Brown Drinks

The Brown drinks are keeping me going.

In the morning, it is the hot creamy variety.

The afternoon, the fizzy cold variety.

And then the evening, the Red Drink completes it.

This is my homage to brown and red drinks.

Exactly 2 weeks until d-day. 

There Is a Difference

It wasn't until medical school that I discovered...there is a difference between having a sore brain, and having a headache!

Who knew?

Are there papers written on the matter? Have people studied this phenomenon? Is there a medical term for it?

The Only Thing Worse Than Getting it Wrong...

We had a lecture today by a very peculiar prof. He fluctuated between funny, rude, interesting, irreverent, and sarcastic. He was asking a lot of questions during the lecture and people were being fairly silent (as he would hear an answer and say something like, "who said that?" and then find the person in the crowd and say "no, that's wrong").

Near the end he asked about ECT and if anyone had any opinions on it.

Another long dead silence.

I finally offered, "it can be a very useful treatment for certain patients".

Him: "What kind of patients"

Me: "Patients with depression"

Him: "What kind of depression"

Me: "Severe depression, like catatonic depression*"

Him: "You are completely right. You are going places."

Yeah, like the 7th circle of adult-learner-nerd-never-going-to-make-friends-hell.

I searched for a way to climb into my empty pop bottle.

Epilogue:

Tonight while walking to do laundry I saw a group of guys from my class (who I hardly know except in passing). They waved and then as I passed one yelled,

"HEY! YOU'RE GOING PLACES!"

Yeah,  thanks for that Mr. Prof Doctor Weird Man.

*I only said this not because I am a super-nerd-gunner but because I worked in acute psyche as a student nurse (and as a casual for a year after I graduated). I was amazed by the recovery that some of our most desperately ill patients made from ECT and was always dismayed by the bad rap that ECT got in the media/medical field. I was trying to give it a little plug while I had the opportunity. Now I basically have a 'kick me' sign on my back. Sigh, oh well!

I Am Medical Student!

Hear me YAWN!

My brain is feeling sore. I have been completely absent minded today. So much sad news and good news coming from home, makes me feel like I am just living in this pseudo-reality that is medical school. People are born, people die. There are floods and earthquakes and civil wars and hockey games and movie festivals yet I seem to be floating just below the surface of all of this. All I am thinking about is the different causes of neutropenia and the histology of a nephron.

This morning I woke up and wondered what day of the week it was and then realised that it didn't really matter because my day would be unfolding in the same way no matter what. The only difference would be if I would wear my really ratty sweat pants (no classes) or my <1year old sweat pants (classes).

I went to the market and bought a green pepper (I hate green peppers!) and when the woman who sells brownies told me she couldn't believe that I ate brownies because I was so "flat" (compliment?) I told her I had an obsessive exercise disorder (I don't). Seriously! Is that the appropriate way to respond to a nice remark about being in shape?

Feel like I am starting to go a little c-r-a-z-y!! But it's almost a nice crazy. I actually don't mind the long days of studying except that it reminds me off the pseudo-euphoric-daze that I'd fall into after too many night shifts in a row, when you get a little giddy and a little nauseated.

My first thought yesterday when I woke up was "What are the three branches that come off the aortic arch??"

That is just not normal.

Study Quote of the Day

Me: Ok, list the clinical and laboratory characteristics of iron deficiency anemia.

Hilarious Study Buddy Eileen: Er.....umm....pallor?? Uh...palmar crease?

Us: Erupting in laughter.

Me: Oh THAT is going on the Blog!!!

The Stumble to the Finish

26 sleeps until I am done finals.

I know that using 'sleeps' as a way of marking time may be seen as infantile but its my kind of countdown.

We're doing the neuroanatomy unit right now which is fascinating and challenging--but overall I am enjoying it. I just wish I didn't have the kidney to be reviewing (and all those other blobs in the abdominal cavity) at the same time. I'd love to just kick it on the porch with my neuro book for a couple of weeks.

Sadly the medical school doesn't roll that way.

Campus is in a state of flux as all of the 18 year old alcoholics majoring in sweet-f*ck-all are finishing up and heading back from whence they came. It's been nice seeing them roll by my window in res with their luggage on wheels.  At least now I wont have to dodge vacuum cleaners that have been thrown off balconies on my walk to class. Speaking of my window, here is the view from it right now:

                                                                    Classy, I know.

Turns out res is turfing all the bedding and buying new stuff for next year. I shudder to think of what a swab from that pile would grow.

I have to admit though it has been making me slightly jealous seeing everyone celebrating and leaving, knowing I still have a month left of classes.

Tobie went back to Canada on Thursday morning. Of course I am going to miss him but with the school work crescendo building to a frenzy it'll probably be better that he doesn't see me again until it is all over. I have already reverted to my pre-Tobie rituals of staying up too late studying and taking meals in front of my computer. BAD ABB!!

