Study Daze

I was studying with my friend Gen today (I'm writing EE on 20th, she's on the 28th). The comedic highlight of the day for me was this.

Gen: So what are some other corticosteroid side effects...?

Me: Dunno, I think I've listed pretty much all of them.

Gen: How about hypokalemic metabolic alkalosis?

Me: Never heard of that one...wow! Ok, good to know.

Gen [deadpan]: You have that underlined and starred in your textbook.

Perfect. 

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.

Need Not Apply

This is what it feels like to be an IMG in the medical community:

MAN
WOMAN
HORSE
DOG
CAT
RAT
COCKROACH
LIVER FLUKE
Clostridium difficile 
IMG

I found out this weekend that I am inelegible to apply to the UK for internship.

Is this some kind of sick joke??

Yes, if you are not a UK, Irish or EU citizen then you need to write the PLAB (Professional and Linguistic Assessment Board exam) which ensures you have a basic grasp of the English language and basic clinical medicine. The downer is that I can't write it while still in medical school which means I am not eligible to meet the criteria to apply for internship. Annoying because Irish students don't have to write it, yet...I am going to graduate from an Irish medical school.

I was really getting excited about the prospect of possibly going to the UK if Canada didn't work out, so having another post-graduate door tightly closed in my face really is starting to get to me.

I feel like standing on top of something large and yelling,

"HEY! Will someone just GIVE me a CHANCE?!? 

I am competent and eager and ridiculously excited about medicine!!!"

It is so hard to stay positive and upbeat about things. I am working really, really hard studying for the Canadian exams, working on CaRMS, doing my current school work, applying for more electives...and sometimes I just feel like it is for nothing. It feels like no one will even consider me as a legitimate applicant because I have a big NEON sign that says, 

****WARNING---IMG---WARNING***

over my head. 

Ok. I am done ranting for now. I am letting it go. No sense regretting things from the past and no point worrying about the future. 

My only request is that if you happen to see an IMG walking around your neighborhood you should give them a hug. And tell them not to let The Man get them down.   

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. 

Oh COME on!!

Last Monday I started my placement at yet another hospital. It is the frustrating thing about this rotation: in an effort to expose us to various communities and outpatient clinics we have to travel to a new attachment for each of the six weeks. So, after the debacle in Hospital, Ireland two Mondays ago, I once again gave myself plenty of time, looked at two maps, and plugged my destination into the sat nav. 

I should have known that things were taking a turn for the worst again when the road began getting smaller and smaller, the crumbling castle ruins and petrol stations fading into the distance. Two old Irishman standing at a gate completely stopped talking to watch me roll by. Clearly I wasn't a local and clearly I didn't know where the eff I was going. 

And here, pictured below, was where my trusty sat nav directed me to. You may be able to read the "empty" status of my gas tank and appreciate that I had to back out  down the road because it was too small to turn around on. Yes, back out past the Irish farmers whose expressions may or may not have displayed a smirk at guessing my displacement. 

Of course I had to bail, once again and call the facility and request directions from "somewhere near the castle*". When I arrived, late, everyone made such a fuss over how often people get lost and how sorry they were that I had started my Monday that way. I was told to take a break and tea was made, scones were proffered and I figured, "Hmm, I could really get on board with this whole psychiatry thing!"

---


*Reason #342 that I love Ireland. 

Understandably Lost

Tuesday was the first day of my new attachment in psychiatry. I had google mapped how to get there and saw that it took 39 mins, so I gave myself an hour. My prof had also passed on the typical vague Irish direction set, "Take the road, it kinda veers, follow that for a while, eventually turn right before the motorway, near the hill, you can't miss it..."

I figured, "a hospital in the midlands, how hard can it be?"

In Europe it isn't uncommon for many little towns to be on top of each other. You don't realize you've arrived in a new place because all you've done is cross the river, or cross the street. So when I was quite sure that I was getting close to the town my hospital was in I saw this sign:

So I followed the sign to the hospital, naturally. I was, in fact, delighted that someone had been clued in enough to provide direction to the hospital! I drove and drove, but seemed to be getting farther away from any town, with no hospital in sight. I was getting nervous now too as it was getting close to the hour I was supposed to start. 

Then I see the big sign, "Hospital". Perfect. Except I cannot see an actual hospital-y looking building anywhere. I see the "Hospital Traffic Calming Area" signs so I know I am in the area...but then I start to think that maybe I am having a mini-stroke or something because there is no hospital to be seen. 

Finally, I get out of my car to inspect an old, yet stately looking building which could certainly be a dilapidated Irish community hospital, only to discover it is in fact a town hall. 

I am now 10 minutes late. I give in and call the number given to me during orientation week, having no idea if it is the consultants mobile or the hospital administrator's emergency line . A woman answers and I say, 

"Hello, my name is ABB...I was supposed to start my psychiatry rotation today...but I appear to be lost. I followed the signs to the hospital but I can't seem to find it....anywhere!"

She chuckles. I am now acutely mortified by the fact that I am late and lost on my first day. 

"You're in the town of Hospital. Like how Kilmallock is the name of the town, you're in the town named Hospital...take the road back to Kilmallock and ring me when you get there. I'll give you directions from town."

Of course the town of Hospital had to be spitting distance from the town I was doing my placement in. 

