Sunday, November 17, 2013

Is there a doctor on board?

So a few days ago I delivered a baby on board my KLM flight from Amsterdam to Calgary. It was one of the most surreal, frightening, exciting, unbelievable experiences in my life.

Full story to follow soon!! :))

Sunday, October 6, 2013

Life Goals = Check

So for the first time since June, I feel somewhat ready for the week ahead. For the past 10 days or so my main life goal has been to empty the dishwasher. I thought, if I could pull that off I might even lift my game and wash the sheets on my bed.

Well, done and done.

You might be thinking that this is THE most boring post you've ever come across but honestly, I feel this deserves to be put down in the history books. My food for the week is made (mulligatawny stew, curried cauliflower soup, and some slow-cooked peanut chicken), the sheets are fresh, the floors are vacuumed/washed, my bathroom is clean, laundry is done, bills are paid, dog food is stocked, and the fridge is sparkling. Oh it is sweet. This is what happens when I get two whole days off!! (Ok, I was post-call on Saturday so I slept until 1415h, thus making my achievements even more impressive, as far as I am concerned).

This week will be busy, I have volleyball tomorrow, am on call in the ED on Tuesday and on call for anesthetics on Wednesday but then on Friday I am flying home for Thanksgiving!! I can't even remember the last time I spent Thanksgiving with the family. It's been at least 10 years for sure. I am ridiculously excited...and prepping my elastic waistband pants in advance. Ah screw it, I'll just wear scrub bottoms the entire weekend.

In other GREAT news, Duncan finally gave his notice at work which means that the Manfriend will be joining me here shortly on the bald prairies. Yes, he is leaving his job and house on the ocean in BC to move here. It must be love.

Let's hope he's still smiling come February...

It's going to make such a difference having him here in the shoebox-sized rental. Residency has been a heavy go and a lonely road so far, and it's definitely been tough to keep the fires burning long-distance. Hopefully his tender British hide doesn't get frostbitten during his first REAL Canadian winter. Eep. Yeah, he's been in Canada for four years but Vancouver Island winters really don't count. We had a long discussion about vehicular modifications required for -40 degree winters, phrases like "block heater installation" and "winter tire purchases" were thrown around. I think he is still processing all of this. I get random questions like, " people plug their cars in at work??" in the middle of a conversation about running shoes.


I am currently on my combined gen surg/ortho rotation. It is...meh. I really enjoy being in the O.R but my program has really changed up our rotation so that we spend most of our time in ambulatory care and surgical clinics. Which, I suppose, is nice for the people who hate being in theatre and who plan to have mainly GP clinic based practice. (In case it isn't already painfully obvious I don't plan on having a predominately clinic based practice). I recognize that this approach makes sense in terms of what family medicine residents need to know from a surgical rotation perspective - I just wish I had some more time getting to assist and do procedural things. Which is probably why I LOVED LOVED LOVED my anesthetics rotation (but that is a whole other post). Did I mention, I LOVED ANESTHETICS?!?! 

Well, that is enough rambling for one night. I just thought I should check in with the odd happy post from now on so that people don't think I am scouting highway accessible bridge abutments.  

Also. My dog rules.

Wake up and pet me dammit!!!
Roll on, Monday. 

Tuesday, September 24, 2013

Medicine Giveth and Taketh Away

My relationship with medicine has been a complicated affair. Depending on the day I can feel anything from anger and resentment to gratitude and love for it. It's been this big, ambling, shuffling entity in the background and foreground of my life for as long as I can remember. At times it is all encompassing, at times it disappears to a pin hole in the distance. Some days I find medicine grounds me, makes me feel like I have a better understanding of the world and what is truly important. Other days I feel that it warps my perceptions so much that I have no idea which direction is north.

I took two days off this week, leading up to an emergency medicine conference that I am attending (in Whistler - if any of you are also going to be there, come and say "hi!")

Having a couple of days to breathe (and by 'breathe' I mean 'finally catch up on paperwork, presentations, research assignments, leave requests, and emails') has given me some time to think about the last few months and my initiation into being a physician.

The weeks fan out behind me, some moments are vividly etched, the others already faded and gone.

Like finally being able to eat at the end of a 15 hour shift, with my only option being the last bowl of chile in Subway. I mean why did the guy have to tell me that it was the last bowl of chile? He could have just said, "Here is a delightful bowl of piping hot chile!" not "you got the very LAST bowl".

Or having to appear interested and awake during post-call re-enactments of Duck Dynasty episodes by an attending. Informing a patient that there is no such thing as a "butt cast" for her pain following a hard landing on her derrière. Holding a fibrillating heart between my fingers and squeezing, squeezing, squeezing until there was nothing left to do but wash off the blood that had managed to seep under my sterile gloves. There were unexpected flowers at the hospital on my birthday from Duncan. There were babies that came into the world, chubby and screaming while yellow-gowned, O.R capped men proudly stroked their wife's hair. And also the grey dishwater colored ooze and rotting flesh stench of necrotizing fasciitis, and countless miles spent walking the rotary trail with my puppy, Monty, while I tried to make sense of it all.

So many moments. Tumbling. Flashing before my eyes while I try to fall asleep. Those nights when the sweetest feeling ever is having your feet at the same level as your heart. That bone-tired exhaustion surpassed only by the relief that the day is over. On the especially bad days Monty is allowed up on the couch with me. His scruffy face and propensity to lick my socked feet are enough to make me laugh and take my mind off whatever transpired at the hospital that day.

Which is why I am never sure of how to answer the question, "How is residency going?" My mind floods with all of the images of these moments. Some hilarious, some disturbing, touching, rewarding, enlightening...humbling. So I suppose the best answer to that question is, "it's complicated".

Thursday, August 22, 2013

Easy Life

It can be a passing comment. Or the answer to a question.

