Showing posts with label YIKES. Show all posts
Showing posts with label YIKES. Show all posts

Monday, March 25, 2013

Insert Foot

I was in outpatient clinic recently when I called a patient in from the hall. He was awkwardly positioned in a wheelchair, looked to be in about his mid 50's, with thick brown hair neatly combed back, smartly dressed in a tie and sweater. An elderly woman wearing thick support stockings, polyester skirt and heavy woolen shawls pushed the man into my office.

I introduced myself and said hello to the man, then said to the elderly woman, "and you must be his mother?"

Now I can hear you all cringing and possibly yelling, "NOOOOooooooooooo" at the computer screen. Well as Mike Birbiglia would say,

I know....I am in the future too!!!!

See the thing is, I learned long ago never to assign relationship speculations during interactions with patients! In the emergency department I've often been surprised to discover that the young woman wearing the leather dress, knitting beside the stretcher of an elderly man isn't his daughter / girlfriend / caregiver / niece but is in fact his surrogate mother / Wiccan priestess / life coach / financial advisor.

So I don't know what was wrong with me when I said that, but the elderly woman quickly jumped in to correct me with,

I am NOT his mother, I am his WIFE. I know taking care of him has worn me down but COME ON!

Oh dear. So I apologized and attempted to carry on with the consultation. I was actually surprised that I didn't lose my composure completely. Suppose being berated for years as a basketball referee and then a triage nurse has helped me stay calm when the waters of communication get choppy.

But rather than let it go she kept bringing it up.

At one point she asked me about my "American accent" and I said, "Yeah, actually I am Canadian" to which she replied, "I know, I just said that to annoy you considering what you said to me earlier".  I was mortified. It was awful. Lesson, re-learned.

This is what medical school has done to me! All of my healthcare street smarts have been replaced with useless lists of things like the rare causes of secondary hyperparathyroidism! Thankfully I will be back in the real world soon.



 

Monday, February 11, 2013

Gathering Thoughts and Dirty Laundry

I am a horrible blogger these days, I know.

It has been an absolutely wild ride recently. I have spent the last 3 weeks on the interview trail, living out of my suitcase, in rental cars, spare rooms, hotel suites. I am back in Ireland, on a nephrology rotation, and pseudo-homeless (as in, I have been looking for a place to live since I returned a few days ago).

I have a week to decide what I want to do with the rest of my life (and where I want to live for possibly the next 10 years). Yes, in one week I am submitting my rank order list. It is basically a wish list, in order of preference, of where I want to do my post graduate training. 

So once I've officially unpacked, set up my internet, done some soul searching, eaten some non-restaurant food, had some exercise and a full 6h of uninterrupted sleep...I will write an actual post.

In the meantime know that I am alive, wrestling with a major life decision and an ever expanding pile of dirty laundry.

Sunday, December 9, 2012

Waiting

Time...goes...by...so....slowly! So...slowly!
Hey, so have I mentioned that 'tis the season of CaRMS, interview offers, interviews? Yes, OK, probably once or twice.

Whaaaaattttt? You are tired of seeing the word CaRMS?

Believe me, so am I. My apologies. It is just that right now, whenever the constant chatter in my brain stops to take a breath, the word CARMS appears and I descend into one of my thought spirals of:

what if I don't get any interviews?
what if I get loads of interviews for jobs I really want?
what if I have interviews during my surgery elective in Ontario?
what if I don't get a job next year in Canada or Ireland?
how am I going to start paying off my suffocating debt?
am I going to work as a nurse next year?
do these flannel Christmas pajamas make my bum look big?

and so on... 

Ack! Waiting!!! 

“...of all the hardships a person had to face none was more punishing than the simple act of waiting.” -Hosseini

Tuesday, December 4, 2012

File Review Starts Today!

Dearest Readers,

Today all of the programs start reviewing the mountain of applications for residency positions. That means that today is when the "Yes!" and "Hell NO!" piles are made. On average each IMG seat has >100 applicants vying for an interview. The programs typically give about 3-8 interviews per position. I'm no mathematician but those odds are not ideal, to say the least.

