talk at our medschool last night; Car Hermit organized the whole thing. Lewis is a former Canadian ambassador to the UN, and is currently the UN Special Envoy for HIV/AIDS in Africa. Pretty interesting guy, obviously. Apparently, he's a big fan of Bill Clinton; he had just met with him on Wednesday, after the US Democrats' big gains in their midterm elections. Apparently, the Clinton Foundation has been crucial in the negotiation of lower prices for antiretrovirals. Lewis sees this week's power shift in the US as potentially resulting in a big changes in their policies in regards to sub-Saharan Africa. We'll see.

On the Canadian side of things, our current Prime Minister, Stephen Harper, has also been floundering on international health issues, but I'm guessing that he'll be dumped by Parliament sometime in spring. Hopefully, Michael Ignatieff will do a better job. He did, after all, work at Harvard for a few years, so he should be a smart guy!

In contrast to last night, tonight's agenda is Borat.

Wasting Time

2006-11-08T23:26:00.000-07:00

So, once again, I find myself with upcoming exams; this time, it's repro on Friday. Once again, I can't get into studying. Thus, I'm writing this post, despite having no subject to write about.

Hmm, we had a bizarre heat wave this week (by default, we Canadians like to talk about the weather). All the snow that we had sitting around all of last week quickly melted away, even on the north side of my building. Today, the temperatures dipped a bit again, and when we left the anatomy lab this evening, we were greeted by a gorgeous snowfall, with huge, soft flakes, gently coming down in mass quantities. Tonight, after killing time by browsing myspace, I headed over to 7/11, to spend a bit of time in the cold and snow.

Oh, I've acquired a new nickname: *** Needledriverhands.

Forwards to the Past

2006-11-05T18:04:00.000-07:00

Yesterday, I spent six hours in labour and delivery. Now I know that I can cross obstetrics off of the list of potential specialties.

The (only!) problem was that I was the only male in the entire ward, for those six hours. Everybody was super-nice (to use the parlance of the region), but I just got the feeling that I wasn't supposed to be there. I realized that that was how women must have felt in medicine thirty years ago. Perhaps it was just my overactive self-consciousness, but I have to wonder if other males in my class had similar experiences.

Anyways, Rococo pointed out to me, that that is how the women in my class felt over in Africa. The docs were super-nice to them, but the paucity of female docs made them feel like intruders into a male world. Hmm, I recall that a big percentage of the residents there were female, though, close to 50-50; just the older docs were all male.

The Goose is Getting Fat

2006-10-29T19:48:00.000-07:00

On Saturday, the high was supposed to be around 15 ºC, but instead, it rose above broke freezing. Wow, what a misprediction. So, as I was coming home from a party at about 1:30 this morning, there was a fine ice 'mist' in the air; I took it to be a positive omen. Lo and behold, when I woke up this morning, it was snowing heavily, and there was a good three inches of snow on the ground. It snowed all day. I love the twilight in wintertime; everything seems grey and dark, and for some reason, that gives me this intense feeling of contentment, like I'm 'at home'. I guess my love of extremes is why I enjoy the dark of a Canadian winter so much, as well as its antithesis, the wonderful heat of an İstanbul summer.

Speaking of İstanbul summers, for some unexplained reason, I went nuts over yogurt this weekend. I walked past the dairy isle on Friday, as I was shopping for baking ingredients, and saw that yogurt was on sale. I immediately bought 3.1 litres. Today, I went back and bought another 3.3 litres. Mmm, life should go smoothly for the next few days.

Tied Up

2006-10-28T17:35:00.000-06:00

You know you're having fun when you spend Friday evening practicing tying one-handed knots. One hundred forwards, one hundred backwards. Repeat for the other hand, to attain ambidexterity. Do this every night, before going to bed. It reminds me of knitting.

Why did I begin this regime this week? I began my 40-hour pediatric surgery clinical 'encounter' this week. I also spent a couple of hours in obs/gyn surgery. I think I'm mostly over my fear of screwing up, and I'm ready to actually become helpful... anyways, I'm really excited about all this upcoming OR time.

Meanwhile, my apartment has turned into a pigsty lately. I rectified the problem today, and did some baking too, to top off the day.

