Showing posts with label Random Thoughts. Show all posts
Showing posts with label Random Thoughts. Show all posts

Wednesday, September 12, 2012

The Burden of Work

As I plod through drop down menus and hustle reference letters, I try to remind myself that I am thankful to have the burden of CaRMS. 5 years ago when I started the process of summer school organic chemistry courses I didn't even know if this day would ever arrive. But here I am, gathering all the little stones and jewels of experience from the last ten years, shining and presenting them for various selection committees, hoping to catch the eye and interest of some program director.

Obviously my thoughts are overrun with pre-exam stress (my Canadian board exam is a week from tomorrow) and the uncertainty of my future, but I am trying to stay positive and focus on one day at a time living.

And I reminded myself of what Kahlil Gibran writes about Work, and use that to keep it all in perspective.

Always you have been told that work is a curse and labor a misfortune.
But I say to you that when you work you fulfill a part of earth's furthest dream, assigned to you when that dream was born,
And in keeping yourself with labor you are in truth loving life,
And to love life through labor is to be intimate with life's inmost secret.

But if you in your pain call birth an affliction and the support of the flesh a curse written upon your brow, then I answer that naught but the sweat of your brow shall wash away that which is written...


...Work is love made visible.
And if you cannot work with love but only with distaste, it is better that you should leave your work and sit at the gate of the temple and take alms of those who work with joy.
For if you bake bread with indifference, you bake a bitter bread that feeds but half man's hunger.
And if you grudge the crushing of the grapes, your grudge distils a poison in the wine.
And if you sing though as angels, and love not the singing, you muffle man's ears to the voices of the day and the voices of the night.

Monday, July 16, 2012

RBC Revisited

12 years ago Keith took the train from Montréal to Halifax to meet me for a mini holiday while I was doing a French immersion program in Pointe D'Eglise, NS. We had very little money and very little idea about local geography, apparently.

After getting halfway to Charlottetown by hitching rides, we somehow found ourselves on the wrong side of the highway with our sign labelled "Bridge". It was only after a couple of long hours that some kind passerby pulled over, manually rolled down the window of her Mercury, and shouted at us that we were on the wrong side of the road if we wanted to get to the bridge.

I should also mention that during that time the sun was hot and we had one line of "Hold me closer, tiny dancer" in our heads. Singing it over and over and over again without knowing any more of the words but being equally incapable of thinking of new songs to replace it with.

We finally arrived in Charlottetown and blew our last $32 on a lobster meal. Somehow we had made a miscalculation of our finances which caused us to discover (too late) that indeed neither of us had any more cash. This was before the days when banks let us have visas or lines of credit. We called Keith's sister (collect) in a panic to have some money wired to us but it was going to take another day to arrive. I knew I had $15 dollars in my bank account so we went on a mission to find a bank machine that doled out cash in $5 bills.

Cue Hallelujah chorus from Handel's Messiah
Eventually we found one and were able to extract my final $15 to make it to the next day. We stayed at a barn shaped hostel run by a tyrant who wouldn't allow any lights on after 2200h. But life was good.

I had completely forgotten about this adventure until I went to visit a fellow blogger / friend this weekend. When I saw the RBC a faint halo appeared around it in my mind and I felt I ought to make a pilgrimage to the automated teller that saved us.


Funny, I thought I was poor then! Oh I had no idea how poor I could go. Sure, I can get wads of cash these days if I want, but I am also six figures in debt with no tangible thing to show for it yet.

Basically, I have the equivalent of a mortgage on the contents of my brain.

Excuse me while I go and put on a bicycle helmet. Always.

Wednesday, July 4, 2012

Rolling Stone

Feels like I am back to my nomadic travel nursing days. Once again living out of suitcases and buying tinned fish and microwave meals to avoid over-using kitchen spaces. I had to chuckle when in one day I received emails from several different people all with the same subject heading "Where Are You??". My friend Kara says she has a separate page in her address book just for me. The phone numbers and addresses have changed so many times that she's erased through the paper in some places. I think I have "Z"  all to myself.

I've been planning to spend a few days on the west coast but hadn't quite nailed down when I'd be in specific towns. Kara knew when to expect me (roughly) so I called her yesterday to firm up when I'd be arriving at her house. I had forgotten that I was calling from my friend Erin's American cell phone.

"Hi Kar, how are you?!"

"Hey! Where are you?"

"Sorry I haven't been in touch this week. It's been really crazy and my phone doesn't work outside of the major cities because I am on a crap network--".

[she cuts in]"--Where are you??"

"I am in Squamish! I was thinking of coming to your place....tomorrow?"

"You are in Squamish? Really? Because your phone number says Idaho and if there is one person in the world who could plan on being in the lower mainland but end up in Idaho, it is you."

I think I am going to take that as a high compliment, a reflection of my fly-by-the-seat-of-my-pants-wanderlust tendencies which I often think have long faded away. 


Friday, June 22, 2012

My Face Is My Fortune...

...that's why I'm totally broke!