So, as of now I ask that you cross your fingers, and all other paired appendages for me (ok, well not all...I do want you to keep your gonads) . If you're a praying person, throw up a few prayers. If you're a wiccan / pagan / animalist scatter some ground up chewable aspirin into the wind while chanting "grant ABB an interview".  

It's exciting, and frightening, and nerve wracking all at the same time. Pretty sure that is why I woke up with a gut ache this morning. Or maybe that was secondary to the paroxysmal coughing fits I was suffering all night (upside to coughing fits--sore abs! See post below).

I do take small comfort in knowing that up to this point in my medical career I did absolutely everything that I could, with every fiber of my being, to succeed at this stage. If I don't get a residency in Canada, well...I've got plan B and C simmering away on the backburner.

Alea iacta est. The dye is cast.

I am trying to let go and know that wherever I end up is absolutely where I am meant to be, even though it may not be where I think I ought to go. But I am still allowed to hope for certain things. Right?

Thursday, November 1, 2012

CaRMS Chest Pain

You know that feeling you get when you realize you may have made a major, life plan threatening mistake? When, in an instant you feel the blood drain from your face and limbs, and your stomach takes up residence in the back of your throat?

Yeah. I had one of those recently.

I was calmly working away at CaRMS, putting in all of my volunteer, work, clinical experience. Filling in dates, ticking boxes, clicking on drop-down menus. It was Saturday night at around 1am and I was starting to get very tired, losing my ability to focus. But I was buzzing from reading program descriptions and fantasizing about where I might be a year from now. So I kept on a little longer than I probably should have.

I wanted to finish this last section and then go to bed. I came to the program selection area and when I saw the big shiny "SUBMIT" button I figured it was just with regards to payment (my application far from being finished).

So I hit "SUBMIT" and then realised that I had, in fact, made a very large mistake. My body was instantly unsure of how to contain it's fluids. Sweat soaked my shirt, then I nearly vomited and peed myself at the same time.

In my mind I saw myself spending 2013-2014 with a micropipette in some dimly lit lab, tucked away under a hospital stairwell somewhere. Hiding from both the bank and my mother. I then remembered hearing stories of people who didn't match due to clerical errors, and those who missed a form here, a deadline there. I saw myself becoming a CaRMS urban legend.

I frantically sent a FB message to my friend Rob who went through this process last year, I think the word "crisis" may have been heavily overused.

Robert say, "nothing you can't fix". Grasshopper calm down.

He may look like a normal guy, but he's actually a little CaRMS Confucius. An Online Residency Application Oracle. Despite being on the drive home from a shift in Detroit he kindly messaged me back and called me as soon as he got in, talked me down from my window ledge and explained that all was not lost. I actually think I would have gone crazy if I'd had to wait until Monday at 0900h EST to call the helpdesk. By about 0300h my breathing had retured to my lung bases, gastro and urinary symptoms had disappeared and my tremor had resolved. It's nice to have 24h free support line!! So thaaaannnnnnnkkkkksssssss ROB!!!! (He is one of the 10 of you that hasn't given up on the blog!)

Oh I cannot wait to have this all finished and to start finding out about interviews.....eeeeeeeeeep!

Back to the land of tick boxes and drop down menu. Tedium, thy name is residency applications!!

Sunday, October 28, 2012

My Achilles is Actually My Heel

I have problems with my feet.

If you are a long-time reader you may recall "Uncle Fester" from my Himalayan trip training days...or my Summer of Cellulitis last year thanks to a hike in the eastern Reeks..Well it appears that the hills of Ireland have once again bitten me (okay, it was actually my new fell running shoes...)


Ahh, nice views, nice spot for lunch...say, I love my new shoes!


La la la ridge running so fun, these shoes are so great! Mud claw's forevveeerrrrrrrr!!!


