Friday, October 29, 2010

Tobie Quote of the Day

I was struggling to explain to Tobie what an "internal medicine" doctor does. I just have a sense of their crazy jobs from dealing with them in the hospital but found it hard to convey it to someone who doesn't really know different specialties or how the hospital rhythm works. All I know is they have a hard job that requires the ability to understand pretty much everything about every system, what all lab values mean, and how to fix them.

When I was done my vague and pathetic explanation Tobie replied:

"Oh, so they are sort of like specialized GP's that work in the hospital, but with the really really sick people, who are pretty much never going home."

Oh dear. Don't ever say that to my friends who are doing internal med!!

In fairness, the ACP doesn't do much better of a job of explaining...

Wednesday, October 27, 2010

So Unbelievably Lame

So remember how I was all exited about the USMLE course that the school was going to provide?

Well I found out today that now it will likely be cancelled and I am seriously pissed.

The school was offering the course to Canadians who have the obstacle of being International Medical Graduates* upon completion, and it was going to be free for us. If Irish students wanted to take it, it would cost them 1000 Euro.

There was a meeting last night and apparently the Irish complained so bitterly that we were getting it for free while they were having to pay, that now the school is thinking of cancelling it altogether.

(Did I mention that we pay the equivalent to $36 000 per year more than they do?)

I would happily pay the cost of the course if they offered it, I am already in a bottomless pit of debt and if the course brings up my mark by even a handful of points it'll be worth it in the long run.

Classic case of a few people ruining it for everyone. Buhhhhhhhhhhhhhhhhhh.


*The deal is, when you leave Canada to study medicine you become an IMG in the eyes of our residency matching system. Not a Canadian-Who-Studied-Abroad-And-Now-Wants-To-Come-Home-And-Provide-Services.

This limits your opportunities for residency, especially in competitive ones because you are part of the IMG pool and IMG's rarely match in the 1st iteration--unless you go into a return of service pool. Fine if you want to spend 7 years in Saskatchewan POST-training (not that there is anything wrong with SK, just that neither Tobie or I have any bonds/family there so having to spend possibly 13 years there if I specialize seems a bit harsh).

The Irish students who study abroad have a sweet deal: they are given priority over foreign grads (like me) for post-grad training when they return home. That means, even if I was the number 1 ranked student in my class then I'd have to wait until the lowest Irish applicant matched before I could get a position in Ireland, if I wanted to stay.

In a nutshell, we get screwed in Ireland and Canada.

So, I planned to write the USMLE as it gives me some more options, and both Tobie and I are keen on living in the States for a few years. The bummer part is that our curriculum is not at all geared toward the exam so we are at a bit of a disadvantage compared to students who studied in places like the Caribbean.

Sunday, October 24, 2010

When Study Notes Go Wrong

My attempt at drawing a cross section of the spinal cord. Because I am such a terrible sketch artist (hard to believe, right?) it is a major cognitive event for me to draw something---thus my recall for drawn notes is incredible.

This one however did nothing to improve my understanding of the spinal cord. Mostly because it resembled a headless obese man with a bikini top on.

At that point I put down the pencil and picked up the mandolin. You just have to know when to admit defeat.

Thursday, October 21, 2010

Bloggers Block

I realize that there has been a dearth of meaty content lately on the blog. Mostly photos of my surroundings and anecdotes showcasing me losing my grip on rational thought.

I have to say though that lately all I feel like writing about is how bogged down I feel with school and how completely overwhelmed I feel most days.

So I start to write. Then read it. Stop. Throw it into the trash.

*She drums fingertips on keyboard.*

Things that are currently annoying me:

-mouth ulcer (the inevitable red flag of rising stress levels)

-the fact that the International office ticked the wrong box and said that I was in a "correspondance program" on my loan application for Canada, thus resulting in me not qualifying for the $15000 loan I received last year...a fact that only came to my attention when I noticed that it was about the time when my disbursement notice should be showing up (6 weeks after submitting forms) and it still hadn't arrived. I called the loans people in Canada to find this out: cue more paperwork, more waiting, re-processing, re-mailing, re-faxing. Hopefully I will still a) qualify for the loan and b) receive said loan before Spring....Inshallah

-neuro knowledge from last year is apparently no longer in lodged in my CNS

-zero motivation for weights/gym x1 week, not aided by the fact that my shuffle ear-buds died resulting in me having to listen to a smattering of Glenn Gould, David Grey, Brian Eno, Bill Frisell, and the Baraka soundtrack during my last workout. Granted, all brilliant songs/artists/albums, but not so brilliant when you are trying to crank a hill on a treadmill!!!