But medicine can break your heart, or crack it just a little. And it isn't always the big, dramatic moments. Sometimes a patient says something to me that is such an unbelievably loaded statement, such a deep and unguarded truth about who they are, that I feel both weighed down by it's burden and lifted up by the privilege of hearing it.


"What does her name mean?"

"It means, easy". 

I chuckle a little and smile. The woman speaking to me has perfect, chocolate colored skin. Her hair is wrapped in a regal looking, multicolored scarf. Her cheekbones are high. Her eyes see that I don't understand.

"It means, easy life. My other three children were born in refugee camps in Kenya. She was born in a hospital in Canada. Compared to the rest of us, she will have an easy life." 

Now I understand, but really have no idea.


His right rotator cuff and surrounding musculature was so badly torn one day at work that the orthopedic surgeon stated in his letter that he "abandoned the procedure" when the first repair was attempted. As the patient spoke to me I saw dozens of deep, linear, pale scars on his left forearm, the kind of scars that you get when you cut yourself deep enough to draw blood but not deep enough to bleed to death.

The patient told me about the numbness in his fingertips and the ache in his arm. About the surgical waiting list. I asked if he was right or left handed.

"I am right handed. Well, actually, I was left handed. But I went to a residential school and they forced me to write with my right hand. They didn't use very nice techniques to do so. They wouldn't let anybody be different in any way. Same hair, same clothes. They wouldn't let me use my left hand. So now I am right handed...I have a granddaughter. She is left handed. She gets to stay that way."

Monday, August 19, 2013

Blog Readers, I Salute You

This is just an aside. A short note to say that I really appreciated the folks who took time to send comments and emails my way in response to my last post.

It pleases me greatly that people still read this blog (which is...ok maybe not in asystole but certainly a life threatening bradycardia - forgive me, I had to). It also is humbling and thought provoking and reality checking to hear the thoughts of people who have been reading this blog (or who know me / are related to me). I appreciate that I can be (somewhat) candid and honest. Which is what I would want if I was reading story of someone who was chasing a dream.

I think that too often we get to the goal and the story is over. Happily ever after. But really, everyone knows, deep down inside that this isn't true. My mother reminds me that what doesn't kill you makes you piss on your shoes and that the people who got their dream residencies in their dream specialties are pissing on their shoes for many reasons as well.

So thank you all, for your thoughts and notes and perspectives and wisdom. I had intended to end the blog after graduation but it seems there are still people out there who read it, and even enjoy it!  And I think I still have a lot to say about medicine and this journey which continues to unfold in strange and challenging ways.

In a completely unrelated note: today while the pediatrician was listening to the lungs of my 3 year old patient the kid gave his mum a thumbs up. I swear I am laughing as I type this. Even though I am looking forward to my next rotation (anesthetics) I will miss certain things about peds. Though, I will not miss the daily cough in my face routine that occurs.

Wednesday, July 31, 2013

Okay okay okay!

So today my friend Rob posted this on my FB page, "I feel like the blog is circling the drain.. like an end stage nephro patient. Write more stuff!!!" 

Which is fair enough. I've had a lot of posts or snippets of posts floating through my head since I started residency but for a number of reasons I feel like I can't write them. 

For one, I live in a pretty small town and I have an ever-increasing paranoia that I am violating patient confidentiality by writing about things that happen at work. Also, for some reason I feel slightly more duty-bound to pretend that everything is fantastic because SHAZAMMMM! I am done medical school and am actually a doctor now - i.e. life goal has been realized and therefore I should be rolling through a field of tulips with an ecstatic expression on my face. 

Truth is, I am actually not that happy. But I mean really, the cards are stacked a little against happiness right now. 

I just moved to a new town and have no friends. I just started a new job which is always stressful. The herniated disc in my back is unrelentingly painful and restricting my activity (thus quality of life). I am broke as a joke. My boyfriend still lives two time zones away because Canadian immigration moves slower than maple water in an ice storm and his permanent visa has yet to be granted. This town is ROUGH. I could go on and continue to list another dozen first world problems but I will stop myself there. 

I am a positive person, I really am. I always try to find the silver lining in things. I try to think that everything happens for a reason and that the universe puts me where I need to be. But I just can't seem to go there in my mind right now. I am not a person of regret usually but right now I regret so many things. I regret studying abroad and the financial repercussions as well as the professional ones. I don't want to be here. Am I allowed to say that? I can't wait for the end of the day (or night) when I can be home watching "Parks and Recreation" reruns in the quiet darkness of my curtain drawn living room. 

Transitions are hard, and I know that. I remember being nauseated and sleepless before every shift when I first became a nurse, and gradually that faded. I just suppose that I am frustrated too that I didn't anticipate these growing pains. I (erroneously) believed that I knew what I was getting into, coming into medicine from a nursing perspective. But I realize now, more than ever, that every stage of life brings with it some joys and some sorrows, some stimulation and some tedium. Becoming a doctor hasn't allowed me to transcend that reality. It's just given me more waking hours to experience all of it.

Thursday, July 18, 2013

What apps?

Hello world.

I am keen for some suggestions on apps that people find indispensable. Recall that I am doing rural medicine which means I need all specialties, all drugs, and all procedures, at all times. 

I was hoping that PEPID would answer this call since it has the ambulatory medicine suite and the EM suite - it's ok. But the interface looks like something from the 80's and it keeps crashing on my iphone. Boo.

I am mostly using Medscape and Pedi-STAT (and PEPID when it works and while I am still enjoying a free trial).  

Also, actual books that people found useful in residency would be welcomed. Currently I only bring my "Bugs and Drugs" with me. I'm just that hardcore.

Annnnnnnnnd GO!