I had a feisty 8 y.o girl come in tonight. Her long blonde hair was pulled back in a messy pony tail, an oversized black Karate hoodie hung low over her leggings. I saw she had the beginnings of two black eyes, a bit of a swollen nose, and a bump sitting on the bridge. She excitedly told me about how she got accidentally head-butted yesterday in karate just before winning her competition. She then mock-kissed her biceps.


So what brings you in today? Are you worried your nose is broken?

Yeah, we need to check it out....this [said while circling her face with her index finger] is my money maker.

And that was when an 8 y.o girl became my hero. I mean, she had me at the bicep kissing, but that line cinched it.

Monday, June 11, 2012

Success / Fail

Success:

When you correctly diagnose an appendicitis in a child who no one thought had appendicitis.

When you think you heard coarse lung sounds in the right middle lobe and (lo!) the x-ray shows a RML pneumonia.

When you finally get a kid who has clamped his teeth down on your tongue depressor to actually open his mouth wide enough to see tonsils. 

When part of your work day involves witnessing a 4 y.o perform a convincing and prolonged air-drum solo on his dinner tray with 2 brightly colored straws.

When you finally get a sample of liquid gold urine from a child with tummy pain and a fever.

Fail:

When you are taking a history and ask about immunization status and the parent states, "Immunizations are not based on science". 

When you ask a parent to keep their kid from eating any food until their nausea / vomiting / abdominal pain are sorted out and you go back in the room to find the child eating bright blue cotton candy (or is that a success because the child is clearly feeling better?)

Friday, June 8, 2012

Peds? Really?

First of all, I love pediatrics!

Children are such completely different animals. My experience so far with pediatrics has been fairly limited to the odd asthma, RSV, gastro, or rash that presents to general emergency. But working exclusively in a pediatric emergency department has been a completely different reality. I have really been enjoying the challenge of trying to connect with children, like figuring out ways to make clinical exams tolerable to them or jazzing up the neuro exam to make it like a game. I get to be kind of silly and fun, disguising the seriousness of it all. It's a treat, especially when you can get on the level with a kid. Most of them seem to lack the hang-ups that adults have around illness and disease. They are stoic but not in the look how stoic I am being, so stoic that I am actually not providing accurate information to my health care providers way that adults are. There is a different kind of job satisfaction that comes with helping to name a new teddy bear (Mr. Fall off the Wall) or getting an energetic high-five from a kid who was burying himself in his mother's skirt for most of the history. 

Plus, I always thought that (because I am really not that great with kids in the real world) I'd dislike pediatrics. And then there is the crazy parents, who also frighten me. But it seems that crazy parents are not as common as I'd imagined. Or maybe I am just not noticing them because my interaction time with parents is more limited, compared to when I was nursing.

The hospital is beautiful, brand new, and completely child-centered. T.V in every room, popsicle fridges at every corner. The staff seem to really love their work. I'm so impressed at how they are able to balance between the focused intensity of acute care while making it fun and minimally scary for the wee patients. Everyone is just so nice. Maybe it is harder to be a curmudgeonly pediatrician or crotchety nurse, I don't know.

It's been a great learning experience also, being put in with the residents for all of their teaching sessions and tutorials. Their simulation training has a dedicated faux trauma bay in the department, complete with all the drugs, pumps, and machines that go bing! We did a session on Thursday with mannequins that are very realistic (heart, breath, bowel sounds, as well as pulses, intubatable throats, seizure capability, etc.). All the mock codes were run in real time, that is, you wouldn't just say, "I would start an IV and give ceftriaxone", you actually assign the task of IV start to one of the team, they put in a line, someone draws up the actual drug and sets up the infusion. The enthusiasm to teach and job satisfaction of the attendings is contagious and I must admit I look forward to every shift.

It is strange though, being in a new city. I feel like I am regressing as an adult. No phone, no car, no idea how the city is laid out. I walked for over an hour in the hopes of buying a new burner only to  find they were sold out. The saleswoman kindly advised me to call ahead next time. I gently pointed out that I didn't have a phone, hence why I was trying to purchase one! Sigh.

And so, getting settled in. Trying to enjoy each day for what it offers. I have already managed to locate and join a yoga studio for the month, so at least some physical activity will take place. Did I mention there is also a very decent wine store down the street allowing me to finally taste my favorite American grapes again (in Ireland you're lucky to find Ernest & Julio). It's Friday night, I'm post hot-yoga and ready for a glass of red and my new book.

Back to work tomorrow, the adventure continues.

Thursday, March 22, 2012

Apparently I Look Like a Drug Dealer

So, I am here in BC doing an orthopedics elective. But really, I am doing an everything elective. I've worked in this hospital before as a nurse and most of the doctors know me. I want to scrub for surgeries, stitch wounds in the ER, catch babies, intubate, whathaveyou. So I need a cell phone, otherwise no one can reach me when wounds / babies / femurs are presenting themselves.

