Sunday Mornings

I love Sunday mornings.

Tobie and I wake up, he brings me breakfast in bed (and a delicious americano).

And we either listen to a "This American Life" podcast, a CBC Ideas podcast, or we watch a CBC episode of Q* (because now they also film the radio broadcasts). I know, it's nerdy, but it's our way of staying somewhat connected to our roots. Makes us feel a little less homesick. Which we both are, most of the time.

Then I start school work and Tobie practices.

Today we watched the Q interview with Paul Shaffer. It was pretty hilarious, if you've got 20 mins it's entertaining and worth a watch. But the pinnacle of the interview was when Jian Ghomeshi brought up that Paul Shaffer had written some award winning music, and a number one hit, "It's Raining Men". To which Paul said that it was kind of awkward to have been a bachelor at the time and only known for writing the song (implying it could have easily destroyed his chances with any future women). But his rationale was,

"You gotta be straight to have written a song like, 'It's Raining Men'".

I don't quite get the logic but I thought it was brilliant.

Off to try and wrap my brain around the kidney. Ugh. Hormones, pumps, ions--oh my!

 --

*This all started because of the famous Bill-E-Bob interview, also highly recommended. You can watch Billy have a little temper tantrum on live national radio. I am not going to lie, Jian gives me a rash sometimes but my respect for him as an interviewer began when I watched him handle this debacle. Paul Shaffer actually alluded to the Bill-ee interview as well.

Quotables from Today's Classroom Adventures

In the mind-numbing 6 hours of lecture today on such topics as fulminant liver failure, biochem, narcotic abusing colleagues, and the kidney...a few snippets of lecture really stood out of the rest.

For example, the comparison of the kidney's microtubular cells and microvilli to the X Factors 'Jedward' twins. Also making note of their 'tight junctions' what with them being twins and all.

The discussion of the positive "doggy style" sign which is when a patients hepatic encephalopathy has gotten to at least a stage 3 causing them to get on all fours on the bed (and then rip out their central line and start waving it around like a lasso--OUCH)!

And how ionic bonds are basically like two desperate people speed dating. One ion is desperately needy and the other is desperately wanting to give. They form a strong bond due to their mutual dysfunction.

Wow.

Today In Histology

My prof got a little more colorful with her description of cirrhosis saying, "it causes complete anarchy of liver architecture".

Oh SNAP! Cirrhosis--you BAD!

A New Chapter

I wish there were more hours in the day so that I could read. Well, non-medical texts, that is. Although it'd be nice for some extra time to crank through those as well.

I miss the mountains, I miss my nieces and nephews, and I miss reading.

My reading time is now after Tobie falls asleep, headlamp on, buried under the covers. It's a bit like summer-camp or secret reading after your parents told you to go to sleep. But it's the only time that I don't feel guilty doing it.

I just started "Anatomy of an Illness" by Norman Cousins, and I am so excited about it. Almost as excited as I am about getting to "William Osler, A Life in Medicine" by Bliss, which is also burning a hole on my nightstand.

The intro to the Cousins book contained the famous quote by Francis Peabody, "The secret of the care of the patient is in caring for the patient".

A simple, and very true fact.

I sense many late(r) nights ahead.

Busted

I have said before that I feel like a mole in MD school but today my nurse-self was on, full force.

In class one of our clinical instructors was going on about how when the shite hits the fan, the nurses are the first to point out that it was the doctors orders or the doctors mistake. He went on to describe how a friend of his worked in the really horrible psyche ward where "the nurses looked the same as the patients" blah blah blah...then he sees me sitting in the front row, "Er, but there are a lot of brilliant nurses and nurses that will help you out but..." then he goes on to tell how a psyche patient committed suicide and the nurses blamed the doctor for not writing stricter observation orders.

Now my classmates are shooting dagger stares at me and the guy behind me starts kicking my chair.