Monday, July 15, 2013


I picked up the kid's chart. It wasn't a simple consultation as he had been referred to the pediatric clinic for ongoing investigations of chest pain and palpitations. It was a busy clinic and so I was trying to juggle reading referral letters, getting histories, and writing notes all at the same time.

I was sifting though the documentation while a sweet, round faced lad swung his legs against the examination table - non stop kid-style stream of consciousness monologue pouring forth. So while I'm seeing ECG's and prescription refills and trying to elucidate the history from his mom, ignore the chatter and read through a holter monitor report from the cardiologist he says, "Excuse me, excuse me..." I realise that I am not emulating the appropriate 'doctor/patient/parent' interaction so I stop mid sentence in the specialist report and say, "Yes?"

"Did you know that lemurs have opposable thumbs?"

No kid. No I didn't. I'll just add that to the seemingly countless other things I do not know in this world. I laughed and made a mental note to start dropping more non sequiturs into conversation.

Now back to that pediatric cardiology referral.

At the end of the consultation I told him he was one sharp kid and he agreed adding, "and a curious one too".

Yes indeed. 

Wednesday, July 10, 2013

Orientation to Nursery Discussion

"How far are you from the hospital?"
"6 minutes."
"Ok so....pretty far....get the OB nurses to call you in early then for c-sections".

Gotta love the rural perspective on 'long commutes'.

Tuesday, July 2, 2013

Blood spurting!! Life saving!! Code calling!!

No. That wasn't at all how my first day went.

It was all very dimly lit and civilized. It was all about how to fill out forms for vacation requests and travel, how to submit log books, finding computer passwords and parking instructions.

I still have a few days of orientation ahead of me. Today I purchased a propane tank, a Co-Op membership, and maple syrup. I am feeling very 'rural Canadian'.

These transitions are tough. Tonight while I was making homemade ketchup I was thinking that it has been a long time since I've been a new person in a new town. There has always been a safety net of friends or well known colleagues in my previous nooks and crannies. I know I'll be on my feet soon but I know I am stress-condiment-making (I am not a baker, so I cannot stress-bake).

Right now I am melting in the >30 degree heat, in my house that has no AC.

Next Tuesday is my actual first day on the job. Eeeep! For now, I will bask in the paperwork.

Sunday, June 30, 2013


Dr. Albino Blackbear BSc. N., BM BS (Hons)

It actually happened!

Residency two days! 

I am a terrible blogger. Once the last box is unpacked and internet is hooked up, a proper post will follow. 

Thursday, May 23, 2013


My hand was shoved down, awkwardly positioned between the folds of trousers and half-pulled down underwear, in the man's groin crease, trying to palpate his testicles without pulling any of his pubic hair. Something didn't feel right, but it wasn't his testicles.

I was in my final surgical OSCE's and it was my first station, where the adrenalin was flowing and my mind was racing faster than my running commentary...

...and I would be checking to see if there were any hard lumps in the scrotum, or if I could not get above the swelling...

I had only just recovered from initially describing my landmarking for the deep inguinal ring as the "midpoint between the pubic trochanter and the anterior superior iliac spine" which caused my examiner to hover his pencil over the marking pad as I searched for the correct word that started with a "T".

TUBERCLE. Tubercle. Tubercle. Tubercle. Dammit. 


Initially I hadn't been too flustered. It was a groin exam for a lump, which is pretty standard on a surgical final. But I didn't think that we'd be expected to actually tackle the tackle in the exam. I said the usual "Ideally I would like to expose the patient fully and perform a genital exam to complete my hernia assessment" and waited the beat for the examiner to butt in, rescuing the patient from a succession of 32 fumbling medical students.


Maybe he hadn't heard me.

Ideally I would like to EXPOSE the patient fully and perform a genital exam...

Still nothing. So I went for it. Which is how I found myself rolling this 70 year old man's testicles around in my hand at 0905h on my last day of medical school, wondering WHAT it was that didn't seem right.

It wasn't until my rest station a few stops later that I saw, between a one inch crack in the curtain, a colleague pulling on a pair of gloves.


That was what felt weird. I have been a nurse for 5 years and a medical student for 4. I put on gloves when I hear the ambulance bay doors open, even before I see the patient. So WHAT THE HELL WAS I THINKING DOING THE EXAM BARE HANDED?!?!? What felt weird was the fact that I didn't have a nice latex barrier between myself and that poor man's private parts.

I started wondering if maybe my mistake had been a red flag (i.e. cause for failure of my surgical OSCE's as a whole). When one of the emerg docs walked by and asked how I was doing during a later rest station I told her, "Well, pretty good for starting the day by ball handling without gloves, how's your day going? Do you think I red flagged???"

She said she couldn't be sure but told me not to worry as once during her emergency medicine exams she put in a chest tube without gloves (I'll point out that this involves sticking a FINGER INTO THE CHEST after you've made an incision in the rib cage). She did make me feel better.

Afterwards with some of my classmates during our postmortem on the exam I confessed to my ridiculous oversight. The color drained from one girl's face as she suddenly realized that she had done the same. Ohmygodohmygodohmygod. She seemed to be quite disturbed by this realization. It wasn't until much later in the evening when she had consumed a few celebratory pints that she approached me at the bar and confessed.

You know how freaked I got about not wearing gloves? Well...I couldn't tell you at the time because I was so mortified....but mostly the reason I was so upset was that when you said that I realised that right after that station I had EATEN A SCONE!!!!!

Tuesday, May 14, 2013

Finito Mosquito

It was a rush. It was not anticlimactic at all.

I had been warning myself not to build up in my mind the last moments of medical school and the thrill of being done. So many milestones have felt disappointingly bland once they were reached.

Well it turns out that finishing medical school is not one of those milestones.