For now though I am going to try and enjoy the sunshine and the studies. Now that the din is lowered studying at home ought to be a viable option. If you're looking for me I will be located here, in the study pit (another glimpse into the glamorous life of medical students in Ireland).

Be Careful When You Hit That 'Send' Button...

So my good friend Eileen and I have this running joke where we say to each other (in our ditziest Valley Girl voices):

"Can you believe I am going to be a doctor??" and then we giggle in a very ditzy Valley Girl type way.

We've been seriously hitting the books lately, so Eileen and I take weekly turns being each others 'Med School Cheerleader'. I informed her that this week it was her turn to keep me motivated so she emailed me this (heavily photoshopped photo) of myself with the caption, "Can you believe *I* am going to be a doctor??" and reminded me (in the subject heading) that if I quit I'd never be able to utter those words.

Last night during a study session I emailed it to all who were present so they could see Eileen's handiwork. George received it and had a good chuckle but for some reason Ryan didn't receive it. George then pointed out that in the group email I had sent it to a "Mrs. Jane Ryan" instead of my study buddy Ryan.

Panic.

Fear.

Who the HELL is this 'Jane Ryan' person? DAMN YOU AUTO COMPLETE!!!!!!

An adrenaline fueled search of my account showed one lonely email from this woman many years ago. 

Turns out, she was a nurse that I worked up North with in 2006. I have no recollection whatsoever of her but was mortified nonetheless.

Suppose it could have been worse. It could have been the Dean of Medicine. Or one of my employers. Or former employers. Or professional contacts.

Note to self: double check 'to' field before hitting 'send' button EVERY TIME!

*facepalm*

Nostalgia

The gig (I know, I know...another post about Hawksley Workman...bear with me) was in this small little club in Soho. The place was standing room only and packed to the hilt.

It was just Hawksley and a keyboard player, and it was fantastic.

I used to listen to him a lot about 8 years ago and saw him play at the Sidetrack Cafe in Edmonton. On Saturday there was an equally devoted mass of fans who knew all the lyrics and hung on his every word between songs. He's actually a hilarious story teller as well as a kick ass rocker and songwriter.

When I was in nursing school I did a placement at a seniors drop-in center. They used to crank out the piano and sing war songs, many of them seemed to drift completely to another place and time during these singalongs. Some had sad wistful smiles, others seemed lost in happy memories.

I felt that in myself on Saturday.

I remembered being in the audience and having a beer soaked shirt on, dancing until the sweat made my hair cling to my face. I remembered what it was like to play music for people, to see a crowd singing along to our songs.

It made me feel a little sad.

The Sidetrack was torn down to build plywood condos. The band I used to have that rocked the same stage is scattered across Canada now. I remembered that time in my life when anything seemed possible and at the end of the day you'd just drop on your futon and decide to worry about things later.

The perfect part was being there with my dear friend Keith who has been beside me in a beer soaked shirt since we were 15.

We're in a different phase now and I know that is a natural progression, but it doesn't mean we can't enjoy those reminders of our reckless and feckless youth, and sigh.

Exciting Things

Tobie and I are off to London tomorrow to see one of my favorite artists--Hawksley Workman. Back on Sunday morning. Just in time for me to cram neuro anatomy into my brain.

We also put the deposit on our apartment for next year!

More on that to follow. Happy Friday!

Epilogue to Affirmation

I felt it was important for the school to know how much I appreciated the speaker that we had last week, so I sent a little note and asked them to forward on my thanks to her.

Tonight I received this lovely email from her in return:

YES - be inspired, yes be a neurologist or a researcher in neurology, or a neurosurgeon!  

Your reaction and your thanks are appreciated, but if you can, imagine what the effect is on me every time I switch off the device. There is not on day that passes for which I am not grateful. I am not putting this very well, but I am saying that if I have touched even one of you in some way that will prove positive for even one person with Parkinson's, then I have done a good day's work.

Thank you for your email, and good luck to you in whatever area of medicine you end up.

I think there is more than one of us in the blogosphere that might take a small seed of happiness from that. 

Here's to the nurses*, doctors, medical students, researchers, pharmacists, physiotherapists, speech and language therapists, occupational health, lab technicians, and social workers that are spending their days and nights making the world a little bit better for someone. These grateful people are out there, we just don't get to hear their voices sometimes.

*And a Happy Belated Nurses Week!

A New Low?

So now not only do I buy wine* only if it is in the "2 for 1 special" section at Tesco.

Tobie busted me buying chicken breasts** at the convenience store today.

I told him it wasn't so bad.

When I was in University (round 1) 10 years ago my best friend Keith and I used to use the FasGas card that his parents gave him to stock up on Michelenas tv dinners, the odd scratch 'n' win, and probably a pack or two of Craven A's.