I walked into the 7-eleven and looked for the cheapest phone. $39. Brilliant. I asked the attendant to please fetch me the $39 phone from behind the counter. He looked at me strangely and said, "Er....are you sure you don't want a nicer phone? These ones are only $100". I waffled for a moment but held strong. All I need this for is "baby coming" texts. Status symbol, status schmimbol. Give me the ridiculous one. 

I was quite proud of my new phone so during my next shift I whipped it out to show one of the murses. He burst out laughing, "Dude!! You've got a burner!!"


"Uh...what is a burner?"

"It's a phone that drug dealers use so that their calls can't be traced. They're disposable. Hilarious. You totally will look like a dealer every time you take that phone out."

Now I feel old, and crazy out of touch with slang.

The next day I get a text at the nurses station and I'm trying to thumb my way through a response when one of the other nurses starts pointing and laughing, "NICE BURNER!!!!"

Siiiiiiighhhhhh. Am I the only person that didn't know this term? Apparently if I watched The Wire or CSI I'd be well versed in these matters.

I sent a text to my orthopod to give him my number (since we were on call) saying "Here is my mobile number courtesy of 7-eleven" and the next day in theater he tells me that his wife saw the text and asked him who was sending him messages from a burner.

For the record, he's in his 50's.


It's no iphone 4, it's small, it is ridiculous. I look like a complete rube (and low-life, apparently) when I try to text from it. But you know what? It is almost so lame that it feels cool. In fact, I like that it is ghetto. It feels slightly rebellious and hip to not be showing off what apps I can get on it. I wear rubber boots to work and I own a burner. It is just how I roll these days.

Friday, March 16, 2012

Surgical Pearl: Nutrition

Today the locum pediatric orthopod took me down to the x-ray department to look at some films, on our way out he stopped at their desk and poached some chocolate. He clearly saw my judging questioning gaze (I have firm beliefs that you ought to contribute to the trough you graze from).

"Look, when you're a surgical resident you learn to get calories from any source available. It's an old habit. You find every patient fridge that is stocked with ensure or crackers...this hospital is great because the recovery room fridge has cheese. Cheese will be where you get your fluids from."

Residency: when you begin to see cheese as hydrating nourishment.

Wednesday, February 29, 2012

When Med Students Pretend to Know

Hugh: So, Doc tells me to go ahead and do the vag exam. I'm hoping he'll, you know, teach me how to do it. So I get gloves on...wait for Doc to come and help me out. I pretend to spend ages looking for lube hoping Doc will join me, the nurse gets annoyed and asks if I am going to do exam or not. I put on confidence face hoping that it hides fear face and tell her uh yeah! as I realize doc is actually now scrubbing up and has no intention of teaching me.



So I put a finger in and think Shit! what am i supposed to be feeling for? I kind of move my finger around and try to figure out the noteworthy anatomy and all I can think of is the vagina is so spacious! I can't feel a damn thing! Then I think if only I could put TWO fingers in, then maybe I could feel something...but I don't want to look greedy so I just keep to the one. How are you supposed to feel anything in there? How are you supposed to actually do a vag exam??

Me: [Initially unable to speak due to fit of laughter and piece of chicken lodged in my throat] Dude, first of all, never put the words 'spacious' and 'vagina' together in a sentence ever again. Second, two fingers isn't 'greedy' it is proper technique. Third, there is a reason it is called a bimanual exam.

That was an excerpt from recent dinner conversation with MD student currently on obs/gyn rotation. In fairness, Hugh is actually a very smart, personable, and responsible medical student. And yes, he had consented the patient to perform a vaginal exam under anesthetic prior to her procedure. It is probably good that she was asleep.

I am sure the nurses thought he was a complete idiot while they watched him flounder. But this whole story illustrates one of the pet peeves I have about medical culture. Medical students are students which means they are allowed to not know the right dose of clopidogrel the first time they see a heart attack. They are allowed to not know how to do a bimanual exam the first time they are faced with a real person and not a doll during a 1st year clinical skills lab. But yet the culture of medicine makes you think that you should know everything at all times and if you admit to not knowing, you are admitting to being a sub-standard medical student / future doctor / human. So as I nurse I witnessed loads of medical students pretending to know how to do something and not asking for help or not admitting they hadn't a clue.

It is scary that even as students we are afraid to admit we don't know, admit when we need help, or admit we're in over our heads.  What happens when we grow up to become real doctors?

*Shudder*

I know there is a fine line between looking incompetent and looking like someone who might have a clue, and clearly everyone would rather be in the latter category. But I can honestly say that in the past when I've admitted that I didn't know something in similar situations the person is usually happy to explain or demonstrate (passive-aggressive bullies, aside). In fact, afterwards (again, passive-aggressive bullies aside) the teacher generally trusts you more because they've seen that you're willing to admit your shortcomings, i.e. that you are safe.

I fear that many more botched vaginal exams will occur before medicine accepts learning and ignorance as part of medical education. In the meantime, confidence face?




Monday, February 20, 2012

When Nerds Bake or My Version of a Rorschach

Or Rawscone test, if you will...