After a week from absolute hell (which I will get into once my medical degree is firmly planted in my hand) I arrived on Thursday morning for the last set of OSCE's (clinical exams). It was 12 five minute stations of medical or surgical skills. My last station was giving discharge instructions to a patient and when the buzzer rang, the actor patient stood up and shook my hand to say, "Well done!! You're done!!" The examiner said "Congrats!" and I emerged from the cubicle to see my friend, JM standing there with a huge grin on his face.

JM was the very first person I met in our class. We met in Toronto while taking the elevator up to our interviews. He surmised that I was there for the same reason and asked me where I was from, what I did for a living etc. When I told him I was living in Whistler, working in the emergency department there he stopped me and said, "Wait, so you live in Whistler, you have a job you love, yet you're planning on giving it all up to move to a different country and become hundreds of thousands of dollars in debt to be a doctor? Why?"

Well, when you put it that way. I had thought about his comment many, many times during the last 4 years. Why, indeed.

So when I saw his face as I stepped out of my last station I had to chuckle at the perfect end to medical school. We gave each other a rib-crushing hug and he said in my ear, "You know why this is a perfect finish don't you?"

I laughed and cried a little and said "YES! You were the first person I met on this journey!"

Then I randomly hugged a few other bewildered, exhausted, adrenaline frazzled classmates...I may have pounced on a few invigilator bystanders as well. It is all a bit of a blur.

We were then put in a 'holding tank' room in the hotel for over an hour as the other groups of students hadn't gone in for their exams yet. We weren't allowed to use our phones so as not to text anyone what cases were in the OSCE. I came prepared though. One little bottle of Champagne in my handbag which was quietly popped and then poured into the coffee cups they had provided for tea. A "CHEERS!" and few gulps to my pals that were also in the group. Shortly after the Prof of Medicine arrived and was asking us how it went. We were gathered in little groups chatting away, so when he approached we had just finished our Champagne. He said, "Are you having drinks soon?"

"Er.....well yes! In fact we've already had a little Champagne!"

You could see him mulling over this fact...hmmm are they allowed to have alcohol? This is an's only 1030h...

Then he said, "Of COURSE you've already had Champagne! You're DONE! Good thinking on packing some in advance!!"


We were set free.

I went and had an Indian head massage (best idea ever) at the spa, and spent the afternoon in the steam rooms and saunas with my dear friend, Emma.

The evening contained all the predictable events. Champagne. Great dinner out. Drinks at pub. Eventually going to Nancy's (the bar I LOVE to HATE). Having a drunk Irishman spill an entire pint of Guinness on me. Heading home with soaking wet jeans and a blister from my high heels.

And then it was over.

But I know it isn't the end. As a friend of mine on FB said, it isn't even the beginning of the end! 

Thursday, April 25, 2013

Oh Our Lives

The main comment going back and forth between my friend Gen and I these days is, "Our LIVES!" to basically summarize all the insanity going on. Finishing medical school and leaving Ireland continues to unravel in quirky and unexpected ways.

We are both trying to cope with all the aspects of tying up our lives here while suffering from brain asystole, attempting to cram more information into our grey matter which is already packed to the rafters with random facts.

Gen is trying to sell her car and found a potential buyer who is a physician at a hospital 90 mins from town. I offered to go with her to show it so we could study in the car. That way she wouldn't feel like the precious hours before exams start were wasted.

We pulled up to the ambulance bay and waited for the guy to come out. Finally he appeared as we talked our way through rheumatology questions. He wanted to take the car for a test drive so I hopped in the back seat, she sat up front. He took the wheel, told us he didn't have a drivers license, and proceeded to start pulling donuts. Then he began screeching around the ambulance bay, speeding up towards the cement dividers and slamming on the breaks. I hollered at him to stop the car and let me out--he apologized and then began whipping a second donut near the parked ambulance. I told him, "STOP THE CAR AND LET ME OUT!!! So he did.

He then proceeded to take Gen on a terrifying ride through nearby streets, not using the windshield wipers despite the rain, and accelerating towards the waiting cars at the traffic circles. Gen was convinced that she was saying goodbye to life over a 1000 Euro car.

Incidentally, I also posted my car online and so far have received random late-night texts from weird Irishmen and an offer from an "off shore worker" who wanted to pay by PayPal without coming to see the car.

Hmmm. Yeah. No.

So we retreated to the safe enclave of my kitchen where I then received emails of required documents and YET ANOTHER POLICE RECORD CHECK for my residency program. Both for Ireland and Canada. Really?? I am in medical school here. I wish I had the time to have enough fun to get arrested in Ireland. Today my mom asked me if I was going to quit medical school. I told her yeah, it was just one criminal record check too many.

Tomorrow exams start. Six hours of written papers. The books are now closed. Mostly because studying has taken a giddy and ridiculous turn.

Gen, tell me about the life cycle of malaria...

Well, it replicates in the mosquitoes liver...uhh....

Dude, I don't think mosquitoes have livers...

**Cue peals of laughter**

[You had to be there.]

Ok, next question...Pearl, an 89 year old nursing student suddenly develops intractable HOME resident...

Wait...woah...GO PEARL! 89 year old nursing student!

**Cue peals of laughter**

[You also had to be there].





Saturday, April 20, 2013

Where are the balloons?!

Yesterday was the last day of my surgery rotation, which also happened to be the last day I had to show up to the hospital as a lowly medical student. Of course it ended with me racing in for a 0730h ward round which didn't happen, giving me time to kill before surgical Grand Rounds. Afterwards our professor of surgery gave us a little pre-finals pep talk which included the well worn phrases:

-don't worry, these are the easiest exams you write in medical school
-know the basics
-you'll be fine
-try not to get too stressed
-know all the medical emergencies
-soon it will be over and you'll wonder what all the fuss was about

It was an uncharacteristically nice and reassuring discussion with him, though it did nothing for my chronic teeth grinding and constant gut-ache. After a few questions about exam specifics from the others I asked him if he was going to miss us. He said (sarcastically) yes, and I will especially miss your esoteric and obscure contributions to tutorial from the corner of the room.