So I promptly advise him to tell a story where a nurse saved his ass...because kids I can talk until I am blue in the face on that topic (and no--not all 'when I saved the day stories', I have seen old Nurse Ratched's with 200 years experience curtail bad situations before they happened many oh many times). Just like I have seen bad nurses try to shift the blame to doctors. But if it is story time here people, let's at least make it fair!

He mumbled something about being in the NICU the first time and not knowing how to hold, feed, or look at a baby and the nurses being very helpful.

I wasn't really that offended by the remarks because for the most part the blame game does happen in health care when things go wrong. But I pointed out to him that patient care *is* ultimately the doctors responsibility, that is why they have an additional 4-7 years of medical training, that is why they make more money, and that is why they get respect in society! Responsibility.

I have made mistakes at work and when I have, the finger was never pointed at anyone else. There are crappy nurses out there just like there are crappy doctors. I am just glad that my presence at *least* caused him to apologize and admit to the fact that for the most part nurses are a helpful and important part of the team.

The Bad Old Days

Yesterday we had a presentation from our Associate Dean regarding the changing face of GP medicine in Ireland over the past 40 years.

In 1969 when he started as a GP the world of medicine was a very different place (in some regards).

The competition was fierce for patients, there were almost no group practices or associates in practice, your wife was the secretary, you saw patients out of your home (or in their home), and you were always on call...as in, every day and night. 

He told us about how there was an acupuncturist a few doors down from him who had a hopping business and people would often ring his door asking for the doctor--when he'd reply "Um, I'm a doctor" they'd say, "no no, the guy with the needles!" and he'd have to point them down the street.

In the early years of his practice he said some days he'd only see two patients.

And this is where I suppose some things are the same: he said once the drug reps heard he was in business...

"I'd go out into my waiting room and there would  be 2 patients and 6 drug reps waiting to see me!"

The more things change, the more they stay the same. 

PUSH!

Finally when the baby's head was crowning, just after midnight, I heard the irritating sound of the downstairs doorbell. Knowing that Jason (who was actually the first nurse on call) was not downstairs and that he hadn't radioed me to expect anyone--the midwifes and I decided whomever it was--was going to wait.

It seems that often in the crux of situations; when you are taping a baby's IV in place, suturing in a sterile field, or doing a pelvic exam, the phone or doorbell will ring. Most of the time, it is a relative just calling to see how so and so is doing. When you're on call at night in the clinic you have to be the janitor, the nurse, the doctor, the mental health counselor, the medevac coordinator, and secretary-- so these interruptions can be aggravating to say the least.

So as the PING PING PING sound of the doorbell chimed over our shouts of "PUSH!! KEEP PUSHING!! YOU'RE ALMOST THERE" we didn't think much of ignoring it.

I saw a contraction starting to wane and decided I should run downstairs and just make sure everything was copacetic. I got down there and no one was in the foyer, I wasn't surprised as in other health centers kids often would hit the buzzer and run off at night  This doorbell needed only be touched once and it would ring until someone unlocked the front office and manually turned it off. 

I unlocked the office and turned off the bell. The shouts on the other side of the door startled me to a new level of adrenaline. I found two men banging on the door and shouting at the window which separated us. One had a fat lip and a wild look on his sweaty face. I jumped back initially and then went into the corridor which lead upstairs. No way in hell was I opening the door to these two menacing creatures who were obviously pissed about something and more than likely pissed drunk. They both looked like the usual Friday Night Crowd that we stitch up, either when their friends drag them in or when they start to sober up and feel the throb of the cut. I pointed upstairs and yelled back through the glass that I was dealing with a birth, turned and ran up the stairs. Dammed if I was going to miss something happy and beautiful happening at the health centre for once.

As I took the stairs two at a time I radioed Jason , "Call the RCMP, there are a couple of drunks banging on the entrance to the health centre and there is no way I am letting them in down there alone. You better come down here to see what's up".

"I'm on my way".