-boyfriend? Who is that? You mean the person I never get to spend any time with that lives in my home with me?

Things that are currently pleasing me:

-my squirrel-like behaviour last week resulted in many frozen meals ranging from beef and Guinness stew, to seafood paella à la-student-who-is-missing-most-vital-ingredients-including-saffron-and-rabbit, to red lentil curry. This means easy-happy-healthy meals all around. Yay for procrastination cooking!

-the school is paying for 2 of our consultant lecturers to teach a kaplan USMLE prep course. It starts in November and will be one three hour session every week, as well as free access to the q-banks, two full length mock exams, videos, prep books, a diagnostic exam, etc. This pleases me greatly as I was just about to invest in a bunch of study materials which I will now get FREEEEEEEE. Well, possibly "included" in my 38500 Euro/year tuition. Ahem.

look into my WILL learn
about ligand-gated channels
-which brings me to this guy...Dr. Conrad Fisher. I've spent the last few days watching the kaplan videos for physiology and he's the instructor. Ok I will admit he is completely over the top but HEY! he's the first person to make action potentials make sense in my pea-brain...and he quotes poets like Walt Whitman and Rumi randomly throughout the lectures. You can't fault a guy who fits in poetry between shouting about calcium channels, you just can't.

-Tobie and I celebrated our anniversary on Saturday. We met on Thanksgiving (CDN) last year, but our first big official date was on the Saturday after. Our first date was epic and grand in every way. He picked me up at 10am and we spent the day in town, checking out the bookstore, some shoe shops, Irish pub...then we went to a great Indian restaurant which we closed down around 2300h, and tea at my house after.

All told, it was a 14h first date of loveliness. So naturally we decided to retrace some of our steps for the one year later version. This year Tobie actually walked about 4kms to the nearest florist to bring me a bouquet of white flowers. Lovely, and cute that he dressed up to give them to me when I got home from school Friday afternoon.
Greens and herbs from "the Herbman" as we like to call him.
I know, not overly original or lacking in euphemistic overtones.

Saturday afternoon was the usual farmers market adventure. 

Sigh. The farmers market. Really, the best part of my week, every week. 

We returned to the scene of the original date and had a most delightful meal--our first night out in fact since I returned to Ireland in August! (Is that pathetic or admirable, can't tell). 

-This weekend I am doing a shadowing shift with the EMS crew out of the big hospital in the Mid-West. I am going back and forth between being intrigued about how the night might unfold and being annoyed that I signed up. I am doing it more for archeological/sociological purposes than medical ones really. 

I just pray to the emergency medicine gods that it is not a slow night otherwise it is going to be a hella long 12h shift with two Irish dudes I've never met before. 

Tuesday, October 19, 2010

I Can't Pronounce The Tallest Mountain in Ireland...

But I can climb it!

It's called Carrauntoohil and it is just over 1000m/3400ft tall. A small herd* of us took Sunday off and drove to Killarney, near where the mountain is located.

The hobbits have "second breakfast" before departure. 
The beginning was a boggy adventure of slew dodging. My runners were dry up to about 1ms after these photos were taken.
"Crouching bank loan, hidden med student".  Camera 1.
Camera 2.

So we waded through the marsh with high spirits and soggy footwear. Not exactly rain, more like an Irish mist covered us initially.

Dry and happy!

My impersonation of an Irish explorer. 

As we ascended we got more and more into the clouds.

Well at least we knew which way was up!

Wet and hungry. 

We eventually got to the top...and enjoyed a nice leisurely lunch while admiring the views. *cough*

And then the rain and wind really decided to remind us that at all times,  Mother Nature is boss. 

But as we descended the clouds began to lift and our efforts paid off. 

Beautiful vista's opened up and the hammering on my knees became a little quieter. 