Question:

When you see this photo of dough about to go in the oven what is the first thing that comes to mind?



a) mmm....scones
b) cardiac axis
c) the apocalypse
d) pink bunnies


Results:

If you answered 'a' you are a normal, high functioning person in society.
If you answered 'b' you are either in medical school or residency.
If you answered 'c' you ought to seek professional help from someone who has completed 'b'.
If you answered 'd' you are probably taking pills given to you by someone who has completed 'b' or someone who sells things in back alleys.  



Thursday, February 9, 2012

Slippery Slope

So I've just accepted my first handful of samples from a drug rep.

I shamelessly asked for them (to take myself) and he obliged.

Is this the start of a long and amoral love affair with pharmaceutical reps?

Perhaps.

(For the record, it was vitamin D and also for the record I think the stuff should be mega-dosed into the water table. Just sayin'.)


Wednesday, February 8, 2012

The Heart of Inspiration


Below is the combination of several pieces that I've written about my granddad and the story of his lectures which were given to me this past summer. I wanted to post this version, which I recently submitted for a school project. I think that (finally) this tells the whole story in the way that I wanted. Apologies to my frequent readers who are probably tired of hearing me harp on about all of this. 

I thought the timing was interesting, as this is another week where I've needed some major inspiration to keep my head up. 

--


My Beginning

I remember the exact moment that I decided to become a doctor. I was seven years old and standing in the front pew at my granddad’s funeral. I had been listening, really listening, to what the mourners in that packed church had to say. Granddad was a doctor. The eulogists spoke of his wisdom, generosity, and kindness. I heard references to his medical innovation, his skill as a physician, and his dedication to patients. Throughout the speeches there were murmurs and nodding of heads, dabbing of eyes. I was mesmerized by the sea of stricken faces behind me, feeling the powerful impact his life had had on all of these people. I saw very clearly a glimpse of what a meaningful life looked like, the legacy that was left behind. I knew I wanted to leave a similar mark on the world and I remember determining, in my seven-year-old mind, that like my grandfather, I would be a doctor.

Long Before That

My granddad, Russ Taylor, fought in WWII. For his service as a navigator in the Royal Canadian Air Force, he was granted free tuition in the university and program of his choice.  As a fifteen-year-old Russ had heard Norman Bethune, famous humanitarian and champion of universal medicine, speak at his high school.  From that time on Russ had wanted to study medicine. But the Taylors were a farm family with six children so Russ had attended normal school to become a teacher. And as well, in a part-time job his hand had been deformed in a printing press.  He never imagined that because of the war his dream would be realized.

For his post-war training Russ chose biochemistry and medicine at McGill and went on to become, first, a legendary rural family doctor and eventually a polio expert. He was on the team of physicians who brought the first iron lung to Canada. In his forties Russ studied internal medicine and then specialized in cardiology.  After further training at McGill he returned to set up the first Cardiac Care Unit (CCU) in Alberta.

Even after being diagnosed with cancer Russ Taylor continued to work in cardiology, still visiting his long-surviving polio patients.  In his last months he wrote an account of the polio epidemic for the university and he was working on a cardiology textbook when he died. The cardiac ICU at the University of Alberta hospital is named the Russell F. Taylor ward in his honor.

It almost feels wrong to extol the virtues and accomplishments of this truly humble man who was never comfortable with praise. Because I was a child when he died most of my knowledge of him is second-hand. I have only a handful of my own memories… watching  him play the piano, sitting with my head on his chest listening to his mechanical heart valve (consequence of childhood rheumatic fever), sharing scrambled eggs with him in the morning before he left for ward rounds.  I also remember clearly that he was one of the few adults who spoke and listened to me with genuine interest and delight… with respect for my personhood.

 All of my life I've been steeped in stories of his astounding medical career, his profound love of medicine, his intelligence, insatiable curiosity, and his interest in the world around him. Each of these stories is locked in my memory coupled with the sadness that I was never able to know him as a health care practitioner, myself. Sad that I could never hear his opinions on certain procedures, ethical dilemmas, learn what he loved about medicine, or find out what frustrated him. Ultimately, I feel cheated that I never was able to have him as a mentor. Others have often described him to me as the 'greatest teacher and mentor' and yet I never had the opportunity to learn from him.

My Granddad’s Voice

In the spring of 2011 my mother woke up one night thinking about a couple who been good friends of my Granddad’s, Dora and Richard Lam.  Dora had arrived in Canada as a young Chinese woman, to study at the Southern Alberta Institute of Technology in Calgary. After finishing her secretarial program she became my Granddad's medical secretary. Over time she and her husband, Richard, developed a close friendship with Granddad.  At that time Richard was a masters student trying to gain entry into medical school.

Knowing how much I valued learning more about my grandfather’s life, my mother set about trying to find the Lams in the hope I could someday meet them.  And I did meet them.

It was the week before my writing of the USMLE. I was feeling guilty for taking a day off from cramming for the exam, but at the same time I was looking forward with delight to meeting them and gleaning a few more details to add to the mental portrait I have of Granddad.  It makes me feel somehow closer to him when I hear about him from people whose lives he touched.