Jason was  a 1 minute ride from the health centre and he had confessed to an America's Next Top Model addiction-so I knew he wasn't in bed yet.  I got back into the birthing room just in time to see another contraction starting and again the baby's head peeking out then deciding not to stick around, ducking back behind the skin of his mother. 

The doorbell starting ringing again and the midwives looked at me for the update. I told them about the two guys, that Jason was calling the RCMP, and that he was on his way down.

My radio cut into the silence between pushes,

"Get down here now."

I pulled myself away from the evenings climax and ran down the hall. Took the stairs as fast as I could and opened the door to the main floor. There I saw the foyer door propped open, a stain of blood  more than a foot in diameter marked the spot. Bloody smears covered the hand railings and buzzer, the floor showed footprints of blood leading to the emergency room. Yelling came from the room and my adrenal glands were pinched into action once more, with the main thought in my head a clear "ohhh shit!!!"

Jason stood over a man, naked but for his underwear and caked in dried blood. His clothes lay in a saturated heap on the floor. Jason looked as though he'd just had a walk through in a meat processing plant. The man lay with his back toward the door,  the white gauze Jason was holding against a hole in the mans back was quickly becoming red like the rest of the bed.  I couldn't tell if Jason was putting pressure on the wound or holding the guy down as the patient yelled and struggled beneath him.

"I WANT A DRINK OF WATER"  he yelled over and over.

"Call Doctor Friedman, tell him Bobby's been stabbed, get O2 on this guy and try to get a set of vitals, he needs 2 large IV's going NOW".

"Friedman, we need you in here now. Bobby D has been stabbed in back, he's bleeding profusely, combative. No we haven't got vitals on him yet, it's just the two of us and Jason is trying to keep pressure on the wound".

Friedman showed a few mintues later while I was in the middle of trying to keep Bobby still long enough to get an IV in him, he kicked and yelled about wanting water. No matter how much we'd give him to sip he wouldn't settle. Plus we could be sure this guy would be going to the O.R and so the less in his stomach the better. Bobby flailed around grabbing angrily at anything he could. In no time my arms were covered in bloodly hand prints.

"That bitch did this to me--she punched my face and when I said I was leaving, she stabbed me in the back! That fucking bitch! Hey leave me alone! Stop pressing on my back so hard! It fucking hurts. FUCK OFF".

"Bobby. Calm the fuck down! We are trying to help you. If you don't let us press on your stab wound you will bleed to death." Friedman yelled to his face.

"Get me some fucking WATER".

"Bobby! Look at me---look into my eyes--NO--LOOK INTO MY EYES! You are FUCKING BLEEDING TO DEATH! You need to let us help you, now calm the fuck down. We'll get you some water as soon as we get an IV going and get your blood pressure back up okay?"

I hadn't ever heard a doctor drop and F-Bomb on a patient before, but if there ever was an appropriate time, this was it. Bobby was yelling. Jason was yelling. Friedman was yelling. I was yelling. For a minute it felt like we were locked in a power struggle in which there were only losers. This guy could tear a bleeder that was barely staying together, or maybe he was bleeding into his belly as much as he was onto the floor. His bowel contents could be seeping through a hole into his peritoneal cavity, his lung could be filling with blood, or air, or both.

Jason took over the IV attempts after my first one was pulled out by Booby's thrashing, the dripping catheter being dragged along the floor with the sweeping arc of his arm. I was facing him now, hunched over as I pressed on his right flank, feeling his heartbeat under my fingers.

Friedman came to the other side of the bed and I pulled off the soaked gauze to take a look at what we were dealing with here. Down through the thin layer of fat and fascia a shiny encapsulated mass reflected the ER lights.

"Looks like his kidney there..." I remarked.

The dark red glistening sponge of liver also appeared in our field of vision--"and there's his liver" said Friedman, "put pressure back on".

Friedman went to the phone and called Aparna, the resident, and Sue the X-ray tech. They both arrived in short order despite the hour.