Despite walking like a pirate with two wooden legs afterwards, and completely bog-destroying my sneaks it was well worth it to get a little air in my bones. I miss the mountains so much, it was a nice little re-acquaintance weekend.


*What is a gang of medical students called? A "mensa of med students"? A "herd of nerds"? A "gaggle of geeks"? A"swoop of stress-balls"?

Thursday, October 14, 2010

Currently Reading

It is seriously blowing my mind. 

And keeping me motivated to stay in medical school. More on this when I actually finish it. 

Tuesday, October 12, 2010

I am an Idiot

Thanks y'all for the reassuring emails and comments.

Turns out I am actually the most high-reactive-psycho-with-impaired-self-diagnosing-abilities.

Proof that one should never diagnose/treat oneself.

I guess when you spend the summer in a pit of MRSA it is bound to be on your list of differentials but really ABB? Really?? Gad! I am so annoyed with myself for jumping to that conclusion (and depleting my Bactrim stash).


Stress does really weird things to rational thought processes. Really weird things. Funny how I can be calm when someone starts bleeding out of their eye sockets in front of me but when I have a few bumps of folliculitis on my leg I completely fly off the handle.

I am actually so embarrassed I thought about taking the original MRSA post down, but then thought, no...I'll leave it as a reminder to myself of what happens when I turn into an irrational medical student/emergency nurse.

I promise I will use this event as a lesson for the future.


Monday, October 11, 2010

In Other News, I am dating AJ from the Backstreet Boys

So this weekend one of my classmates had a 90's themed birthday party. Tobie decided to go as A.J from the Backstreet Boys. I must admit I had to google the guy because I had no idea who he was referring to.
The actual A.J.

How Tobie normally looks.
So with a little hairspray, mousse, eyeliner, and shaving cream I managed to transform him into a creepy 90's pop superstar.

I think I missed my calling as a hair/make-up stylist. 

I created a monster.

I told him he should just recycle the outfit for Hallowe'en and go as Andy Sandberg in the Dick in a Box sketch. 

His only concern was that the lack of SNL in Ireland might lead to an arrest if he went out in public like that. I figure it's worth the risk.

Ninja--My costume wasn't nearly as good...I went as Elaine from Seinfeld. I really should have just been a groupie with A.J. Mind you, that would have involved a sequin miniskirt and heels...and no one deserves to see that while they are trying to digest their dinner! :-)

Thanks for the Memories, thanks for the MRSA

So I got a couple of (let's use normal-person language) red bumps just below my right knee last week. They were itchy and looked like mosquito bites. I really thought nothing of it. I figured since I've been doing a fair bit of trail running lately that it was bugs or some fern that I brushed into.

Nagging thought--"don't remember getting bitten, don't remember brushing into any ferns". 

Then I was sure it was spider bites since we're still at war with a hefty arachnid population that enjoys our windowpanes for web-related activities. But know in my heart of hearts that most spiders cannot actually bite enough to leave a mark on human skin. 

Then a few more of these mystery bumps arrived on the scene, along the side of my right lower leg. Ok, that is weird. Didn't look like bed bugs (washed everything and flipped the mattress just in case) and Tobie does not have a single mark on him. 

Itchy. Annoying. Spreading. 

Then 2 nights ago as I was falling asleep I had a sudden flash of me starting an IV on a patient with MRSA this summer, the lesions on her arms looked pretty much EXACTLY the same. 

Image. Out of mind. Enter state of denial. 

Finally last night I dove into my textbooks and emedicine to look at the beginning stages of cutaneous MRSA and behold it looks like a folliculitis and often is mistaken for a "spider bite". 

Cue litany of curse words. 

Ok, I have worked in some seriously filthy disease-riddled-inner-city emergency departments, as well as some rural places where so many of the patients had the MRSA warning on their chart we started joking that it'd make more sense to start flagging the ones who didn't have MRSA instead. Eleven years since my first hospital placement in nursing school---how many thousand exposures have I had to the whole gamut of infectious bacterial options? 

So I have enjoyed being blissfully unaware of my bacterial flora and fauna--while subconsciously knowing that I likely added MRSA to the list of "bacteria that live on me" a long long time ago. 