According to Richard, it was my Granddad's letter of reference that got him into medical school. His interviewer commented on the weight that a recommendation from Dr. Russ Taylor carried. Dora claims my Granddad was very much like a father to her, and that she would never have become a "damn good lawyer" if it hadn't been for his continuous support and encouragement. When people with tears welling up in their eyes tell you things, you simply have to believe that they are telling the truth.

At one point during our lunch, Dora pulled out a small bag that she had brought in with her.  She told me it was something that she'd kept for the past 30 years, through three residential moves…something she wanted me to have. Even before she pulled out the contents I felt my pulse quicken. "This is going to be a treasure," I thought. It didn't matter what it was...whether it was going to be an old pager, or a chart he had signed, a fountain pen...anything. I couldn't wait to see what the gift was.

Dora handed me a collection of audio tapes. All the hours of my Granddad's cardiology lectures to 3rd year medical students.

She had been the one who typed up the manuscripts for him, and she had kept the old reel-to-reel tapes in a box in her basement. "These are his lectures on cardiology and his notes for the cardiology textbook that he was working on. I could never bring myself to throw them away. And now I know why,” she told me.

I was overcome with emotion.

All my life, all my adult life I have wished that I could hear my granddad speak to me about medicine.  And now that would happen. I couldn't contain myself. The tears poured down my cheeks. There in the trendy restaurant with a handful of photographs on the table and an empty coffee cup to stare into, I could not wrap my head around it. There in the final week of a very challenging year, studying for a terrifying exam, feeling completely over my head, second guessing myself at every turn…at that moment my Granddad's actual voice was given to me.

It was the boost I needed. Granddad speaking to me across the years, reaching me through people whom he loved. Talking with the Lams about their careers and about Dr. Taylor’s vocation for medicine gave me an immeasurable dose of determination and renewed my understanding of why I chose this path. It was not only because he was great physician, but because I could see how his example and his legacy continues to move and inspire others to meet challenges and make contributions.

I have finally been able to listen to my grandfather’s voice, the sound of which I had forgotten. I hear him talk about his passion, about something that inspired awe in him…Medicine.   

CBC

The radio show, White Coat, Black Art is a national program hosted by Dr. Brian Goldman, which airs on the Canadian Broadcast Corporation (CBC) twice weekly. Dr. Goldman is an emergency physician and best-selling author, and one of my medical heroes. I was thrilled when he contacted me last summer and asked me to appear on the show, for a piece they were doing on nurse and physician communication styles. When his producer asked me if I’d like to contribute again to the show I knew what I wanted to do. I wanted to bring the story of these tapes to life and create a radio piece with excerpts from the lectures.

When the show entitled Inspiration aired on Christmas Eve, it was very well received. A former RN who had worked with Dr. Taylor heard the show and emailed the host to say how much she had enjoyed being a colleague of Russ Taylor’s for years on the CCU. It was also a delight for our family to hear him over the radio waves after all these years… the sound of his voice rousing memories.

My Granddad loved listening to CBC, often sitting in his car in front of the house to hear the end of a program before coming in from a house call, or in later years retreating to his study to listen to a program on his old radio. It was a strange and wonderful gift exchanged between us…these tapes with his voice and my voice responding to them through the radio show. But the lasting gift was to me from him…a reminder of who set me on this path, why I chose it, and how I’ll carry on. Rededicated to my childhood ambition of twenty-five years ago… I will be a doctor.


Thursday, February 2, 2012

Life One Liner

(I know this is supposed to be a medically related blog but lately it is more like a this is what I am eating and doing in my free time blog. Apologies. The heart-wrenching and hilarious moments of my emergency nursing days are long gone and I am starting to feel like a broken record of worn-out anecdotes. Also, I'm working like a fiend to finish up my research project and special study module as I hope to do an elective in March. I want to be able to leave the country knowing all my little scholastic ducks are in a row and life is organized. A very non-ABB behavior pattern. Usually when I leave the country there is a dizzying storm of clothes, textbooks, toothbrushes, running shoes, papers, granola bars, open luggage, garbage bags, and USB cables around me for 2-3 days...and then *POOF* I disappear. I swear this time, that shall not be. As a result I fear Asystole is not getting the attention it deserves. Hence, blogger guilt. It's like mommy guilt without the cereal in the hair and spit-up on the shoulder.)

Dr. Joe is on annual leave this week so I sat in with one of the other GP's in the practice, I thought I should branch out in his absence. Everyone here is lovely, though I must admit that I miss Dr. Joe's Prairie Home Companion version of social histories. During one of the consults the patient was talking about the age ranges of her four children, aged 6 - 13.  I thought she summarized things so brilliantly, "Ah sure, in my house there is everything from Santa Claus to maxi-pads". What a perfect slice of life. That is one of the things I miss about bedside nursing, the little glimpses into people's lives, scenes I could collect in a shift.