I may vomit if I have to put a shoe on ever again. 

Wednesday, August 29, 2012

Lust in Translation

I was told last week by my attending that having a medical student sit in on consultations all day was "a bit like having a hitch hiker in the car". That it made him feel slightly self conscious and ill at ease. I thought this was a rather hilarious analogy and so I repeated it to my new attending this week.

He too found it amusing. 

At the end of the day I was saying thank you and going on my merry way and down the hall I called out, "thanks for giving me a ride all afternoon" in reference to the hitch hiker statement. He was smiling and waving and then abruptly stopped with a strange and slightly embarrassed look on his face. 

Yeah. Then it clicked. I've made this mistake before. 

Ride in Ireland = Sex. 

Smooth, ABB. Really, smooth. 

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?)

Saturday, May 26, 2012

Heaven and Hell

Survived third year!! A brief montage and summary of the past week. 

Monday was the long answer written exam (3h, 10 questions) and the extended matching exam (150 questions). I know some people run marathons without food, and most people write exams without food. I could not imagine either. When my blood sugar gets low (i.e. below 6) I get hangry and my brain function ceases. I was certainly not taking chances with finals. Photo below was taken with my sweaty pre-exam hands before we were strip searched for electronics.


After the incredulous feelings of did they really have an immunization schedule long answer question? along with seriously? gynecology emergencies? dissipated, Margaret and I noted that the sun was shining outside and we had two days of studying still ahead of us. 


So we took something beautiful (her parent's backyard)...and made it ugly.


We spent Tuesday and Thursday hammering for the clinical exams. 

 It has been so long since I've had to use sunscreen I thought I ought to take a photo. 

One of the really stressful things about the clinical exams is that they were a different format than the previous 2 years, where we had OSCE's. This year our long case was a patient with real pathology who we had 30 mins to examine and take a history from (the cases ranged from things like a post-op orthopedics case to diabetes). Then the examiners questioned us for 20 mins. 

My patient was a good historian and had a very straightforward presentation which I had prepared well for. I am usually rubbish at presenting (you have to be detail oriented and well-organized) but somehow the planets aligned and I actually did my best case presentation ever! What are the odds? 
There were no questions that stumped me and the absolute best part was after the examiners walked out I turned to the patient and she said to me I hope I am never in the hospital again, but if I am I really hope you are my doctor! I was completely bowled over and honored. 

The short cases went quite well too. They were all very barn-door spot diagnoses and exams. Though I did manage to stutter out some random statements and completely forget basic things (which I would never forget in an actual hospital, i.e taking a blood pressure from a patient in atrial fibrillation). Yeesh. The highlight was one of my surgical case patients yelling to the examiners as they left the room GIVE HER AN A.  
Awesome and awkward. 

So there you have it. Third year, done and dusted. I also just received some rather big news. But that deserves its own post. Heh. A little suspense to keep all of you coming back. In the meantime, it is sleep time. Sweet, sweet sleep.


Monday, May 7, 2012

Welcome To the Jungle - 2012

Things are starting to pick up momentum here on the wild west coast of Ireland. Exams are exactly two short weeks away (eep, why I am I still typing this blog post instead of memorizing differentials for fatigue??)

A brief look at life for the next few months:

May
-exams
-pack up house
-move things / car into storage
-fly home

June
-start pediatric emergency elective in Alberta (4 weeks)

July
-have a week 'off' (see below for what will actually be happening during 'off' days)
-start gastroenterology elective in Nova Scotia
-start CaRMS application process (Canadian post-graduate application)
-have 10 days holiday to study for MCCEE (Canadian board exam)
-fly back to Ireland, find place to live / move in / start psyche rotation

August
-study for boards while doing psyche rotation while working on CaRMS

September
**Canadian Board Exam**

October
-CaRMS and obs/gyne rotation

November
-Submit CaRMS
-collapse from exhaustion

December
-hit 'refresh' on email inbox until residency programs start emailing
-possibly decide that I'll stay across the Atlantic for post-graduate training

Just typing all of that gave me a facial tic. I may have to start playing this song everyday when I get out of bed.