(If I leave a legacy of esoteric obscurity behind then I feel I have succeeded as a student in surgery. In much the same way I felt I succeeded in internal medicine when I received an email from one of consultants telling me about a banjo competition this week. Reassuring to know that my true personality somehow shone through my crusted, exhausted exterior.)

We were dismissed after that and a cluster of us emerged into the morning sunlight, blinking and saying goodbyes and good-luck to one another. It was surreal. I was FINISHED my medical school rotations! Where was the fanfare? Where was the receiving line of dancing nurses and interns patting me on the back, handing me pizza, and popping Champagne corks?

I remembered a conversation I had this summer while I was on my pediatric emergency elective. One of the docs was telling me about his last night as a resident, at the end of his 5 year program. He was walking down the dim corridors, leaving after a night shift, "This was MY hospital, I kept these wards humming through the night for five years. I spent my LIFE in these halls...and when I walked through the automatic doors at the end of that shift I didn't get a handshake or a thank you or a good luck. It was just over and I was standing in the parking lot, in the rain, and it wasn't MY hospital anymore". 

I got it when he told me this story but hadn't thought about it until I left the hospital yesterday. I had a very similar feeling as I drove out of the unbelievable chaos pit they call a parking lot. I cranked up the Mumford and Sons with a fitting song, and left a little mental trail of confetti, streamers, and balloons behind me...

Tuesday, April 16, 2013

Worth It

Things are picking up speed here in the final push to the finish. Suddenly a hundred things are pulling for my attention and I'm remembering the nit-pickiness involved in extricating oneself from one country and moving to another. Annoying things like transferring electrical bills to a different name, showing people the apartment, answering questions about my car to prospective buyers, pawning possessions, cancelling bank accounts and returning internet modems.  Time feels warped in that it seems like an eternity until I am back in Canada, yet there's not enough time to complete all the extracting tasks, study for finals, feed / clothe / wash myself, put petrol in the car from time to time, sleep, and possibly exercise when a window of time and weather presents itself.

Yesterday I was studying with some friends when I realized that we had spent the last 20 minutes discussing which brand of under-eye concealer hides dark circles the best (this may seem like normal conversation to some women but these particular ladies are *not* the make-up discussing types).  This was shortly after we screened each other for depression upon discovering that 'generalized anxiety disorder', 'panic disorder' and 'depression' criteria were starting to hit a little too close to home. We stopped studying psychiatry at that point and moved quickly to cardiology where we all felt slightly safer territory existed.

I woke up a few days ago with a burst blood vessel in my left eye which has definitely hitched up the haggard appearance a couple of notches. I am told that REM sleep can cause blood vessels to burst. Fantastic. This on the heels of 3 straight days of waking up not to an alarm but to the sound of my own teeth, grinding. On the upside I suppose that my face is getting exercise while I am sleeping

But it's not all cereal for dinner and fitful sleeps.

Today I received a card in the mail from one of my maternity patients. She had been one of those women who labored in such a way that I was in complete awe. I am pretty sure that if (and that is a big IF) I ever have a child I will be the craziest, drug-seeking, wild-eyed, foul-mouthed, sweaty, crying mess. She was this calm, focused, sweet, gracious lady throughout her (analgesic-free!) labor until complications resulted in an emergency c-section. For the duration of our long night together she used hypno-birthing and relaxation techniques to stay calm and work through the contractions. It was an amazing thing to see.

In her card she included the hypno-birthing CD along with a photo of her and her now 5 month old daughter, on holiday in Paris. It was a lovely gesture and a beautiful sentiment. My favorite line from the card being, "I will always have the most amazing memories of my labour...remembering yourself so close in my heart when I think of the wonderful team we had together on that night".

During a week (month? year?) when I have often asked myself if all of this is worth it, I receive this card. What a privileged and beautiful place to occupy in a strangers heart: the place that holds the memory of their child's birth.

Knowing something like that makes up for every single stressful hour. It makes up for being the person who breaks bad news, or the person who has to scavenge for food in the day ward after being in the hospital for 20 hours without a meal break. It really does.

It makes all of this worth it.

Saturday, April 6, 2013


When I moved to Ireland I made a conscious decision to try and see it as my home for these four years. I did not want to be counting down the days until each trip back to Canada. It wasn't an easy transition and for the first year I was homesick a lot of the time.

Tobie got me through most of those rough patches. We used to go on Canadian fantasy dates where we would describe scenes to each other of where we'd like to go on a Friday night. Keep in mind that at the time we were both living in dorms with no vehicle, plastic furniture, and a varying caliber roommates (from 'good' to 'reality show awful').

Then last year I moved to Kerry and was living in country bliss, working in a fantastic hospital, surrounded by hilarious staff, beautiful beaches, and boggy mountains. Oh, and I finally became capable of understanding the Kerry accent (have a listen below).

Once I moved back to the city to start 4th year in July, things picked up to break-neck speed and I must admit that much of the last 8 months has been an absolute blur. Wasn't I just writing the MCCEE a few weeks ago? Wasn't I catching babies and listening to manic patients tell me about their new business deals just yesterday?

Now I have less than a month left in Ireland, a job in Canada, and a man who wants to get a dog with me. Now I am anxious to get home. The two weeks in surgery and the week of exams ahead seem like a cruel gauntlet to run through, especially because I feel more like crawling through. It is so hard to stay motivated to study, and to keep smiling and nodding enthusiastically during another clinic where I only get to watch other people doctoring.

Roll. On. Residency.