But I am pissed, more than a little freaked out, and slightly grossed out. Upset. I don't think I am blowing this out of proportion. One of the nurses I worked with 2 summers ago had to go on NINE WEEKS of IV vancomycin for a cutaneous MRSA infection. 

So I started myself on Bactrim DS---I know, I know...I should have had the wound cultured before starting ABX but I couldn't get an appointment today at the school and I have no car/no money/no time/no idea where to go in the city. Hopefully will be able to see a doc tomorrow as I only have 3 days worth of Bactrim. So bloody frustrating!


And that is my Monday morning.


The 1642h update:

Couldn't get an appointment until tomorrow. On advice of a friend I popped over to one of my former profs (who is awesome) to get some advice. Pretty much as soon as I opened my mouth I started getting all teary and emotional which made me annoyed and embarrassed which only made the situation worse.

She was really nice about it but I felt like an IDIOT. Now I feel like an IDIOT with a staph infection (that is probably not MRSA) who had a nervous breakdown in front of a prof that I like/respect.


Ok I'll admit. Stress levels are running at an all time high.

I work in the ED and see patients with this all the time. So I think the combo of stress, proximity, panic, irrational thoughts lead to a  massive  slight overreaction. Worst thing is, I've always laughed at the whole 'studentitis' phenomenon where you believe you have most of the diagnoses you are studying in school.

Gahhhhhhhhhh! I need a holiday.  

Wednesday, October 6, 2010

Photos From Connemara Part II

As promised, a few more favorites from the weekend on the West Coast. 

Below, the gang saddling up to the second bar. Ultan (or Encyclopedia Ultannica as we like to call him due to his freakish depth and breadth of knowledge for all things) and Shane (also ridiculously smart).

Hello delicious friend. 

Tobie and I attempting to be the biggest cheese-balls in the pub. We did not succeed however because the band was playing "Leaving on a Jet Plane" at that moment and winning the cheese competition. 

Ryan and I have an uncanny ability to pull the same face in photos, unaware. More proof that he's my brotha' from anotha' motha'. 

Enough alcohol and self-loathing will cause one to eat this salty treat known as "Bacon Chips". Yup. Little strips of hydrogenated corn meal dyed to look (and taste!) like bacon. I think we ate about 8 packs in 1.7 mins. 

My favorite pub of the night. We were sitting at one of the 3 tables. 

And what photo essay of a weekend away would be complete without photos of Ryan's bed head in the morning? Truly formidable I say. 

And a little music making. 

The "breakfast baguette" or perhaps "meat in a vessel". Sausages, bacon, black and white pudding, and bread. I should have snapped the photo after Ryan added mayo and ketchup. Actually. 

Sigh. The road back to reality. 

This photo reminds me of B.C. *Sniff*. 

And naturally there were some sheep on the side of the road. 

I then arrived home and had a melt-down of stress related blubbering as I shuddered at how much work I didn't do over the weekend.

That is something I miss about working. When my shift was done as a nurse, it was done. My days off belonged to me, not this annoying voice in the back of my head reminding me that I should be doing practice questions, reviewing notes, etc.

I need to get better at switching out of school mode when I am taking a break or taking the day off, otherwise it isn't really a day off. This is clearly a work in progress. All I know is that the only days I feel good are the days that I run/train and the days I get a few hours of really solid, quality studying in. Now to figure out how to do those things 6 days a week, and I'll be sorted.

And on the 7th day, I'll rest.

Monday, October 4, 2010

Photos from Connemara Part I

I basically threw up my hands this weekend at the mountain of school work and headed to the west coast with some great friends from school and Tobie. I thought if I physically distanced myself from the study and books that I could relax and maybe reset my stress-ometer. Shane's parents have a "caravan" i.e. trailer near Roundstone, right on the ocean. So off we went on Saturday afternoon, in a convoy to a caravan in Connemara. Say that 5 times fast.

Weeeee! Carefree weekend right?

I like to call this one, "you can take the girl out of Alberta, but you can't take Alberta out of the girl". 

Rare species of "sea cows" only seen on West Coast of Ireland. 

If med school doesn't pan out I figure they could start a boy band. 

Yes, being around Mike and Ryan is like being around the little brothers I never had. 

Mike infiltrating yet another photo op. 

More to follow later when I am done my homework for PBL this afternoon.