 

Sunday, April 1, 2012

911 Call of the Night

We got the call from the ambulance, just before 2 am informing us that they were bringing in a man who'd called 911 for scabies.

Yes, that was his chief complaint. Which may win the "are you kidding me that you called an ambulance for that?" award.

The two night nurses debated on who would be the one to put the scabies cream on his back. The matter was settled by the ER doc putting a paper clip in one hand and letting the more senior RN choose which hand. She chose poorly.

We all itched and scratched for the rest of the night.

Downside...it cost taxpayers approximately $1000. Upside...the guy had a place to sleep and a change of clothing in the morning.

*Shudder* Image from here.

Saturday, February 11, 2012

Abort! Abort Mission!

My old roommate, Scott, and I used to have this secret hand gesture that we'd use at parties, called "the tap". If one of us was embroiled in a conversation that was giving us a rash we'd lightly tap on the underside of a table, beer can, ashtray, anything we could find. In our perfect, imaginary world you were actually tapping a small, invisible button that would do one of two things: either open a slide chute below that you could escape through, or activate a team of ninjas that would break through the windows, tumbling in, swinging on black rope.

The ninjas would surround you and then whisk you out of the room in a flurry of ninja-like moves. Either way you were freed from the shackles of painful small talk, irritating diatribes, drunken blathering, whathaveyou.

The other day I found myself reflexively tap...tap...tapping to no avail. The conversation went like this with a young fellow medical student...

Med Student: Why on earth would you go into medicine if you were a nurse? I mean, you already had a career, and a paycheck?

Me: Well, just because you are getting paid to do something doesn't mean you should keep doing that thing forever, right? Other things are required to feel fulfilled and happy in your career and life.  I was--

MS [cuts me off]: I mean I had no burning desire to do medicine, I just picked it based on a process of elimination, seemed like it'd be alright. But if I'd been a nurse already I'd never bother going into medicine!

This is the part where I had a flashback to all the money, blood, sweat, tears, and time that it took me to get into medical school. Then a quick roll call of some of the Canadians in my class who could say the same. Followed by all the people I know who are still trying to get into medicine.

Me: Er...[not really sure where to start]

MS: Did you do it because you could make more money as a doctor?

Me: It's really not a money thing [tap]...if I was doing something for money I wouldn't start by going $300 000 dollars in debt [tap]

MS: But you'll make tons of money once you're a doctor so it isn't really a big deal.

Me: tap....tap.....TAP.......TAPPPPPPPPPPPPPPPPP! Scott / Ninja's where are you when I need you??????





Sunday, January 29, 2012

Running

So I signed up for a 10 mile race in February. Figured I needed something to train for and wanted to do a race before I go away for my elective in March. For the record, I haven't run 10 miles since I was living in Revelstoke approximately 4 years ago. And I haven't really been running much lately, just short interval sessions, but no distance. Then I realised the race was in 2 weeks, panicked and registered for a 1/2 marathon trail race at the end of the month. Seems I felt like registering for races = training for races. 

The other twisted logic I recall having at the time was well, if I am running 10 miles on the 12th I might as well run 13 miles on the 26th. Again, there are some major holes in that line of reasoning. Especially if you can't actually do the former.

But then I think the little voice that makes sense piped up and said, you did a 4h and 38 min adventure race in November, how bad could only running for a couple of hours be??

And that was when the true value of thrashing my body all around for the Sea to Summit finally came to light. For the rest of my life I will have to compare all acts of athleticism to that day, and pretty much nothing is going to be that much of a challenge--so why not go for it?? Sweet.  Why not, indeed.

So today I tested the waters (or rather, the pavement) and went for a 10.8 mile run just to see if I could do it. And I could! (At the pace of anvil-dragging snails mind you, but determined anvil-dragging snails.) So maybe I won't die in the Irish countryside this February from a cardiac catastrophe. Hell, maybe I'll even enjoy myself!