Of course the town of Hospital has no hospital. 

Of course. 

Hospital Fashion

This week has been comprised of mostly lectures and case-based learning for psyche. It's been a nice way to wade back into the hospital pool. My head would probably explode if I were doing 4h ward rounds and being pimped on things like the causes of ascites.

Also, our professor of psychiatry is a very dynamic, engaging lecturer who ensures we don't get bogged down in the language and the esoteric aspects of mental health. So that part has been entertaining and educational.

The other day I thought something he said was quite simple, but interesting. We were talking about the dress code on the psyche ward. He scanned the room to take in what we were all wearing (various degrees of LL Bean, basically).

Turtlenecks, they're so hip right now...turtlenecks.

He nodded and gave his approval, then said, "Just think, when you're getting dressed to come to the psyche ward, it is not about you, it is about the patients. If you're wearing provocative clothes, loud, dangly jewelery, etc., you might distress or distract some of the patients in ways that are uncomfortable for them. Bottom line: it is not about you."

I really liked that way of framing it. Because the school has given us detailed lists of 'acceptable' clothing options, though I have seen some...er...interesting outfits trotted out. I think looking at what you wear to work in that light is probably the best gauge for appropriateness. Who am I wearing this for? And I'd say it applies outside the realm of psyche too.

All this, of course, coming from a woman who hopes to spend her life in scrubs and outlandish clogs. 

Back in Eire

More airports, dragging my luggage behind me. More waiting at stuffy gates and cueing for dingy bathrooms. I was able to slightly balance my suitcase on my thigh while weighing in, which allowed me to avoid the $250 excess charge. I didn't feel guilty because last week they charged me $106 and then promptly lost my luggage for two days. I was worried my meeting with Brian was going to be in 3/4 length pajamas with hearts on them and a team-building exercise 1999 t-shirt.

The bright side was being met in Shannon by a friend who had packed an airport picnic lunch. Nothing like arriving to smoked salmon, Greek yogurt, and fresh berries, and a weak cup of Irish coffee.

Two days of mini-vaycay on the west coast, going to my treasured beach and drinking coffee at Moll's Gap was punctuated by having to wake up at 6am to drive to the hospital for my first day of placement.

Thankfully, I am doing a psyche rotation first which means a week of lectures before hitting the ward. It's been a nice way to ease back into school after a fairly frenetic summer, couch surfing from Squamish, BC to Charlottetown, PEI.

Right now life is a little hectic, 1/3 of my belongings in Kerry, 1/3 in the house I am moving into, and 1/3 in my current digs (a spare room at my friend Marg's parent's place) . I was going through bags finding camera battery chargers, hand blenders, lavender oil, textbooks, protein powder, pencil cases, and mittens, all thrown together. Needless to say I'm trying not to feel as scattered as my possessions.

For now, I have my notebook, two pens, clothes for work, and a travel mug. I'll survive the next few weeks until the dust settles. 

Final med: no excuses!

Inside Job

Yesterday I had the chance to finally meet Dr. Brian Goldman. It was quite the adventure, getting there and away. But, how many times do you get to to eat seared tuna with one of your medical heroes?

And how many times do you get to be inside CBC Toronto??

The answer to both is: not very many.

It was starting to unfold like a 1993 comedy. Of course, there was the tornado warning west of Ottawa just a few hours before my flight. Then the flight was delayed. Then just as we were about to taxi for takeoff they grounded the plane on the tarmac for an hour because of a major thunderstorm warning in Toronto. Followed by my arrival in a 31 degree city and a broken down shuttle bus.

Eventually I arrived at the hotel, which happened to be hosting a massive Make-Up-Sold-in-Houses convention. The scene was of drunk middle aged women smoking out front, in completely over the top prom dresses with sashes, proclaiming their yearly sales. Yes, yes I did also see a tiara.

The next morning I arrived at the CBC building in downtown Toronto and had to keep my credit card far far away from the schwag store (I'll take two coffee mugs, one aviator bag, an old-school CBC logo t-shirt and a scarf, thanks). By the way, CBC, if you're reading this I wear medium and I will shamelessly promote you forever on this blog...CBC.....CBC.......CBC.....!

Brian and I did manage to get a lot of work done despite my urges to photograph everything from the security guards to the Anna Maria Tremonti elevator. What do I need to do from this moment forward to someday have an elevator with my face on it?! Seriously. CBC radio is the soundtrack of my life. My earliest memories often involve long car rides with Peter Gzowski's gravelly voice or the As It Happens theme song. 

I was in my Mecca. But I think I behaved. I didn't leave any little Jian Ghomeshi action figures lying around, collect cigarette butts that could have been touched by Peter Mansbridge, or steal pencils off Elanor Wachtels desk. 

I did, however, manage to miss my flight back to Ottawa and ended up having to take the train. All well worth it. Brian and I have worked together on pieces for WCBA before but it was great to finally meet him. Bottom line, if you miss a plane because you're having lunch with a CBC radio host, there really is nothing to complain about.

I was pleased though, to arrive back at Dan and Lisa's for an arctic char feast, and relieved that the final leg of my journey did not involve riding in the back of a pick up truck with migrant workers and hillbillies. 

Though, it would have made a good story, I suppose...

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.