All is Well in the World

2006-10-22T21:25:00.000-06:00

This week, we began our repro course. In concert with that, on Friday afternoon, it was well woman time for my well-person-partner Running Man and me. Well man had made me nervous, when we went through it last school year, but this time around, I didn't have the lead-up time to get nervous.

In the end, it was uneventful and went well. It was a lot more difficult that a good old DRE, but who doesn't like a challenge? Running Man maintains his cool in all situations, so that helped out.

Afterwards, I could really have used a beer. Instead, I had Harvey's twice, and was reminded of why I used to love them so much.

I really have gotten down to studying, btw. I've already put in more hours than I did in the first five weeks of neuro. Hurrah!

Next!

2006-10-17T23:58:00.000-06:00

Another course has come and gone; we had our neuropathology peripatetic yesterday, and the final exam today. Neuro completely failed to grab my attention; I guess the problem was that I already had a rough idea about a lot of the diseases involved, before the course started, so the full seven weeks really wasn't necessary.

Luckily, the ophthalmology section was interesting, primarily because I now know how to spell 'ophthalmology'. What a great word.

Unfortunately, not so great, was that after the exam, we headed to the local pub for a couple of drinks. They have free peanuts, so I ate a lot of them. One tasted exactly like blue cheese, which is not how peanuts are supposed to taste. Now, I have this terrible feeling in my tummy.

It actually snowed most of the day yesterday, and into this morning. Still no accumulation, though, since the ground remains too warm.

Sweatin' with the Oldies

2006-10-15T09:17:00.000-06:00

On Friday, I went camping with a few people from the medschool, about 45 minutes out of town; it was a native health pathways club thing. We set up, and slept in, a Blackfoot-style tipi, which was a fun, obviously. The only downside was that it was pretty darn cold overnight, quite a bit below zero. Happily, the sky was incredible; the best I'd seen since central Asia, all those years ago. As a few of us sat around the embers of a campfire with an elder, having her tell us the story of the wolf trail, I watched two shooting stars fly overhead.

In the morning, we got up at 6:30 to enter the sweat lodge. Sweat was a bit of an understatement; I can't remember being that hot in years. Perhaps the minibuses of İstanbul were a similar temperature? It was a great experience, and reminded me in many ways of a Mevlevi sema. Afterwards, we rinsed off in an ice-cold creek; my skin was all pruney for at least half the day.

As the evening set in, we were back at the hospital, and found that the clerkship schedules were out. I have to start setting the elective wheels in motion after this week's exams...

Bliss

2006-10-11T20:48:00.000-06:00

Well, if I can't go to Thanksgiving, then Thanksgiving will come to me. As I mentioned in my last post, I backed out of Big Poppa's dinner to freak out over neuro. Well, Big Poppa brought a complete meal of turkey, stuffing, mashed potatos, mashed yam, beans, a bun, and cranberry sauce to school today, which I enjoyed for dinner. I broke open a bottle of 2003 Mouton Cadet Bordeaux to enjoy along with it. Wow, a great meal, which reminded me of warm memories of Thanksgivings past. Thus, today's title.

To top it off, I've had a couple of good days musically as well. Yesterday brought me a shipment that included a couple of Faye Wong disks that I had been missing, along with the special edition of 'Smile Again'. This evening I picked up a package from the post office, that completed my original-release Pizzicato Five collection. I had been missing 'Ça et là de Tokyo' up until now (okay, it's a rerelease, but what can a guy do?). Also, I've recently been thinking of submersing into Québécois rock, and lo and behold, today Fluorescent Boy introduced me to a couple of tracks from Anik Jean and Les Cowboys Fringants. It reminded me that I've been meaning to invest in a Beau Dommage album, to rekindle my youth. If that wasn't enough, this aft, Ché slipped me some rips of Cuban and latin tunes he picked up over the summer.

Anyways, to finish off this post, I've been tagged by Med Neophyte, and am supposed to list twenty random things about me. Twenty is a lot of random facts, so I will cut it down to ten useless factoids; otherwise, I'll run out of mysteries.