Shopping at a gas station using a credit card that is only supposed to be used to buy GAS is lower than buying chicken at the Res convenience store, right? Right?

This whole student thing is really only for the early twenties. 

*Ok, so I lied in my bio. I only stay hella away from really cheap red wine.

**I normally buy free-range chook from the local farmer who comes to our Farmers Market every Tuesday so relax people.

Affirmation

It truly was nothing short of a medical miracle.

Today a woman came to speak to our class about what it was like to have Parkinson's.

She told us about how she had diagnosed herself 14 years ago while watching the 1996 Olympic Games. As Muhammad Ali lit the cauldron at the opening ceremonies the commentators made reference to his Parkinson's disease, and in that moment her life changed. She recognized the symptoms he showed as the same ones she had been developing, and trying to ignore.

The woman spoke about when her suspicions were finally confirmed. How she went home from the appointment lost and afraid for her future. She talked about the horrible side effects she suffered from the medication treatment and how walking had become an impossible feat.

As she told her story I started thinking, "hang on...she doesn't appear to have that severe of symptoms". I couldn't see much of a tremor, she didn't appear stiff or show the Parkinson's mask, her gait seemed almost completely normal.

She then spoke about deep brain stimulation (DBS) and how she had had the treatment several years earlier. I vaguely recalled some lecture during nursing school where they mentioned this treatment but I couldn't grab on to any info in my brain. I thought, "wow the treatment must have really worked for her!" Still thinking that they just drilled into your skull, inserted the electrodes, zapped and then took them out.

But she went on to talk about the plastic grommets that the wires go through on her skull and how the pacemaker was near her waist, that she could turn the DBS on or off, or adjust it (within parameters) at will. Apparently some people develop slurred speech or other unwanted side effects so they only turn it on (or up) when they want to move.

I was now sitting straight up. This is clearly a much cooler procedure than I had thought.

The National Institute on Health gives a good summary of the procedure here, but in brief:

"DBS uses a surgically implanted, battery-operated medical device called a neurostimulator—similar to a heart pacemaker and approximately the size of a stopwatch—to deliver electrical stimulation to targeted areas in the brain that control movement, blocking the abnormal nerve signals that cause tremor and PD symptoms.

Before the procedure, a neurosurgeon uses magnetic resonance imaging (MRI) or computed tomography (CT) scanning to identify and locate the exact target within the brain where electrical nerve signals generate the PD symptoms. Some surgeons may use microelectrode recording—which involves a small wire that monitors the activity of nerve cells in the target area—to more specifically identify the precise brain target that will be stimulated. Generally, these targets are the thalamus, subthalamic nucleus, and globus pallidus."

She finished her lecture and then said, "ok now I am going to turn the DBS off so you can see what happens".

With that she pulled a remote-control looking device, held it to her abdomen and clicked a button.

Within moments her arms shook with pronounced tremors, her face changed to an unexpressive stare, and she slowly turned her body in an attempt to walk. She lifted up a jerky arm to show us her attempt to count on each finger but only a profound tremor showed. Her speech became slow but her voice cleared of what sounded like a mild sore throat. She explained that the 'resident frog' in her throat was the only mild side effect the DBS had in her case. With a difficult maneuver she switched the DBS on again by clicking the button.

Her tremor vanished. The frog in her voice returned, her speech slowly returned to its normal tempo and she turned back toward the podium.

I was actually on the verge of tears, even now as I am typing this. I really don't think I am able to convey the impact this demonstration had on me. She was two different people with the press of a button. One would have been unable to drink from a cup and the other had just given a one hour presentation. I really believe that I witnessed a miracle. And I don't use that term lightly. I have been in the room when people who were without a pulse or breath in their body were brought back to life using medications and electricity.

But this moved me in a completely different way.

Suddenly all of the stress, and studying, financial burden, and lack of sleep, became worth it.

Medical conventions often get under my skin. I wonder some days why I am going into a profession that pushes drugs, ignores preventative health, and sees peoples lives as a business.

But if modern medicine means I get to be in the field of work that can do that for patients, I am happy.

Thrilled in fact. And strangely humbled.

It has been a good day.

The Athletic Wear Paradox

You may have heard of the "ulnar nerve paradox".

Well I have come up with my own paradox of late.

The longer I am in medical school, the more weight I put on. This is bad for many reasons, but the main issue right now is that I am poor so I can't even afford to go out and buy some temporary 'fat clothes' while I step up my exercise routine and turn down the stress-snacking.

So I am left with wearing the only clothes that feel comfortable and still fit--my athletic clothes.

That's right...the sweat pants, the lycra tanks, the light poly track pants, the running shorts.

And it's kind of a sad joke, really, because the chubbier I get the more I have to dress like a jock freak.