We were a montley crew to say the least, Sue in her "I Like to Show My Dog" cartoon shirt and sweat pants, Aparna in wool sweater and sandals, me in my running pants and blood soaked scrub top. Jason in dark bloody jeans, hikers and a scrub top, Friedman in a holey t-shirt and kakis.

Enter Bobbys extremely intoxicated parents. Neither of them looking like they'd been sober, or in a clean change of clothes for a week.  His mother weaving unsteadily to the only unoccupied space at the bedside. His father staring glassy eyed at nothing in particular was riveted in the middle of the room. Aparna relieved me of my pressure duty as my back and arms began to cramp from the sustained position and effort required to do such a task on an uncooperative person.

"Let 'im sit up if he wants, he can shhht up if he wants" his mother slurred at me, her eyes not focusing on anything in particular, just in my general direction. I really didn't have the patience for this right now. I escorted them to the door of the trauma bay to wait and look on from there.

Finally, some vital signs on the monitor. Two lines running wide open. With the x-ray machine warmed up we maneuvered him into the room and were able to get him to sit up, supported by the bed, for a dodgy chest x-ray. We knew that having him stand was not only a danger but an impossibility at that time, thus leaving anything that would show on an abdominal x-ray useless.

From what we could tell no major lung damage, but soft tissue or bowel injury was unknown to us. His belly did seem to begin to swell as the minutes ticked on.

During the lull with x-rays I was able to take a few breaths and organize my thoughts. I had taken a bag of blood from the lab and was trying to remember how to hang it. I had given blood dozens of times in the south, but it had been a long time. I knew if I made any errors the blood would be useless. I also remembered that there was a technique to priming the bag and tubing that contained a filter for the blood to pass through. If I rigged it wrong the saline would back flow out into the bad of blood and it'd have to be chucked. Something about gravity, clamping off certain lines....shit!!! The thick red liquid flowed down into the chamber, through the filter and down the tube. It wasn't running as it should. The saline should be dripping in the chamber as well-diluting the blood. Now the droplets spattered on the floor next to Bobby's own splatter pattern.

"Shit". I clamped the line off with a bloody thumb.

"Don't run it if you don't know what you're doing!" Freidman was watching me try to figure it out. No one knew how. Having blood up north was such a rare occurrence none of us could do it with any confidence. I was frustrated and angry with myself, this was a simple task and I needed to be able to perform it now more than ever.

I stood over the garbage can, sticky IV line in one hand, saline bag in the other I took some deep breaths. I closed my eyes. Just for a second. And then, with just a little more coaxing of the clamps and a slight modification to the height difference the saline flowed into the chamber, diluting the blood as needed. The two solutions swirled together and flowed through the filter. Becoming one brightly colored infusion as I let dribble out the few cc's of undiluted blood.

"Now I've got it. Ha! It just took me a few minutes."

Bobby returned into the x-ray department and I felt a small serving of pride cover the insecurity I'd been feeling after the failing to secure the I.V's and my initial botched priming of the solution. The blood was running in. A conservative estimate might be that he'd already lost over a litre since arriving at the health centre. This infusion might prove to be vital depending on how much was being lost in his ever-firming abdomen.

We were told by the people who organize medevacs that the flight crew would be 'timed out' once they returned from their last flight to Winnipeg and thus we'd be waiting until at least 6 am for a team to arrive to fly him the three hours south. Not knowing what was happening internally that delay meant a possible death sentence. He had already received our only supply of blood and there was nothing more we could do with our limited  resources.

Despite the strict aviation guidelines against pilots flying when they are 'timed out' Friedman was able to convince the powers that be that the situation was a life or limb emergency and this man needed to be transferred immediately. A quick letter drafted and faxed in the middle of the night from his office took care of the red tape. At around 3 am the flight team showed up.