1) Okay, where do I start? I believe that life is way, way too short. I was just thinking, I often think of my Glory Days (à la Bruce), and yet here I am currently living another complete set of them, as we type. Lucky!

2) One of my favourite pastimes is shovelling snow.

3) I liked yellow as a kid, then moved on to green. That change of heart may or may not have been related to snow.

4) I enjoy glycobiology more than any other form of biochemistry.

5) I am an Apple maniac, as if you couldn't tell. I spend my days waiting for the perfect Mac to be released.

6) I like cars and planes that have plenty of leg room, and houses with high ceilings.

7) I'm a foreign film addict; if only my textbooks were subtitled. :(

8) I lack drive. I am where I am today, only through the efforts and inspiration of others. Without certain people in my past, I'd be a computer-game-playing comic-book-reading bum (oh wait, that describes me quite well).

9) Sadly (or happily, depending on your feelings about evolution), nobody wants to see me in short shorts.

10) Next week will be rough.

I could pass on the tag to Marysienka, but Anna's already tagged her!

Synapse

2006-10-08T21:16:00.000-06:00

It's been another quiet week. Just studying or wasting time, these days. It's actually Thanksgiving today, and I was invited for dinner by Big Poppa, but backed out for an evening of study instead. Happily, I really have gotten down to it.

The only event of note is that I have suddenly become engrossed in the Trashcan Sinatras. A fellow former Endersian supplied me with an mp3 from them about five years ago, and the song finally got through to my limbic system this weekend.

Illness

2006-10-03T22:29:00.000-06:00

My life has become rather boring recently. The high point of the weekend was that I came down with a throat infection. It sucked, of course, being feverous and sore, with a general malaise about me. I noted a drop in my cognitive ability. 'Obtund' was the best word to describe me on Sunday.

Monday was worse, as I started the day by wacking the back of my head so badly on the bottom of the door of my medicine cabinet that it still hurts. My deficits now focused on attention and concentration. 'Confused' would describe my behaviour for the rest of the day.

In this state of mind, I'm still trying to figure out my future. A week ago, I was set on general surgery. Now, I'm having second thoughts, and trying to organize my clerkship to allow internal as a backup. How about paediatrics? I can slip that in too. The next year and a half will not be easy.

On the plus side, it kind-of snowed again on Monday morning, although it was still too warm for it to settle on the ground. Oh, and I've pretty much defeated whatever virus it was that had the nerve to infect me.

Poor Focus

2006-09-27T02:48:00.000-06:00

Many things have happened in the past week, none of them important. I'll tell you about a few of them anyways.

First, I did some catsitting over the weekend. This involved me spending time with a cat, feeding and playing with him, and observing him. That was quite interesting. Speaking of entertainment, the person I was catsitting for has cable, which drove home the fact that I haven't had a television since coming to Calgary. I recognized very little of what was on.

I also watched a few movies. One of them was 'Vital', a bizarre film about a guy who suffers complete amnesia after an auto accident; after being taken home by his parents, he realizes that he remembers everything in the anatomy textbook in his cupboard, so off he goes to pursue medical school. Dissection, frenzied drawing of anatomy, and a love triangle ensue. In the end, not the most rewarding movie.

Let's see, what else to report? I played my first game of floor hockey in probably 13 years tonight; I joined a local team, succumbing to the peer pressure of Bejeweled! and The Chauffeur. I wasn't great, but I think I held my own; afterwards, a girl asked me whether I was a marathoner or a sprinter, she couldn't tell; perhaps I was into triple jump? She just knew I must do track. Boy, can people be wrong in their analyses.

To top off the evening, I got an extra-large double-double on the way home, and watched 'Der Untergang'. Wow, what a movie; I kept thinking about what my own ancestors were going through at that moment in time. Bruno Ganz is great. Oddly enough, I don't think I've actually seen a movie with him since 'Der Himmel über Berlin', a.k.a. 'Wings of Desire', which is a favourite of mine.

Ah, time for bed. :)

Worms 3D

2006-09-21T20:54:00.000-06:00

So, I got some exciting news today. It turns out that two of the nine of us that were in Tanzania this summer have been diagnosed as having intestinal worms. What species, I don't know. Probably a hookworm, but perhaps some kind of roundworm?