It got me thinking, what would my one-liner of life be right now?

It's all...tupperware and textbooks?

...Band-aids and backpacks?


...practice tests and data tables?


...scones and stethoscopes?


...residency worries and vitamin D supplements?


...bad skype connections and emotional eating? 


Dunno. All of the above I suppose. What is your one-liner these days?




Thursday, January 26, 2012

When Alcohol Should Be Taken Before Exercise: a.k.a Zumba

I was lured into my first zumba class by my eternally optimistic and anti-weightlifting roommate last week. I used to snobbily chortle at the aerobics classes last year in the University gym and vowed never to attend such a fitness monstrosity. I figured zumba must be something completely different...

For those of you who haven't attended a class yet, I'll ruin the surprise: zumba is nothing more than an aerobics class to Latin dance music.

And it doesn't look anything like this:

No, it is more like this:

Which is awesome, actually, because I'd be way too scared an un-glam enough to go to the top class anyway. But the whole experience has been a bit of a disappointment, in myself. I like to think I have rhythm and maybe even some sweet dance moves. Turns out, I have neither. I took highland dancing as a kid which is a very regimented, precise type of choreography. Zumba requires hip gyrating, booty shaking, arm twirling, and general freedom of movement. Possibly some sexiness as well. I am incapable of shaking my money maker with abandon, especially when that money maker is in lycra and not in the gin and tonics. 

Dear Margaret (roommie) and I agreed that we'd probably crush the dance floor if only we arrived a litte tipsy one day. Then we felt like that agreement made us sound like alcoholics. Then we questioned if drink only made us think we were good dancers or if it truly loosened us up enough to display our Jennifer Grey type skills. Either way I think my Irish heritage shows itself well amongst my fellow wooden, self conscious, antitheses of sexy, arhythmic, fair sisters. 

The bottom line, however, is I am sweating and laughing at the end. And possibly expanding my (already killer, right?) repertoire for my next big night out. Which is more than I can say my nemesis The Treadmill can offer!

Zumba, I misjudged you and your aerobic-class self.

Thursday, January 5, 2012

Scenes From A (gastronomical) Canadian Winter Holiday

I've been rather unplugged the last few weeks, in the wintery wilds of Québec. My slothful existence has mostly starred red flannel snowflake pajamas, a reading chair, exquisite food and drink, late mornings, a stack of books, my mother, Tobie, his family, strong coffee, a grand piano, and a few brief appearances by friends (that means you, Liz, Lisa, and Not House!)

Other than my uninterrupted, daily rumination on what will I be when I grow up, will I ever get accepted in a Canadian residency, and how can I somehow turn lead into gold to pay next year's tuition...I threw medicine on the back burner and let other areas of my life simmer. It's been great.

Shortly after my arrival in Québec, Tobie and I swept the car off and made our way to Montréal.

When we were car-less, job-less, penny-less and living in residence 2 years ago, we'd sometimes go on imaginary dates in Canada, pretending our purple comforter was a magic blanket that would take us anywhere. We would try to outdo one another with elaborate descriptions of these dream dates. Montréal was a frequent destination when Tobie was choosing the city. We took our magic comforter to go Christmas shopping at Simon's after a crammed lunch at Schwartz's deli. Then we'd walk the dark and snowy streets looking for a quiet place to duck in for some nice wine or sugary treat. After that, it was a chilly ride back across the Atlantic.

Finally, this year we were able to live some of our magic carpet dreams. And probably shorten our lifespans a little in the process. (Apologies for the double photo posting, but until more than 10% of you look at my tumblr account, I won't feel too bad...)

I give you the lean smoked meat sandwich at Schwartz's.


 Belly up, boys! Take a moment to imagine pure deli chaos: the clink of dishware, the holler of orders, scrape of chairs, splash of fries into the oil, murmurs of 'mmm', the ring of the cash register, the smell of spiced and cured meats, salty pickles, and cherry soda. There, you have it now.


I call this photo of Tobie below, "Quintessentially Canadian".  Next to that is Perside, his sister, presenting her Jaime Oliver turkey recipe extravaganza. This was Christmas dinner, when I ate until I developed an upper right quadrant cramp. Similar to a running stitch, only this one was from eating instead.


Below is the classic 'driving home from Christmas dinner' scene. I miss being five years old, falling asleep during the ride home, having mom carrying me (while I pretended to be asleep) into the house, and being put to bed. These days it'd be an improbable feat of superhuman strength for Tobie to haul my somnolent butt out of the car, coat and all, to tuck me in.

Me proving that yoga can indeed be done in yoga jeans. Tobie reading a rag while we were waiting for our table at La Paryse. Seriously, seriously great burgers. The poppy seed bun is well worth the risk of post-meal embarrassment.

Below we are back at Schwartz's for more smoked meat love, this time with my momma-bear. She was fresh off the plane and ready for a week of gastronomical delights, including our own 'food tour' of Montréal. We all should have worn jogging suits for the trip. Not because we were jogging, but because elastic waistbands would have suited our needs a little better. Mind you, we did stand outside in -20 degree Celsius weather for over 20 mins waiting in line and shivering does burn calories. Oh yes it does. Pretty sure my lips were frozen onto my teeth in this photo.