The usual chaos ensued when the flight nurses arrived. In their blue flight suits, they unloaded their large bags packed full of the kind of gear one needs for any possible emergency situation. Our lines were changed over to theirs, their monitors were applied.  The dose of black humor, friendly chiding, ego overlapping, and introductions began. Through the bustle a catheter was inserted with much difficulty, another pressure dressing was applied to the wound, and an ativan was given to calm the patient down.

His vital signs remained stable and he was much more compliant now. Not necessarily a good sign, but certainly easier to deal with than he had been upon arrival.

Soon he was 'packed and stacked'. The ground transport arrived with stretcher in tow. Gingerly we lowered him, mindful of the various tubes, bags, and monitoring devices present. And off he went.

The clinic looked like a disaster had blown through it. A bloody disaster. Both stretchers had torn and stained sheets, the floor still held on to a film of blood despite Donna's quick mop job. The IV poles, the BP cuff, the O2 sat machine, counters,  garbage, side tables...everything had the same blood smeared horror-film appearance.

Jason rolled up the mat in the front hallway. Aparna busied herself scrubbing the hand rail and the buzzer with some windex and pilling paper towel. I bleached the stretchers a couple of times, washed the pillows and again mopped the trail from the emerg to the front door. The heavy metallic stench of drying blood still hung in the air.

Friedman, Aparna, Jason and I were the only ones left now. We chatted excitedly in the entrance. An informal debriefing over the way the night had unfolded. Each of us cutting the other off as we took over to tell our view of things. Friedman started doing one liners from the old television show "Emergency" yelling about ringers lactate and various code words. We all laughed and breathed sighs of relief with it all. The nervous energy and adrenaline of the night was starting to flow out of us. Soon it'd be replaced with the unavoidable adrenaline hangover of gut-and-head-ache.

"What are we supposed to do now??? Go home and sleep! What I wouldn't do for a beer right now...Jesus!" Jason shook his head and walked toward his office.

"Come look at this!!" He hollered from down the hall.

"I must have come in to grab something in the middle of it all..."

A bloody hand print covered the light switch in his office. Enough to make us all shake our heads and chuckle with laughter again.

And so.

I long hot shower later I crawled into bed knowing in a couple of hours I'd be up again for a full day of clinic.

Closed my eyes and played out many scenes from the night. I berated myself for not opening that door when I first saw them. My thin slice of the situation in that snapshot of time had been totally off. My instinct had been wrong. Just as I was thinking that I was getting some of that "spidey sense" that experienced health practitioners get.

It is frustrating to realize that sometimes your gut instinct isn't right. Scary to think that man could have bled to death in the foyer if he'd been more badly injured and if I hadn't called Jason.

But maybe that is what forms a more accurate instinct. The near misses (or the misses in some cases). That is what makes us take a step back at our assumptions and what we think we know and realize that sometimes we need to go deeper than the thin slice. Skirt around what we hope it is and look at a situation for what it is, what it could be. Unbiased. Objective.

Impossible.

Of course we are fallible.

Turns out Bobby survived. A nicked liver and kidney. A litre of blood in his belly when they got him into the OR.

I guess we all were lucky that night.


-----



20% off Saints Scrubs with code "saints"

It Comes Back

We're learning about G.E.R.D this week, or G.O.R.D --as it's called here thanks to the (o)esophagus.  I am reading about adenocarcinoma tonight when suddenly a patient's face comes sharply into focus in my mind.

A 41 year old male who was about 7 days post-op from a partial gastrectomy due to stomach cancer.

He was brought in by his wife because he hadn't slept for 2 days due to extreme abdominal pain. He was obviously very fit before this ordeal had started but now the weight loss had sunken his large dark eyes into the sockets, his cheek bones pressed upwards under the skin. His tanned skin had changed to greyish.

He never made a sound while I removed the dressings on his abdomen, which was rigid with pain. He just stared at me. Both of them were so afraid, it was unsettling. When you see fear like that you never forget it.

I am again reminded that these diseases don't only exist on histology slides in my Robbins and Cotran Pathologic Basis of Disease textbook.