I had a friend a few years back who loved the video game 'Worms'. Now, I am wondering whether just such a war is currently being fought in my own intestinal tract.

More Pics

2006-09-20T21:38:00.000-06:00

It was another long day today. I was pretty beat by the time we things wrapped up at school. We had a thing in the evening concerning our clerkship: we have to rank our preferred schedules next week, which essentially means committing yourself to a specialty, since you have to choose a schedule that will put your favourite career choice right there, front and centre. Really, this is the number one reason why three-year medical schools should be eliminated. Why are people always in such a rush?

Anyways, I added a couple of photos from my pre-med-school wanderings in Turkey to my picasaweb gallery, just to kill some time.

Eau de Formaldehyde

2006-09-18T21:52:00.000-06:00

It was a long day today. I got up early to wash my white shirts, so that I could wear one to school (still moist, when I headed out to school in 0 ˚C temps). Then, it was two hours of lecture, two hours of small group, four hours of neurosurgery clinic, and another two hours of dissection. All that, with just two coffees and three cookies to serve as fuel.

That last part of the day, dissection, I'm very happy about. As I mentioned in a comment a few days ago, I managed to get our main anatomy prof (and probably my favourite prof here), to oversee me in a dissection project. As a result, I'm happily spending time downstairs, dissecting away, in the pleasant company of my classmate Narco. Today, Rococo came on down too, just to check out the lab, as I freed up a greater auricular nerve from its overlying platysma.

Anyways, today I also started on the paperwork to write the USMLE step 1 next spring. I am not exactly sure why I'm writing it, and it will cost me a pretty penny, but I guess I don't want my options to be limited in the future. It should be like studying for the MCATs again, only this time sans study partner. I wonder if I have it in me; we'll see. Of course, studying for the USMLE should make studying for my later MCCQE part I exam a simpler exercise.

Snow Snow Come Again

2006-09-15T23:20:00.000-06:00

SIt's snowing outside right now. After brainstorming ideas for a project with Magic Pants, Rococo, and Bejeweled! for a few hours, it was time to call it a week, and MP, Rococo, and I headed over to 'Chili's' for dinner. Once we were seated inside the restaurant, it began to snow outside, and so I rushed out to commune for a few minutes with the first flakes of the year.

Oh, I finally got internet access at home this week. Hurrah! My life should be a bit easier from here on out. I also almost bought a 1-V, but it didn't work out; oh well.

Hoo, I love snow. :) Maybe I should head out for a walk... :)

Felicitations

2006-09-09T20:21:00.000-06:00

The neuroanatomy peripatetic exam yesterday went too easily. In a bit of cosmic payback for that, Telus has held out on providing me with DSL service. I decided back in mid-August, that I'd had it with wardriving (and warwalking), and so it was time to graduate to having net access at home. Well, installation has turned out to be maddening, with delay after delay by the phone company. They said yesterday, that they would absolutely, positively, hook me up today by 5 p.m., but 5 p.m. has come and gone. :(

Anyways, today I completed my watching of 'Felicity', with the last two episodes of season 4. Ah, it's a sad life. What series to watch next?

Image is Everything

2006-09-07T02:24:00.000-06:00

I came in to school this evening to go over some CTs and MRIs before Friday's neuroanatomy bellringer. Well, I found the lab quite crowded, so I decided on a bit of websurfing first. I'm looking into a new camera, so I dug around a bit on what was out there. See, I bought my current camera, a Canon EOS A2E back in 1993 or so, and although it's a decent camera, I'm not happy with its auto-exposures. This summer, I had to resort to manual exposure for about half my pics, which slows things down considerably, and results in a lot of lost shots. I see so many nicely exposed pics on el cheapo digital cameras these days, that I think I should be able to find a film camera that does a better job than my current one. Anyways, first I noticed that my current camera body sells for about CAN$100 on ebay, which isn't great.

When I looked at current models, I found something interesting. The Canon EOS 1V, which is six years old at this point, records all the exposure and time info for all pics you take, and you can download that info to your computer. This would solve my other big current photo problem: all my photos are time-stamped with the time I scanned them, not the time I shot them, which sucks, database-wise. So, if I bought a 1V, all I'd have to do is write a little program to take that info and write it into my image headers, and I'd be a happy camper once again. Throw in some GPS tagging, and nothing could stop me! Anyways, all that is just a moderately expensive dream at this point.