Dinner that night at DNA. OK people, take your bucket lists out now and add, Eat At DNA in Montréal.

No, I am not getting any kickbacks for the endorsement (I wish!) I just need to convey that this was one of the most fabulous nights of dining I can remember. You need to experience this place before you die. Period.

Momma-bear had the lamb (on the left), Tobie and I had the suckling pork loin, slow cooked for 7h and then topped with salsa verde, sweet spaghetti squash, and some pureed goodness that tasted like possibly butternut squash and apple. The photos poorly represent the outstanding presentation, but it was the best I could do.


Tobie tucks in. 


The dessert was no disappointment either. 

Tobie and MB had the lime-tart (I was thinking, lime tart? What, are we eating at a hospital cafeteria in the 1950's??) But the joke was on me because the lime tart should have been called, 11 Minutes of Uninterrupted Eating Bliss involving light and (quite) sharp lime, tempered with soft, fluffy whipped cream, and a crust that would make most pastry chefs weep.

The New York cheesecake was no slouch, topped with their house-made rhubarb jam and a wafer of almond and caramel. And by no slouch I mean that it was the 'Goldilocks and Three Bears' of cheesecake--not too heavy, not too light, not too cheesy, not too bland. Juuuuuuuust right.

Not only was the food brilliant, the decor was very chic in an unpretentious way, as were the house staff. They cure their own meats in the basement and sell house-made pickles, jams, chutneys. All ingredients are locally sourced and seasonal. WIN!

After dinner we cabbed our way over to Pullman wine bar and took in the people watching, deliciously fermented grapes, and their funky atmosphere which included a chandelier of inverted glasses.
















Then we returned to the hotel, drank some water, and went to bed.

Just so you don't think we're food snobs, I'd like to direct your attention to the place-setting at the restaurant where we ate dinner the following evening. Let's just also mention that the walls were wood paneled, the waitress was passive-aggressive, no, just straight-up aggressive, and all meals came with white buns and gravy. 'Nuff said.
This is what happens when Tobie chooses the restaurant.
New Year's Eve heralded the invention of a new cocktail (see my recipe posted here), more homemade gourmet feasting (courtesy of Tobie's phenomenal sister), watching fireworks from the living room window, and drinking herbal tea while discussing novels with my mother. It was all very serene. 

Speaking of serene have you ever seen how pretty a preserved hibiscus flower is when it is sitting in a little puddle of gin?  Feast your eyes.


Also, when was the last time you had a drink mixed for you by a blogger in a solar system blouse? Too long ago I bet, too long ago.


And so, another year came to a close. The last few days of my holiday were spent trying to fit into my clothes, packing, and saying goodbye to my near and dear ones. I'm so grateful to have had the opportunity to unwind a little. I know this will be the last long Christmas holiday that I will have for years, which is why only a small dose of daily guilt for my slovenly and sub-academic behavior crept into my awareness.

I'm hoping that 2012 will bring new recipes and races, great reads, light westerly winds, mentorship, adventure, and a few surprises...good surprises. And of course the answer to some of my questions...

Here's to you, 2012, whatever you will be.

Cheers!

Thursday, December 15, 2011

Circular Conversations at Customs

There happened to be a good friend from school on my flight from Newark to Ottawa yesterday. We didn't plan it that way but we were pleased to have some catch-up time throughout the cab-rides and layovers. Naturally we were chatting while waiting in the customs line, until I approached the weedy French Canadian with a friendly, "good afternoon". His blonde hair was shaved to the nub, and he had an expression on his face that said I'd rather be wearing mirrored aviators...

He responded to my greeting with, "who is that you are traveling with?"

Uh, I am traveling alone.

Alone?

Yes, alone.

Who was that guy you were talking to then?

Um, a friend, but we aren't traveling together. [What are you, a jealous boyfriend??]

You are on a flight together but not traveling together, hey?

Yes, I bought my ticket separately, we live in different towns...er...I know him from some classes we took together.  [Confused and now flustered at this strange line of questioning, I think I probably sound like a drug smuggler].

Where do you live then?

I live in Small Town Ireland.

And where do you go to school?

At University in Ireland.

And what are these classes? [Smirking like I am about to say, 'nude sculpting']

Um...medicine classes? [Am I a complete imbecile? When have I ever described my education as 'medicine classes??'] 

What are you studying at University of Ireland?

Oh right, medicine, I am studying medicine. I am a medical student. [The lady doth say 'medicine' too much, methinks...]

And you are in Canada for just 25 days then?

Yes. [Hello, I am a Canadian citizen I can be in Canada for as MANY BLOODY DAYS AS I WANT!!!]

He tosses my passport onto the desk and motions to next person in line. I collect my luggage and walk through gate to see Tobie's smiling face. Until we reach the safe confines of his car my head continues to dart around waiting for customs to taser me or demand a bag / body search.