You Know You are in the Arctic When...

So picture Saskatchewan. Now go straight up, through Nunavut. Over all the rocks and trees and tundra. Over the caribou, lichen, streams, and ravens. Drop off the top of Canada's mainland, cross the frigid waters that will turn you to ice in minutes, then stiffly climb onto the shores of Victoria Island. There you are. In Cambridge Bay.

Imagine a flat, white, landscape. Depending on the day that white will be cut in half on the horizon with blue-bird sky that surrounds you 180 degrees or with a matching shade of blowing white which makes you feel like you are in one of those snow globes someone is shaking vigorously.

Welcome to the North.

It has been cold up here. Not just "oh I think I'll wear a coat today" cold but more like "oh, I think I have to bring my blowdryer and an extension cord to work today so I can de-ice my lock when I get home" cold.

My walk to work is approximately 5 mins (or 1.5 Lucinda Williams songs I've discovered). And in that time all kinds of fun and interesting things can happen to you when it is -50 with the windchill.

Things like:
-your face freezing to the inside of your coat from the moisture in your breath. As if you licked the entire front of your face then stuck it to the side of a metal door.
-your eyelashes freezing shut
-a trail of snotcicles (icicles made of snot) clinging to your upper lip
-a pain, burning, immobility of movement in the fingers which leads you to believe that your fingers are actually freezing. It is not just an expression any more.
-your earphone cord seizing up to a taught, brittle, wire instead of the normally flexible plastic handing loosely by your side.
-tendrils of hair coated by breath moisture turning into wisps of ice hair framing your face, which then melts and plasters to your forehead imediately after stepping indoors.

It's fun. It's something different all the time. Today it is only -37 with the windchill so people are outside snow kiting in the bay to celebrate the chinook like change in weather.

Got to love those hearty northeners, hey?

 

ABB in 2006. Like my mitts?

--

I am bringing over more posts from my other blog on the days when there are no politically incorrect professors, no bizarre statements from classmates, and no flashbacks to my emergency department days. 

Sleep Talker

Tobie talks in his sleep a lot. Usually it is mumbly and in French* so I have a hard time deciphering what the heck he is going on about.

A few nights ago his nocturnal ramblings came out loud and clear:

"Yes, I am going to be an action figure, they'll be flying off the shelves..."

Ok. For those of you who don't know, Tobie is a violist. And not a Hulk sized one.

I cannot get the mental image of a Classical Musician Action figure out of my head now. Complete with tiny little viola case and music stand. He could have his street clothes or performance tuxedo included with purchase.

If only I knew a twisted toy maker. 

*He's French and no he doesn't sound like Justin Timberlake in Love Guru.

You Like Me! You Really Like Me!

In happier news, Dr. D nominated me last week for a medstudent blogger award, and I actually tied for first place!

I was the third place underdog but with a last minute post of support from Rogue Medic I managed to sneak in a few extra votes.

It was all in fun but it is great to see some of the other blogs out there and read some of the musings from fellow medical students and nurses.

Thanks Doc D for sticking it to The Man with your personal medblogger awards! :)

Homesick

Weird. Seems I am homesick again.

This was partly the fault of a recipe that I am making for Tobie's return from NY tomorrow. Random, yes. It's what I used to make a lot the night before big skiing days.

I knew that I was going to be giving up a lot to go to medical school (i.e. contact with friends, family, my favorite forms of recreation, my favorite fish monger, my favorite tea store, my favorite wine store....oh and money to spend at aforementioned places.)

I know a part of me would have always been unsettled, wrestling with the 'what if?' question if I hadn't gone. The question now is, would that have been more uncomfortable than this feeling now?

Photo taken by me somewhere in the arctic circle, June 2006. 

A Timely Whooping Cough Outbreak

Ok I promise not to turn this blog SOLELY into a vaccination campaign...BUT...today the CBC reported a whooping cough outbreak in the west Kootenay region of BC, Canada. That area of BC's interior has the lowest vaccination rate by the way, not a coincidence.