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.

Sunday, January 15, 2012

Ding! Ding! Round Two.

Today I bought:

-Toronto Notes, 2011. Yes. All 1400 pages. I think it's officially in the lead as most expensive (135 Euro) and heaviest textbook of my collection. Yet it is light compared to the weight of worry which is post graduate training....dun....dun....dunnnnnn. It is basically the study guide for our Canadian boards, known as the "EE"'s because there are too many letters ahead of that, so even the acronym gets shortened.

I've held off until now because I thought it was a bit much in every sense of the word.  But, I've realised that if I don't get 99% on the EE's I'll either be staying in Ireland to train or working as an RN in Canada, with M.D. after my name. And almost half a mil of debt. Sub-awesome. So the Toronto Notes are now becoming my new BFF.

It's true though. The fourth years in my program have just found out their Canadian interview offers and two (of 13 Canadians applying to get back) didn't even get an interview. Nada. The shopping spree continues...

I also bought the kindle version of First Aid Cases for Step 2. Mostly just as a way to structure some of my studying using cases instead of just reams of multiple choice questions. Which brings me to my next purchase...

Access to the Canadian MCCEE's Question bank for the next 9 months.

And then I accidentally bought USMLE Secrets For Step 1 for my ipad kindle. Yeah. I already have written step one. I meant to buy step 2. [Hits head on self-assembled desk.]

After reading dozens of reviews on step 2 study guides I opted for Step Up to Step 2.  It will also be arriving shortly via the postman.

Then I bought some pens. You know the ones. Because there is a lot of writing looming on the horizon, and that writing is going to be done nicely in blue-black 0.3mm point style, dammit. We have the technology, people.



It's only a short matter of time until I also cave on a USMLE q-bank but I just can't decide on USMLE-World or Kaplan. Kaplan is cheaper (wow, I can't believe I just typed that phrase!) but everyone seems to say U-World is tougher and prepares you better. In the same way getting hit repeatedly with a hammer makes getting hit with a hockey stick almost seem gentle.

I need to give my visa some time to stop shaking before I use it again. It was an expensive day. I am not even allowing myself a mental tally at this stage.

As always, any thoughts, experiences, frustrations, or treasured methods of study for the EE's or step 2 welcome.

And so, round two of studying for a life-and-career-path-altering exam begins!! Ding! Ding!




Wednesday, November 9, 2011

Last Ride


2 days ago was my last training ride before the Big Race this weekend. It was an absolutely beautiful evening, only marred by the screaming of my leg muscles. I think the photo does not do the steep climb justice so I am including a screen shot from my GPS so you can appreciate that it actually is a hill and not just a meandering, gentle walking path from the nursing home. 

Note the lack of 'flat bits'.
Tonight I went on a short run, and for the first time in a long time it felt good. I suppose that is the main bonus for me: having something to train for means I'll train. Because I have to admit, I am not really looking forward to the weekend. I'm doing this because I want to see if I can finish it, but I'd be much happier if it didn't involve 8h of driving and staying in a hotel alone for two days (oh and killing myself on a crazy multi-sport course that will probably take me about 5-6 hours!)

The biggest joy for me about the triathlon in June was the fact that most of my family was involved. It was so fantastic to come across the finish line to big hugs from my sister, sister-in-law, bro, bro-in-law, niece, and nephews! It just feels weird that I'll be finishing and high-fiving myself (before collapsing in a twitching mess).

And speaking of high fives...I would not like to high five my body for how has changed in the last 10 weeks. I found my measuring tape a few days ago and thought it'd be interesting to see if my measurements have changed since I kicked s*it into high gear. Granted, the last time I measured myself was about a week before I went on my Himalayan trip and I was in decent shape then but...

First disappointment: 4 inches gone from chest. Buh-bye.
Second disappointment: no inches gone from thighs or butt.