What is it with these uniformed misanthropists? Is it that their job is so bad that they feel the need to be acrimonious power-trippers? Are they actually not allowed to smile, or be polite, engage in socially acceptable forms of communication? I was so annoyed, wishing I could delete the whole welcome home to Canada experience.

The great part is I am home. Sorta. At least I am in the motherland, where the "hot" and "cold" tap are one, my 'accent' doesn't attract attention, and soy milk comes in more than one brand / flavor.

Oh, Canada...you complete me. [Sighs]



Monday, December 12, 2011

The Apples Do Not Fall...

In a complete blog non-sequitar I'd like to present a post by one of my good friends, Ryan. It's like cute overload if you're into children and skiing.

It made me laugh at least.

Oh how I miss Revelstoke, and the great people there (and killer skiing)!

Sunday, November 27, 2011

No Pressure

"So the patient has been temporarily paralyzed by the drugs, and you're the one keeping them alive by squeezing air into their lungs...but...no pressure".

Gulp. 

I was holding the mask as tightly against her face as I could, sealing the rubber to her cheeks in the effort to keep highly oxygenated air from leaking out. Looking down at her from the head of the bed I saw the patient from a different vantage point, a place that made her look so vulnerable.

And she was vulnerable.

A few minutes prior to closing her eyes she had been nervously chatting and laughing away as we prepared her for surgery. The dose of propofol and the inhaled sedatives smoothed her face and left her body limp. Now we had injected medication into her intravenous line to paralyze her. Once her muscles were relaxed we could slide a tube down her throat and into the trachea, providing the means to ensure that her airway would remain open and her lungs could be well ventilated with oxygen during the surgery.

I removed the mask to prepare for the intubation. Her skin was pale, the freckles standing out now that the nervous blush had faded from her cheeks and neck. She was perfectly still and we were moving into action. 

It struck me then how explicitly patients trust their doctors and nurses. Of course I have always understood this as a general concept in healthcare but this was suddenly a much more concrete example. Patients literally put their lives in our hands on a daily basis.

Why have I never said to a patient, "Thank you for trusting me with your most precious possession"? Why has a patient never said to me, "Please do not be hurried, or harried, distracted or inattentive, because today you are responsible for my survival"?

I suppose these are silent agreements and understandings that we have in all of our patient interactions. Yet the fact that we don't outwardly acknowledge these understandings means that maybe we've forgotten that at the core, it is an honor to be in this role. I'm not so unrealistic to think that one is thankful when the bleep goes off for the 47th time on a Christmas eve night shift...but I hope that at the end of the day when I am bone tired and flopped-out on the couch in the call room I'll remember this, and take even just a tiny measure of satisfaction from the honor of responsibility. 

No pressure.

Thursday, November 17, 2011

Engrossed

I don't know where to begin talking about "And the Band Played On" by Schiltz.

I've been wanting to read it since I had the unique opportunity to hear Dr. Paul Gallo speak 2 years ago at the University. Of course, I am only now beginning to grasp his role in the discovery of HIV and how he stood at the epicenter of an extraordinary time in medical science.

At the risk of sounding laughably naive, I never thought of how powerfully the politics of the time and society's value judgements facilitated the development of the AIDS epidemic. I hadn't considered the blatant discrimination displayed against gays by the lack of alarm and media coverage. How one of the first news stories to appear about the epidemic was only when a woman had contracted the disease...suddenly it was a story only when someone other than a homosexual man was sick. As I write this I shake my head at how stupid I sound. Of course politics and conservative beliefs played a huge role in the pathetic response by agencies like the CDC and the NIH. Of course. I just hadn't considered all these angles to the issue before.

But still, it boggles my mind. And it saddens me so deeply to learn how many lives could have been spared if only things had been handled more efficiently and more aggressively by people in power--from government agencies to gay leaders. I temper this statement only by saying that I know how easy it is to judge through the lens of the retrospectoscope.

And yet it is also enthralling to read about a time in medical science when clinicians and researchers were scrambling to put together this puzzle with seemingly random pieces. Some patients had toxoplasmosis, others had PCP, some thrush, many Kaposi's sarcoma...no wonder if took time for people to figure out this was one disease with so many faces. Even the concept of determining that it was an infectious disease...when many thought it came from a bad batch of 'poppers', inhaled nitrites.

I am just over half way through the book and already it has made me frustrated, angry, inspired, impressed and very, very sad. What would it have been like to be a nurse or doctor in San Fransisco in 1982 when we didn't know how the disease was transmitted? Let alone, what it would have been like to be a gay man in the same place at the same time? It is chilling to go there in one's mind.

I grew up knowing AIDS only as something famous people did fundraisers for, then as a rare disease I might encounter as a nurse, to a collection of the faces of AIDS patients I did care for. Then it was a complex subject I needed to memorize for the USMLE, and now to this...something I really know nothing about at all.

This book has certainly opened my eyes and heavied my heart.