Oh, and after actually looking at those MRIs, I finally set up a little photo gallery for public perusal, but unfortunately, it seems that google locks out everybody that doesn't have a picasaweb account, so it's kind of useless. I guess I should try flickr next...

September, I'll Remember

2006-09-02T00:14:00.000-06:00

September has arrived. Last night was cold, and tonight will be cold too. Luckily, we will make it back into the mid-twenties for the Labour Day weekend. Still, the leaves have already started to change colour, and I've gotten out my winter coat (heck, I'm wearing it as I type this, and yeah, it's still Bil's old jacket with my green hoodie underneath).

Oh, the psych exam last week went fine, although I could have studied harder. I think I'm done with my self-analysis for a while. For the week before the exam, I was like some modern-day Freud, lying back on my Lillberg couch from Ikea, conducting psychodynamic psychotherapy on myself.

I meant to get some summer photos up, especially now with autumn upon us. Maybe next weekend...

Psych

2006-08-23T22:30:00.000-06:00

I have my 'The Mind' (a.k.a. psych) exam tomorrow morning. I did a great job studying over the weekend, but really let things slide since Monday afternoon. That day, I made the mistake of having four Arby's Juniors with cheese for lunch, and followed it up with a Wendy's Wild Mountain Spicy Chicken for dinner (Biggie sized, no less). What followed, was two days of indigestion. I am thinking that perhaps my continued use of my anti-malarial doxycycline has something to do with that indigestion...

To refer to Alanis, I think that I need to get off of these antibiotics. The prescription runs out next week. :)

Anyways, I have also been reading 'Blind Willow, Sleeping Woman', since receiving it on Tuesday afternoon, which has also not been good for my studying. I had forgotten that it was a book of short stories, and not a new novel. I had actually already read a fair number of them in the past, but I am enjoying them nonetheless. With all the psych classes and clinics of the last three weeks, I have a whole new perspective on Murakami's work.

I have also been stuck on a particular song for the last three days: 'Chelsea Hotel #2', by LC, of course.

I remember you well in the Chelsea Hotel
you were famous, your heart was a legend.
You told me again you preferred handsome men,
but for me you would make an exception.

And clenching your fist for the ones like us,
who are oppressed by the figures of beauty,
you fixed yourself, you said, "Well never mind,
we are ugly but we have the music."

Maybe some body-dysmorphic traits visible there...

Bookish

2006-08-21T11:44:00.000-06:00

I just got an email from Chapters that they've shipped 'Blind Willow, Sleeping Woman', the latest book by Haruki Murakami. I thought that it wasn't out for another week. Well, I can't wait.

At the moment, I'm trying to make my way through The Maarif again. I stopped halfway through on my last read, as I have trouble dealing with 'second translation' new-ageism. Still, I wanted to finish it off, as I just bought 'Portable Nietsche', and want to get going on it. Fun!

Out of Shape

2006-08-20T09:39:00.000-06:00

I went for a run yesterday morning, I think for the first time since the Banff-to-Calgary relay. My quads are really sore today.

Today, I need to exercise my brain. Four days until our psych exam, and so I need to know 50% of the material by tonight, as we have other distractions before Thursday, like an informatics "exam" (a.k.a. quiz) on Tuesday, and more psych clinic time on Wednesday.

I'm off to Tim Horton's to begin my exam prep. :)

Flatliners

2006-08-18T10:28:00.000-06:00

On Wednesday this week, I joined up with Magic Pants' and UroVision's dissection group, to replace absent members. Here, we don't actually do dissections in class; instead, we work with prosections prepared by the anatomy professor and a couple of his assistants. This also avoids the problem of obtaining donors; they are quite rare, and needless to say, bodies obtained from foreign sources are not necessarily true donors, if you know what I mean. However, students who wish to dissect can still do so after hours, as part of the dissection club. However, due to limited availability last year, we ended up having to join the dissection group via a lottery, and of course, I didn't get in. Well, with people dropping out all the time, I have finally gotten my chance. The lab is deep in the basement, hidden away from the eyes of all. It was good to get in there; my anatomy knowledge is terrible, so I always felt that this would be crucial to my learning.