So I am starting to shift now between Ireland and Canada. It's strange, and very nostalgia inducing. When a bottle of fish sauce runs out I don't replace it because I doubt I'll get through another bottle in 6 weeks. My pantry is starting to look very bachelor-esque and barren. I've started using all my hotel shampoo's and soaps because I loathe the thought of buying more that I won't finish (why don't hotels also provide tiny laundry soaps?!) Friends are randomly given clothing, books, music when they come over as part of a pre-purge offloading. I look at all my belongings with a more discerning eye...hmm will I bring my yoga mat home or leave it with 'Enable Ireland'?

I'll tell you one thing, the silicone oven mitts and wine aerator are coming home with me!!!  Oh Ireland, it's been fun but I gotta make a move.

Thursday, March 28, 2013

Intimate Insight

I know that these images and this story are making the rounds on social media these days, so my apologies if you're feeling inundated. I felt that these images were too profound and raw and beautiful to pass over.

It is one of the most heart wrenching photo essays I've had the privilege of seeing. I think it shows so poignantly the suffering, strength, love, hope, fear, and anger that features in the struggle with such a devastating diagnosis. To me, these photos express very clearly the questions that we struggle to form when we ask about cancer, and I believe they show the answers to those questions. A few of Angelo Merendino's photos from the website are shown below. In my opinion he is a brilliant photographer, and she a powerful subject.

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.


Thursday, March 14, 2013

6 Minutes

So in case you didn't know, it is World Kidney Day today! I was at our local shopping mall with a gang of retired nurses, fellow medical students, renal nurses, and the renal pharmacist, giving out information and checking blood pressures and blood sugars.

We were MAD busy all day with a steady queue of feisty Irish grannies (mostly) and the odd Irishman who had been dragged there by his wife. It was actually a really fun day but the highlight for me was when a woman standing there with a pram said as I went by, "Hey! I know you!" I looked at her and scanned my mental files for her face. "Er....." She said, "you were there in the maternity hospital when I had my son! Remember me?"

I felt terrible because I couldn't place her (and I am usually great with faces). She said, "Remember? Six minutes??" Then I remembered. YES! I had even written about her on the blog! She was the one that had gone shooting by in the wheelchair panting while the midwife yelled at her not to push yet.

Of course I remembered her. I told her if I'd seen a side profile with her hair blowing behind her I would have recognized her right away. We had a nice visit and I had a chance to see her gorgeous blue eyed chubby boy, grinning away at us. So delightful.

I love my job!

Have you hugged your kidneys yet today?

Monday, March 11, 2013


I am totally blown away by how many people commented on my match post!

I have been soaking in the sweet sunshine of many lovely, kind, thoughtful, generous comments from so many readers (many of whom I didn't know existed!) I actually didn't want to make another post because I wanted that one to stay front and centre for a few more days.

Honestly, people. Thank you so much for taking the time to comment and send on such wonderful encouragement. I am truly humbled by this.

Note to self: have mega life accomplishment more often!

Wednesday, March 6, 2013


Into what specialty do you match the girl who loves everything?


I felt that this post needed to be written today. So despite the fact that I am running on 1.5 hrs of sleep and am still trying to grasp the outcome of yesterday's events, I wanted to update the blogosphere. 

The last few weeks seemed to drag on with painful anticipation. I spent many sleepless nights trying to sort out how to rank, and trying to decide what I truly wanted to be. After I submitted my list to CaRMS I started really doubting my list order. I mean, really started doubting. I had what can only be described as pseudo-panic attacks where I would go around and around in my head all the possible outcomes of the match. What would make me happy now? In 5 years? In 10 years? What was going to be able to give me the life that I wanted outside of work? What could provide me with the chance to write, maybe do some more work for CBC, travel, have flexibility, allow me to keep my athletic pursuits up, and also just enjoy big and small adventures with Duncan (I know, I know...I am introducing this character late in the game but he deserves his own post later). I've been wrestling with my first love (emergency medicine) and my new love (obstetrics) and trying to decide which of the two I wanted to do. Then I would be in clinic and see a few kids and think, "But...peds! I LOVE PEDS TOO!" or I'd meet the most fly 87 y.o lady who'd reinforce my hope for aging awesomely and I would mourn the loss of elderly patients. Also? It turns out I really enjoy continuity of care in my life. It just brings a whole other layer to job satisfaction for me.

I know, could the writing on the wall have been any more obvious?! I love getting off the beaten track, away from throbbing mega-hospitals and being somewhere that I know the radiographer's names as well as the name of the woman who serves the casseroles in the cafeteria. I don't want to live somewhere that people look at your handbag, not your face when they see you in the street. I don't want to take a subway to work or require reservations every time I go out. I am a country girl who loves country medicine. I don't know why it took me so long to come back to that, and accept it! 

So when I saw that I matched in rural family medicine, I thought..."Of course!!!" But I've forgiven myself for not knowing this a long time ago. I allowed myself to contemplate other areas of medical specialization to the furthest degree. When I said that I was going to just experience medical school and see what I liked, without preconceived ideas, I DID that. And this is where I ended up. It feels very full circle-ish to me. Now I get to do everything! Peds, obs, emerg, women's health, sports medicine, chronic disease management, surgical assist, palliative, hospitalist and down home family medicine. 

Some weird and wonderful things that have crossed my mind in the last day. 

I matched in the first program that I interviewed at. I adored the program, the people, the location. But I was guarded and wondered if part of my swoon was attributable to the fact that I was fresh and excited about interviews. I mean, initially I was so delighted with the place that I thought about not going to any other interviews. But then realised that would be a ridiculously bad idea for someone like me (a lowly IMG). I kept going back and comparing each subsequent program with that first one. Wondering.