SERIOUSLY BODY? Seriously???

Great, so now I have the upper body of a 10 year old newspaper delivery boy, and the lower body of a middle-aged Greco-Roman wrestler. That is sub-awesome.

Um...do these vertical stripes make my thighs look big?

Sunday, November 6, 2011

An Unexpected Test--Part III

And then I remembered…I was supposed to phone Paul when I got down. What if he heard about the rescue or saw the helicopter and thought it was me. He knew I was heading up alone…and my bike! (Now I know it might sound like a crass thought to have in an emergency but that bike is worth more than my car and heaven knows I’d never be able to afford a replacement.)

I asked one of Tina’s friends to take over c-spine for me while I called Paul and checked on Maggie again. Paul was stunned when I told him the situation, and said he had started to wonder what had happened to me. He offered to help in any way he could. I wasn’t sure how long the elderly Irishman was going to be selling walking sticks and watching my bike, so I asked Paul if he’d pick it up for me and then collect me later once the ordeal was over. He was happy to do so and I could breathe a little easier.

I resumed my post after a short jog on unsteady legs in an effort to get my body temperature up again. Tina was oscillating between drowsy silence and angry outbursts directed at the cold. We were all starting to shiver. I couldn’t remember a time when I’d been that cold. I’ve been outside during winter in the Arctic circle but I was always appropriately dressed for that. My cold sweat and thin jacket were a bad combination and at times my hands and body started shaking to the point where I wondered how effective my c-spine stabilization was.

Finally we heard the reassuring buzz of the approaching helicopter. The fog was so thick that only the sound alerted us to its descent nearby. Tina began to cry out with relief. Our huddle, which consisted of Father Henry, two teens, the Swiss couple, and myself, looked around at each other with relief on our faces. Relief that soon turned to concern as we heard the noise change and then grow quieter and quieter. Tina soon realized the helicopter was gone and started to cry.

Twice more our rescuers tried to land unsuccessfully. Each time our hopes rose with the crescendo of its approach and fell further as it drifted away again. I was getting genuinely worried now about hypothermia, for all of us. How cold did it have to get before the injured ones really started getting into trouble? Our little circle got tighter and tighter. After the helicopters 3rd failed attempt to land, another hiker coming down the mountain stopped to offer help. She immediately started pulling out extra pieces of clothing, hot coffee, and chocolate. She threw an extra coat over my shoulders and then sat behind me rubbing my back and arms in an effort to stop the shakes which were starting to take intermittent control of my body. As she pressed up against me she said, “I know I am getting into your personal space here, if I am annoying just tell me to go, but you really look like you need warming up…” I told her she was the farthest thing from annoying and that I was extremely grateful for the warmth she brought down with her.

Finally, the helicopter was able to drop a rescuer down nearby. Keith was a tall, stocky flight paramedic and he had with him two large bags filled with emergency medical supplies and outdoor protection gear. I gave him the best report I could from my initial surveys, and helped place a collar on Tina. We were able to wrap her in a thick, warm, bright orange emergency sack.  Soon many other rescuers were on the scene. I didn’t ever find out if they had arrived on foot or along with Keith when he was dropped off.  Someone, who I think was a doctor taking direction from Keith, took over c-spine. I asked the Swiss guy to pull my bent leg straight for me so I could stand.  My leg muscles had seized up and fallen asleep during the nearly three hours that I’d stayed almost motionless. It was a strange combination of sensations as I tried to negotiate the rocky terrain over to Maggie and the swarm of rescuers who surrounded her.  I knew the patients were in good hands and I suddenly felt like a supernumerary gawker. Where had all those bystanders come from? I approached Keith and told him I was planning to head down. He offered to give me a lift in the helicopter to the hospital. I thought for a moment how much I would love a spin down in the whirly bird but I felt like I needed to go sooner rather than later. He didn’t know how long the refueling would take and I didn’t know how much longer I could stay on the rocks. Not to mention that I’d long ago called Paul and told him ‘the helicopter is landing’ and then forgotten to update him with ‘and now it is gone’. He’d probably been waiting at the bottom for well over an hour.