In unrelated news, I need to eat less kimchi noodle soup. I had something else to say, but I forget what it was...

The Good

2006-08-14T16:32:00.000-06:00

One and a half weeks left in psych, and I'm not back in the groove yet. I should be studying pharm right now, but instead, I just watched 'Blackmail is My Life'.

I wanted to contrast my last few summer posts with something positive. So, I am going to list off some of the best things that happened to me this summer:

The bats outside of the New World Cinema, in Dar. The cinema is inside a walled compound, of course. I saw a few movies there: 'Poseidon', 'Inside Man', and 'Superman Returns'. An interesting thing about the theatre was, that you would order dinner in the food court, and they would bring it to your seat during the movie. What a concept. But, the best thing about the theatre was the huge flowering tree out at the front of the parking lot. The flowers attracted bats like anything; on the trip there, every branch had a bat on it, with it's long winged arms, crawling, grabbing, stretching, staring at a tall human, digging into the flowers. Amazing to watch.

Animals in Lake Manyara, the Serengeti, and the Ngorongoro crater. The photo is of a young guy in Manyara, living life to its fullest. I never knew that they put so much effort into brushing the dirt off their food.

Birth. Rococo and I had the pleasure of watching a woman, with no pain killers, give birth to her third child. That was a first for both of us. She was lying there, grunted a bit, told the nurses she was ready, and gave birth right there and then. To see a baby arrive into the world was magical. 'The miracle of life!', I thought to myself. Sure looked easy! What a priviledge, to be there at the moment that life begins for a person, the meeting between the mother and child. When we walked out, we saw the happy-looking father waiting in the hallway. What a smile he had. Rococo, however, was traumatized; she said something about 'screams' and 'liquids'. I have to say, the delivery of the placenta caught me off guard. The thing looked like a watermelon from space. I guess I'd never thought about it before.

The east coast of Zanzibar. Like I said before, it was paradise. What a peaceful hotel, my favourite of the trip. Vibe, Rococo, and I really needed the relaxation, after four weeks of intense ups and downs. Closer to Dar, Bongoyo island was pretty amazing too; so close to town, and yet you feel like you're on Gilligan's Island.

The auto parts market in Dar. It was a maze of 30-cm-wide pathways containing at least one hundred tiny little used-part booths. It was invisible from the street, with the entrances completely unmarked. I wonder how many tourists end up in that place every year. Probably none.

Bananas. I think I had bananas every single day I was in Tanzania. In a related subject (food), seeing clove trees, cinnamon trees, and vanilla vines was amazing too. It changed the way I think about those spices.

Pain au chocolat. In the afternoons, it was nice to head over to 'Épi d'or' for some nice French baking, and perhaps a coffee or a tonic.

I guess I should have written this post earlier, when my mind was closer to the summer. Here's a funny tidbit. Somehow, street salespeople always knew we were Canadian, on sight. At the end of the trip, a guy told me how they knew: if a group of people was mixed-race and English-speaking, it was probably Canadian.

Seeing Things

2006-08-09T14:09:00.000-06:00

I got new glasses today. I have been trying to figure out how they look. I think that 'classy nerd' is the best description.

My new prescription feels weird, though. Before, my glasses were so scratched, that I saw the world in soft focus. Now, it's all hard edges and solid colours.

The Ugly

2006-08-06T20:54:00.000-06:00

I am still really tired from my trip. My coherency for the last week has been weak, at best. Last night, I slept around 11 hours. I need to quickly reestablish a more rigid schedule, since our psych course is but three weeks long.

Anyways, let me finish off my downer posts with some examples of the terrible things I saw while in Tanzania.

A girl of about 11, who was admitted with abdominal pain. The resident apparently decided on exploratory surgery instead of imaging, and cut her open from her xiphoid to her pubus, leaving a big ugly zig-zagging scar. He found nothing conclusive, save signs of peritoneal infection, and had not yet made a diagnosis. On rounds, he couldn't explain to the head surgeon why he decided to do surgery, why he used a huge vertical incision, that will make pregnancy problematic in the future, nor did he have a differential. A smile and respectuful silence were all he needed to be let off the hook.