When I was driving into the town (where I ended up matching) I came to a bridge and had a very strong sense that I would end up crossing this bridge a thousand times. I loved the look of it, I think partly because it reminded me of a bridge near my house where I grew up in Alberta. It was one of the few photos that I took during those two weeks of interviews, but it is my favorite. Looking at it, I can remember exactly that sense of predicted familiarity and how my heart had already started to feel tied to the place. It was strangely powerful and most unexpected.

Then last week, I had a dream that I matched to my program. In my dream I was shrieking and celebrating and telling myself that this was the perfect thing, and that I was so happy with the way things worked out. Of course when I woke up I felt the stress and worry creep back in as consciousness returned. The dream had been so vivid. That was where I wanted to go. What if I matched somewhere else?

I recently started on a new rotation with a congenial, fiercely intelligent, slightly quirky, banjo-playing dermatologist. When we met he asked what specialties I had interviewed for while I was in Canada. I told him, but I didn't say where in Canada any of these programs were. I told him about my previous life as a nurse in Nunavut and the NWT. A little while later he was introducing me to a patient and said, "This is ABB, she is going to be a family doctor in northern Saskatchewan". Now, again I will say that I hadn't told him where I was interviewing, and I have yet to find many Irish people who can even pronounce "Saskatchewan" let alone use it in a sentence. I mean, most Irish people know Ontario because their cousins always live in Toronto, and they've all been to Niagara Falls. Funny because it is true. So the comment from Dr. R threw me a little, but I didn't say anything to him about it, I just made a mental note. Innnterrrrresting. 

And now I am here. A little like a dog spinning around before he lies down. I still haven't fully grasped that the uncertainty, that has been hanging over me since I started on this journey over 5 years ago, has lifted.

I have a job as a doctor in Canada.

Let me just say that again on the off-chance that it sinks in.

I have a job as a doctor in Canada.

And it is a bloody good thing (as I am ~$250 000 in debt!) And an exciting thing. I am beyond grateful and excited to start on July 1st. I feel like I've been in the starting blocks for years. As a nurse I hoped some day I would become a doctor, and then as a medical student I had to deal with being slightly taken away from direct patient care. Mostly watching others do the nursing and doctoring. I've been striving, waiting, chomping at the bit for this responsibility.

This past week especially I've had a most distractible mind. My normal regime of night-before ironed work clothes, packed lunches and leisurely breakfasts has disintegrated to eating dry cereal and turning my underwear inside out instead of finding time for laundry...

But tonight I eased myself back into life. I cooked a delicious pot of veggie chilli, did loads of laundry, and sat down to write this post. The lack of sleep last night is catching up with me but I am happy.

It seems I've gradually started living my way into the answers. I cannot believe that I can actually say,

"I am going to be a rural GP!"

At the risk of extending this stream-of-ramblingness any more I just want to also say that over the years this blog has given me a great outlet and a wonderful connection to people all over the world. Even when I've felt like a tiny medical student, hidden away in a dark study room for weeks at a time, I felt connected to the people that read and commented, or took the time to write. I have made great friends and kept in touch with old ones through Asystole and I feel like it has given me many gifts on this wild ride.

And so writing this post for those of you that have been following along, gives me so much pleasure! Thank you all for the words of encouragement, advice, offer of cars, couches, lifts from the airport...for mailing forgotten bathing suits, buying me giant soup pots, sending mugs, meeting me at airports, buying me lunch and even the odd train ticket.

Expect the unexpected. Or maybe what was right in front of you the whole time.

Tuesday, February 19, 2013

Well That Wasn't Easy

So I finally submitted my rank order list. Those of you who have gone through this whole process please skip the following couple paragraphs. Actually, just skip to the bottom of the post.

After interviewing for residency jobs the candidate has to rank the programs in order of preference. The programs do the same, they rank the candidates in order of preference. These lists are kept confidential so neither the candidates nor the programs ever find out who ranked what / where (theoretically). These lists go into an algorithm which "matches" the program the candidate wanted the most with the program that ranked him/her the highest. The algorithm favors the candidate. What that means is...(by the way, I am explaining this for the 117th time in the last 3 weeks so from now on I will be referring people to this post rather than reciting my little speech)...I will be matched to a program I really want over a program that really wants me. 

An example. I interviewed for several programs. Let's say every program I interviewed for had three IMG positions (this was not usually the case, most places only had one IMG position but this is my fairy tale blogland).

-If the program that I ranked first ranked me in their top three then I match there.

-If the program that I ranked first didn't rank me in their top three then the list goes to my number two choice.

-If my number two choice ranked me in their top three then I will match there.

And it goes down the list like that until I match (hopefully).

-Now, conversely, if I am ranked number four at my top choice, but their top three match somewhere else, then I get bumped up the list and would be their new first choice, thus I will match there. And so on.

So the programs have already submitted their rank order lists which is why I feel like I can be slightly more open about the process now. Well, a tiny little smidgen more open.

I spent the last 3 weeks in a career choice mulling daydream. I emailed former colleagues, texted friends, called my boyfriend, mother, and siblings to ponder out loud. I dropped in on past professors, lunched with career idols, and lay awake at night trying to figure out how I wanted to rank the programs. See the thing is, I interviewed in 3 different specialties...all of which I truly enjoy and all of which I see myself being happy in, ultimately.

These are examples of my considerations for some of the different programs (in no particular order...heh):

1. LOVED the residents, they sold the program very very well. The faculty were very upbeat and relaxed. They had really put a lot of effort into the call schedule and maximizing learning. Great access to outdoor adventures, training tailored to someone who wants to work in rural setting. Research project support as well as required classes on medical education that count towards a masters. Downsides were that the city is sketchy, the winters are brutal, and it is pretty far from the Rockies.

2. LOVED the program, very similar to one above. Brand new hospital, great call schedule, opportunity to engage with the community in interesting ways, very flexible and supportive of residents cultivating their interests within the program. Far from international airport, smaller population, lower volumes, loads of hands on training though as no competing fellows and fewer co-residents.