Sigh.

Dazzling New Changes

Well they aren't that dazzling really but I've been wanting to mess with the layout of the blog for a while and this is what my procrastination bred today.

Good? Bad? Ugly?

I am still undecided.

You know healthcare workers and how we resist change...

Hah.

Who Walk Among Us

This post was written last summer on my old blog. I like going back to those past entries from time to time so that I can remind myself of all the reasons I chose this path, and why I am here.

--


I was tired this morning when my alarm went off at 0445h. I had to drive to the city to catch a 0750h flight and therefore didn't want to leave the house later than 0515h.

I hit the 'dismiss' option instead of 'snooze' on my phone and fell back asleep. I awoke just after five and raced around the house gathering up the last of my belongings, showering, and grabbing some toast for the road. Ugh! I realized I needed gas as well. Of course, when I am running late...

Zoomed into the quiet station and put 15$ in only to find I had locked my keys in my car.

Aghghg! Remembered my hatchback was unlocked. Sigh, ok, I can handle looking like an idiot to the gas station attendant for a few minutes vs missing my flight. Finally I got on the road, but I was pretty frazzled.

Going to a new contract always makes me a bit edgy...What will the staff be like? What is the housing going to be like? Is my roomie going to be a psycho-chain-smoking-television-blaring-messy-chews-with-mouth-open-racist? Will there be internet? Will there be soymilk in town? Will there be a gym in town?

So when I arrived at the airport I was not in the mood for the baggage lady to tell me my bag was 3 kilos overweight. I fought the urge to make a sarcastic remark about all of us probably being 3 kilos overweight. So there I was, the girl who has to open her suitcase for all to see, randomly pulling hefty objects out and stuffing them into a plastic bag (classy). Thankfully I didn't send a shower of tampons into the air or accidentally fling a pair of underwear at a baggage handler.

I was cursing Air Canada and the woman who kept calling me "ma'am".

Oh how I hate flying Air Canada.

And I hate all the little invasions of my personal space when I fly.

Take off my shoes? Undo my belt? Open my top button? Take out my toiletries bag? Really? Is this all really necessary? Sigh. Remember the good old days when you could fly with a leatherman on your belt and have toothpaste in your carry-on?

I was muttering to myself about my severe dislike for all-things-air-travel as the dude in front of me in the security line was completely faffing with this ridiculously large bouquet of flowers.

Finally got to the gate and sat down for a few minutes before having to board.

My flight arrived on the island and we then waited for about 45 minutes for a shuttle to take us across the inlet on a ferry to the town. Yawwnnnnnnnn. Sleepy. Hungry. Cranky.

A taxi stopped to give me a ride to the hospital. The driver was a middle aged Vietnamese man, very pleasant and upbeat, waving and smiling at people as we drove through town. He laughed when I asked him if he knew where I was staying,

"25 years in a 4 mile radius town you know where everything is!"

Right. Good point.

So I asked him how he had ended up here of all random places in the country to be, it didn't seem like a place that would jump out at someone immigrating to Canada.

He said, "have you heard of the boat people?"

I scanned my thoughts wondering if admitting that would seem racist, I had assumed that term was only used in a derogatory sense.

"Ummm yeah...you mean people that escaped Vietnam and came on boats to North America?"

"Yes, that was me and my sister. I was 16, she was 14. Our boat ran out of gas in international waters and it took 7 days for a US coast guard to find us, there were 49 of us on the boat. They brought us to their ship and people were given the choice of moving to Canada or US. I chose Canada and was sent here, neither my sister or I spoke a word of English. I started out washing dishes in a restaurant, getting the waitresses to teach me English. Now I have the good life."

I asked him if anyone died on his voyage. He told me that they had been 2 days without food and water when they were rescued, that two children had almost died but ended up surviving. I told him he should write a book about his life, his bravery, his story. He said, "no, that journey brings up too many sad memories". And that was that, he popped the trunk and was soon on his way.

I've thought about our conversation all afternoon. Here was this man who survived a very dangerous voyage to a completely unknown land. When he arrived he had no money, no education, and couldn't speak the language.

And here was I. Cranky at having to suffer the inconveniences of air travel. I wasn't leaving my family behind on a dangerous journey where I'd arrive and not know how I'd get food in my belly or a roof over my head.

I am glad this man held a mirror up to my irritations of the day. How truly fortunate I am in my comfortable life.

I am glad I got to see how my day of travel compares to some of the travels that have been endured by the people around me. People who will never whisper a word of it to me, stories I will never know.

I like being reminded that sometimes I should stop to consider what chain of events have brought me  to the place I'm at.

That perhaps I could never know in a thousand lifetimes the experiences of others.

And how thankful I should be that my 'humiliations' only include locking my keys in the car and having to take off my shoes to show a hole in my sock.