A young boy only a few years old. He probably had malaria, but the resident decided to do exploratory surgery on him, and found nothing. Oh, and he forgot to order a blood smear, so there was still no diagnosis. Again, the resident got away with it. As with the previous case, the resident had basically used the patient for personal experimentation, and if I may simplify the situation, it was 'okay', since the patient was from the lower classes.

A baby a couple of months old, with pyloric stenosis. The baby was one of a set of twins; we saw them together. The other twin was nice and chubby, a picture of health. The sick twin was much smaller (textbook 'failure to thrive'), with terrible signs of dehydration, with his eye sockets deeply burrowed into his skull. The baby had been in for over 24 hours, and had not yet been given anything for its dehydration. No IV drip, not even oral liquids to supplement the breast-feeding of the mother. The diagnosis was not made by the resident handling the case, who had not yet bothered to take a history, but by the chief surgeon doing rounds. Why was the baby not given an IV? The resident smiled and kept a respectful silence. Why no proper history, and no attempt at diagnosis? Smile and stay quiet, and the problem blows over. In this case, there are three possibilities, as far as I could tell, as to the resident's malpractice: (1) the resident was simply too lazy to examine the baby, (2) the family had not paid a sufficient bribe to the resident, or (3) the resident was simply malicious.

A young woman failing to recover from a hysterectomy. She had had a backstreet abortion, which had resulted in a crisis requiring the emergency hysterectomy. She had been 'doing well', but apparently, the staff had forgotten to feed her for a few days. She was very dehydrated, with tachycardia and severe tachypnea (i.e. she was gasping for breath). From her appearance, I would guess that she was not simply dehydrated, but probably also in sepsis. I doubt she survived. Again, I wonder why she was allowed to fall into that state, and malevolence and greed are at the top of the differential. Okay, that's enough for examples of malpractice (all of those were at the government hospital, by the way, and all offending docs were residents, working under almost no oversight).

A mother with very bad oral thrush, breastfeeding a young infant. This was probably a first presentation of AIDS. The doctor gave her something for the candidiasis, and booked a follow-up appointment, where she would be counselled for an HIV test. Of course, according to statistics, the baby had about a 40% chance of having HIV, as well. Obviously, seeing a young woman with HIV is heart-wrenching; to see a baby with HIV, and knowing they will never know a life without antiretroviral therapy, is indescribable. I saw so many cases of parent and child visiting the local HIV clinic together; I can't begin to imagine what life is like for them. Luckily for them, the world is waking up to the situation, and the HIV clinics I went to in Dar Es Salaam and Arusha were excellent. Still, I don't have a handle on what a lifetime of ARV treatment is like.

Well, enough of that. Let's change the subject.

One song by Leonard kept entering my head on my trip, to the dismay of Rococo and Vibe, who were forced to listen to my rough voice:

Un Canadien érrant,
Banni de ses foyers,
Parcourait en pleurant
Des pays étrangers.

Un jour triste et pensif,
Assis au bord des flots,
Au courant fugitif,
Il addressa ces mots:

"Si tu vois mon pays,
Mon pays malheureux,
Va dire à mes amis
Que je me souviens d'eux."

Thanks again to Mr. Cohen for writing a song appropriate to my mood du jour.

Posts from here on out will be more optimistic. :)

The Bad

2006-08-01T16:20:00.000-06:00

I'm sitting in class now. :) Psych; it seems like it will be interesting. I spent the last few days readjusting to life at home. I started by buying myself a new razor on Saturday, to reward myself for having survived the summer. I finally tried it out on Monday morning, and man was it awesome. I also hit Nelly's for breakfast on Monday and then Tuesday before class; mmmm.

Anyways, I have also been spending a lot of time ruminating about the summer. As part of the process, I'm currently reading, "Petals of Blood" by Ngugi wa Thiong'o. It's full of all the problems that were so obvious in Tanzania today; the book was written about post-independence Kenya.