3. LOVED the institution and what it represents. State of the art training labs, simulators, anatomy sessions. My favorite location by far, bigger but not too big. A program that would definitely support any type of practice I might want to pursue down the road. Close to great recreation, international airport, major city.

4. LOVED the program director. Again, a lot of flexibility, support for master's training. BIG centers, huge volumes, massive exposure to EVERY POSSIBLE THING YOU COULD EVER WANT TO SEE. Big city, big rent prices, big drive to anywhere green and pretty. Very, very far from the Rockies.

And so it goes. Every place I interviewed had similar pros and cons. I tried to sit down and mathematically create an answer to my dilemma. I made categories like "recreation options" and "location" and "academic advantages" and I gave each place a rank for each category. But when I looked at it in the end, I was favorably ranking the programs I really hoped would come out on top, not necessarily objectively tallying the sums.

In the end, I ranked all of the programs I interviewed for. I suppose that my top four choices are all places that will make me jump up and down if I see them on my computer screen on March 5th (match day). My remaining choices will all be perfectly acceptable starting points that will get me where I need to go (and I suspect may be hidden gems).

I do believe that in 5 and 10 years I will look back at this time in my life (the rapidly approaching fork in the road) and laugh at where I thought I was going...and where I actually ended up.

Monday, February 18, 2013

Kaplan Phone Support RULES!

OK normally I don't do GIANT TEST PREP COMPANY* shout outs but this really deserves one.

I had to call Kaplan because I was having issues with my account there and the guy who I spoke to on the phone was hilarious. After I mumbled something about the fact that I've dropped so much money at the Kaptest store I should have a gold star beside my name he informed me that I did in fact have a gold star beside my name. And then at the end of the conversation he wished me luck on my exams and said that he hoped that in the future if he ever got sick he hoped that I would be his doctor.

You just don't get that kind of flattery customer service when you call Telus.

Way to go random call center dude! I'm almost pleased that I've spent the equivalent to a couple of mortgage payments on your products.

*I am not getting any sort of money or discount from this post. Really. I wish I was!

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.

Thursday, January 17, 2013

Visa on Fire

I just spent the last two hours booking flights, hotels, and car rentals for my Interview Trail Extravaganza!!! And I am not even finished yet.

I think my VISA is about to spontaneously combust. 

So far I am at $1440 dollars (and 21 000 aeroplan points) poorer, with still 5 nights hotel left to book and transportation from Toronto to Hamilton.

I am reminding myself to be thankful for the financial burden. It means I have interviews which probably means I have a future job back here in Canadia...What is that saying about having to spend money in order to make money!?


Tuesday, January 15, 2013

In Hiding

I hate to begin all posts with an apology for the dearth of updates. I have good excuses though: patchy internet access, roaming around Canada and the US living out of a suitcase, distaste for staring at computer screens except when absolutely necessary, awareness that future program directors may be reading the blog...

It's been a wonderful handful of weeks though, I really must say. You know, I love Ireland, but I LOVE Canada. The fact that my future job prospects are looking quite good here makes me oh so very delighted. I actually left a suitcase of winter clothing at Momma Bear's house, knowing that my next Christmas will likely be HERE! It is exciting. Also, did I mention that I actually got some skiing in this year?!

Luc and I on the lift. Quality time with my nephew/Godson (said with Brando voice while stroking underside of chin).

Cruisey Tree Skiing = Happy Place!
Yes. After family Christmas in the dark we traveled to Montana for some fine, fine skiing and even the odd celebrity sighting! Saw Timberlake and Biel snowboarding (they're quite good!), Affleck and Garner skiing (she is even more gorgeous in real life, he's a scruff box) and had a random chat about powder quality with Mary Hart (ridiculously nice and bubbly).

I forgot how much I love spending a day on my skis. The quiet of the trees, the hypnotizing snow flakes, the tired legs, crisp air. It was such a beautiful resort, they had to drag me away at the end of our week there.

Will post some more updates about the last couple of weeks soon. 2013 has already been VERY top shelf. A nice change so far from 2012.

In the meantime, working on a literature review and getting ready for my interviews.


Tuesday, January 8, 2013

The Griswolds Meet Pieces of April

Somehow the post I wrote about our family Christmas was lost to the binary blinkings of blogger. This displeases me greatly as of course I am quite sure that it was the most delightful post I've ever written (probably not). So now, in its place I will make a quick summary the first (of two) family Christmas dinners.

It started with (what I refer to as) The Griswolds meet Pieces of April Christmas.

We had a major power outage the night before and day of our planned family Christmas feast. In fact, not just our house, but the entire neighborhood. This resulted in my mother and sister kicking into full food preparation RED ALERT. Driving across town to several surrogate ovens and bringing back cooked dishes wrapped in tea towels and hoisted into coolers. Meanwhile my brother in law bought dozens of electronic tea lights, large candles, and industrial flashlights to illuminate the house. We tried to strategically place the various beams (including one shining directly on the darkened Christmas tree).

"Yes, the tree!"
Buffet by flashlight.
A romantic family Christmas...?!
Gift opening in the dark.
And then there was light!!!
Regardless of the electricity situation, the food was fabulous thanks to the industrious problem solving skills of my sister and the fact that she has a gas stove (no Christmas feast would be right without steaming sour cherry sauce for the pork and hot gravy for everything else). Despite being in the dark things maintained a degree of normalcy, the adults ate too much and the teenagers texted too much. We drank wine, opened presents, and enjoyed having (almost the entire) family together for the first time in ages. I have to admit, being home for Christmas for the first time in 9 years has made me very excited at the prospect of being back in Canada. As much as I love Ireland and all the adventures I've had, there is something to be said about being home, in the dark, with my crazy family.