I said goodbye to the rag-tag gang who I’d spent the afternoon with, wished the patients my best, and gave Keith my contact information.  Leaving the scene I took one last look at Maggie, getting rolled into the bright orange rescue blankets. The bruising on her face had started to look like raccoon eyes and I stiffened with the thought that maybe she did have a skull fracture after all…and that I hadn’t observed her close enough.  My next thought of course, was what could I have done differently if she was a skull fracture?

I started running down the mountain.

It felt so good to get moving again. My legs were rubbery and sore. Soon my body temperature started rising and the sweat started pouring. By the time I reached the bottom I was pulling off the extra layers and soaked again. I pulled open the door to the café at the bottom and spotted Paul reading at a table near the window. The teapot in front of him was empty. I sat down and began a litany of apologies for my lack of communication and keeping him waiting. He too apologized for the crazy afternoon of training that turned into a rescue off the mountain. He got up to buy me some tea and I went to the bathroom to wash my hands and face.

I looked like I’d been through the wars. Clothes damp from fog and perspiration, hair and eyes wild from the wind, lip cracked from nervous chewing. My attempts to make myself presentable to the café crowd were futile. I dried my face and hands with some toilet paper and went out to enjoy the hot tea and padded chair.

Epilogue

That evening, while I was driving home, Keith called to tell me they’d successfully airlifted one patient after the other, off Croagh Patrick. Maggie had gone second, and they’d left with her just after 1730h. He said both were stable and expected to do well. I thanked him for the call.

The next day Father Henry called me to say that Maggie had been released with a few stitches, and that Tina was expected to go home the next day. She had no broken bones, just a bad sprain, concussion, and a few head and facial cuts that required stitches. He thanked me profusely for my help. I felt somewhat sheepish because I didn’t really feel like I had done anything except stay with them. He told me that just being there and my reassurance that they weren’t doing anything to make the situation worse had been invaluable and extremely helpful.   

Two days ago I received a series of text messages from Tina, thanking me for my help, telling me how scared she was, and how she had been convinced that she was going to die.

I was very touched by the fact that all three people had endeavored to make contact with me and that they were so appreciative. It didn’t change the fact that I had felt helpless and useless during most of that afternoon on the mountain. But it was nice to think that in their eyes I’d made a difference.

I’d spent the 4h drive home going over the scenario in my head and thinking about all of the things that I should have done differently. I berated myself for things like not having thought of getting both of them off the cold ground right away, and not showing one of the people in Maggie’s group how to hold c-spine. All told, it was a very good learning experience. It showed me the power of reassurance, reminded me of my love for emergency situations, and reiterated the importance of never, ever, going out without a headlamp and an emergency blanket.

Thursday, October 20, 2011

Alright. Medicine, I misjudged you.

I am sure this will induce some smugness out there to you medicine-y people, so I will say it just this once: you were right.

Internal medicine isn't terrible. I have seen some really interesting cases and signs...water-hammer pulse, palpable heaves...murmurs, palsies, and masses oh my! DiGeorge syndrome, death, dementia, failure to cope, hyponatremia, acoustic neuroma. And that was just one patient!  (I'm kidding. Sort of.)

The other good thing about this rotation is it has definitely removed any lingering doubts that I want to go into surgery or acute care. Internal medicine is just not my cup of tea, which is a good thing know when you are someone like me who finds something of interest in everything I am exposed to.

In other news, training for my race is going...well, it is going. When I see what I am supposed to be able to do at this point (as per the schedule they gave us with registration) I get a little nervous. It is only three weeks away and I haven't been doing multi-sport training yet, mostly because I just don't have time to do a 3h cycle followed by a 1h run in one day. I've just been trying to get out at least 5x per week with one sport at a time. This is not really good enough but it is all I can do right now.