I think I've already mentioned how the setup of society in Tanzania was so shocking to me. The education systems and health care systems are set up in such a way as to deny the lowest classes the possibility of hope. Education beyond primary school is priced beyond the means of a large percentage of the population, and health care is another problem altogether.

First of all, let me say that I met a lot of terrific, dedicated doctors there. Docs work for a piddly income compared to anywhere in Europe or North America, primarily out of a drive to help their patients. Our primary preceptor was really inspirational, given the hours he worked, and the skill and caring he showed in dealing with his patients.

However, those docs were primarily working in the private system, where patients are primarily the wealthy: either they are rich enough that they pay for all their health care with cash on hand, or they are lucky enough to have health insurance provided by their place of work (this would only be a small percentage of the population).

The government system, on the other hand, is supposed to be accessible to the majority of the population, serving even the poorest people, with fees waved according to need to pay. (For Canadians, I'd have to say that the system closely resembled the Alberta government's proposed, and abandoned, 'Third Way' of public-mixed-with-private health care.) Great, it sounds like everyone in the country has access to health care, right? The rich get to go to private hospitals for enhanced services, while the poor still get a basic standard of health care provided to them at minimal or no charge, correct? Wrong.

The problems begin with the minimal up-front payment that patients must pay, in order to see a doctor. Typically, this is in the range of US$17; half is to register, and half is to see an actual doctor. This is in the same range as your typical co-pay in the US, or as the now-illegal user fees were for a short time in parts of Canada. That may not sound like a terrible amount to a North American, although even here co-pays are primarily designed to prevent people of lower income from going to see a doctor, thus lowering costs to insurance companies. But, in Tanzania, where your typical lower-class person is lucky to make $50 a month, and lucky to save 1/10th of that, that is a huge quantity of money already. Next, that inital fee doesn't cover any tests whatsoever, which all must be paid for by the patient. So, need a CBC? Gotta pay for it. Need an X-ray? Hope you have another $20. A biopsy? Good luck. Don't have the money? Then, sorry, no tests for you, and a clinical diagnosis is all you'll get.

An expense I haven't mentioned so far is tea money, a.k.a. bribery. Doctors and nurses at the government hospitals are paid very little, and so a system of bribery is well established, with service often being withheld or delayed if the appropriate bribe of a few dollars here, a few dollars there, is not paid. It starts at the registration desk, where a bribe can get your up-front fees reduced or partially waved, continues with the nurses, where a bribe can mean the difference between getting that IV put into your dehydrated baby or not, and finally with the doctors, where a bribe can make the difference between being seen today or tomorrow or next week.

I said that based on need, you could be given free health care. In theory, that's great, but in practice, the system is almost non-functional. Noone was able to explain to me how people could qualify... I suspect that you qualify by bribing the correct people. In a sad twist, financially the best diseases to have seemed to be HIV and TB, where a positive test resulted in free medication and doctor's visits, provided for by foreign governments, pharmaceuticals, and Bill Gates.

I'll finish off this subject in the next post.

No More Macon

2006-07-29T09:15:00.000-06:00

I'm chewing a nice piece of bacon right now, once again safe and sound at the café by my apartment in Calgary.

Between hopping into a taxi to the airport in Zanzibar, and getting dropped off at home last night, was slightly over 48 hours. I felt sorry for the poor guy who sat next to Rococo and I on the plane into town last night; talk about two smelly people.

Anyways, I have a lot to say about my summer, but it will take a whole bunch of entries to cover them, bit by bit. I'll start by saying that I started the week at the Paradise Beach Bungalows in Paje, and if that was what Paradise is like, I want in. As I was sitting on the beach, I thought to myself, how the heck did I get here? Got frustrated at work in Boston one day, and boom, here I am staring out at the clouds over the Indian ocean.

Spent the last two days in Stone Town, though, where a batik salesman threatened to beat up Rococo as soon as he saw her without my company, because he knew how Asian shit thought. I haven't been challenged to a fight in years... the guy was, apparently, known in the neighbourhood as being a bit deranged, though, so I suppose he was just another victim of a health care system designed to screw over the poorer population.

I had better go pay my MasterCard bill before I anger some collection agent here...