I say it is timely as I just did a post a few days ago on Andrew Wakefield and his contribution to worldwide lows in immunization rates.

All 19 cases in BC were on un-immunized children.

I had an aunt that died at age 2 of whooping cough and a grandfather that was on the team of physicians who brought the first iron lung to Canada.

So I take vaccinations a little more personally that I ought to perhaps...

A Not So Humble Rally For Votes

The last time I won something was when I was 5 years old.

I sent in the bar code from a lucky charms box of cereal and won a large gum ball machine (complete with 2 refills of gumballs).

Now is your chance to give me the win over at Doctor D's blog. He graciously nominated me for a medblogger award and the votes close Friday!

Head over. Vote. For. Me. Often. :)

Heheh.

As Old MD Girl said, it's all for fun....I MUST WIN!!!!!!!!!!!!*

*Ok, actually she was classy and just said the "it's all for fun" part. I am the jackass.

I Do More Before 11 a.m....

So today I defibrillated someone (successfully), taught another person how to use their inhaler, took peak flow readings, conducted a chest pain assessment, a respiratory assessment, diagnosed an otitis media, performed a prenatal assessment, did a peripheral vascular exam, and carried out a Rinne/Weber test. All in 6 minutes or less each. All on actor patients or models (as in dummies, not Kate Moss).

But my proudest achievement of the day: a 6 minute speculum and bimanual vaginal exam. WHO knew it was possible?? I swear every time I have done those things in the real world it takes me about 20-25 minutes! I got the 'one minute' warning bell with the speculum still in and somehow managed to take the speculum out, get new gloves on, get the lube out, and talk my way through palpating the cervix, adnexa, uterus, etc. in time.  All I can say is thank goodness that was on a plastic dummy not an actual woman.

Yes, today was the mock-OCASE. I can't remember what it stands for but it is basically our clinical skills exam. My mind did go blank at a few key moments (like midway through the respiratory exam I forgot to auscultate for an apex beat, I left out the modified Allen's test during the vascular exam--even though the examiner was like "what other tests would you like to do???",  and nearly forgot to ask the prenatal how many weeks gestation she was!) Egad. Aside from the wardrobe malfunction during CPR (administered on the floor) where I am pretty sure the HEAD OF THE EMS saw my underwear due to blouse coming un-tucked and blazer riding up my back, I think overall things went pretty well.

I am going to watch an episode of "Bodies" now to reward myself for a job well done.

As I Chew Off My Tongue In Silence or Please Let This Be a Bad Dream

Today we were doing EKG's on each other and starting talking about our upcomming OCASE (basically it is clinical exams with actor patients who pretend to have various ailments). You go through 12 stations and have no idea what you'll be faced with (as we've covered about 20 examinations/histories).

I was with a small handful of my group members (i.e the 10 people that I spend 8 hours a week with in tutorial and clinical skills sessions) and we started discussing how twisted the sense of humor is with the faculty here. For example, apparently last year one of the stations during the exam consisted of one of our very esteemed the senior professors (and assistant Dean) sitting at a table with a giant red dildo on it and the station was to explain how to put a condom on and safe sex teaching.

Imagine a guy you see every day in a 3 piece suit that you only run into at big med events and you, in your exam nervousness, having to put a condom on a dildo for him. Cruel. Evil. But the twisted part of me gets a chuckle out of how genius it is.

Anyway in this discussion one of my group mates pipes up:

Classmate: Oh I didn't listen to any of that lecture on sexual health because I won't ever have to explain to a patient how to put a condom on, so it didn't apply to me.

Me: Oh yeah, why is that?

Classmate: Because I am only going to provide information on NFP in my practice.

Me (thinking--'NFP' is going to stand for something irritating so I shouldn't even ask...): NFP?

Classmate: Natural family planning. I don't condone the use of condoms.

*Curtain Drops*