I have already given a heads up to my medical team that I may end up becoming one of our patient's on Nov 12th. I know the registrar will take good care of me, she's very smart.

And now I must return to my daily meditation on the kidney, the neuro exam, and all things cardiac.

Sunday, September 25, 2011

Another Charming Trend in Medicine


"IMG" means "International Medical Graduate". As in, anyone who studied medicine outside of Canada and wants to do post-graduate studies in Canada.

Did I mention there are 45 Canadians in my medical class alone?

Dare I delve into how many of those 6.5% matched to something other than internal or family medicine?

Hello, Ireland. Need a doctor?

Sunday, September 18, 2011

The Blasket Blast

Last week I was whining to Paddy (our surgical SHO) about the fact that my bike needed a tune up, M.C overheard and kindly offered to get it road worthy for me. From this, the topic of the Blasket Blast road ride came up. It is an organized bike ride that goes around the Dingle Peninsula, along some of the most breath taking scenery that this country has to offer. So M.C asks Paddy and I if we want to enter the event with him as he's going to be participating. In true ABB form, I agree without asking any questions (you know, shoot first, ask questions later). I either didn't hear that it was 150 kms or figured that he was exaggerating.

I forgot all about the discussion until a few days later when M.C informed me that he'd paid my registration. Paddy was out because he was on call and couldn't get anyone to switch (how hard he tried is unknown!) Right, so at that point I started asking for details because the longest road ride I've  done is ~70 km in Prince Rupert TWO SUMMERS AGO. He tells me it is 150 km and 8 days away, that was when I started to get really, really worried. This was compounded the day my roommie met M.C and uttered immediately afterward: you are so screwed! He looks seriously fit. Great. Thanks.

Thus began my week of fretting and bike riding. I did ~80 kms last Sunday, then two 35 km rides during the week. I had no idea what was going to happen but I figured I better give it a lash. 

I did enjoy the carb loading part of the whole thing and took it to the next level...indulging for several days before the ride. You know--popcorn for dinner, hummus and crackers several times a day, granola by the handfuls...and chocolate mousse the night before (there are carbs in chocolate, right?)



A scene from the night before, all the food and water ready. And spare socks. Of course my riding shoes with clips were nowhere to be found so I busted out the sneaks. Awwww yeah.

First coffees, just after the summit of Connor Pass.
So there were two rides, one that was 110 kms and one that was 150 kms. We were doing the latter with about 40 other people, men in tights to be specific. Ok, there was one other woman doing the long ride...at least we think she was...a woman. If you note the biker in the background you'll get an idea of the one-piece spandex jumpsuits and waterproof clip booties that everyone else was wearing. All the long riders were SERIOUSLY decked out. We looked like we'd found our gear at a garage sale the night before, by comparison. Both M.C and I were also the only people wearing running shoes. We got some very disappointed and looks and clucks throughout the day due to our athletic faux pas of epic proportions!



And then there was the flat tire. The guy who stopped to radio the support car with a foot pump informed us that he hadn't gotten a flat in 4000 miles. We were undeterred though our place at the end of the line was definitely secured.




And then we got stuck behind some sheep. As you do, when you're riding the Tour De Irelande.




Some lovely scenes from the day. 

The Blasket Islands.

The above photo shows the Irish version of a 'highway', and how wide a bike rider can expect the shoulders to be. 



First lunches. And a latte from a road-side bus! This was my kind of race. 

 
 At the 95 km mark we decided it was time for ice-cream.


And a photo op of the old ABB and her bike.


Finally! Several hours, 150 kms, 2 pairs of socks, 2 lunches, 3 coffees, 1 ice cream, several rainstorms, and 3 pee breaks later we arrived back at the start. We had a really fun day, actually. I even managed to pull out my last bit of juice on the final summit and trash talked M.C all the way to the top.

And it was GREAT!!

I am so glad I did it. I love it when I surprise myself! Go Team Sneaks!!