A year of clerkship

I just wrote my paediatrics exam. It is the final exam of my clerkship.

Officially, the medical school has done all the clinical teaching that it's going to do.

I remember starting my first day of clerkship in January. It was in internal medicine. I was absolutely lost on the ward. Lost in a sea of procedures, dictations, charts, notes, exams, lectures. I was given my first patients that afternoon. I spent a good part of that same afternoon doing an in depth neurological examination on someone with pneumonia.

Later on that month, one of my patients died suddenly from a massive stroke. I used to perch on the corner of her bed and we'd have nice little chats. She was quite a peach to put up with my daily questions regarding her bowel movements. It is easy to take the privileges granted to medical students for granted.

What happens in a year of clerkship?

I've lived in five cities (Hamilton, Vancouver, Grimsby, Brantford, Toronto).

I've cared for kids with strokes, adults with strokes, middle-aged blokes, wheelchair-bound grannies, pregnant ladies, premature babies and everything in between.

I've lost two bicycles, two stethoscopes, and a pager.

I've auscultated, poked, percussed, palpated, sutured, stapled and listened, listened, listened.

I've rollerbladed to the hospital, to the library, to play soccer, to the grocery store and back again.

I've slept little and ate less. I've studied more and known less.

It's an odd year. I've come so far, but am daunted by how far remains to be travelled.

Karma

I wonder if such a thing as karma exists. In stories and in movies, the evil-doers always get theirs in the end, but I wonder if this is actually the case? Real life seems to improperly reward good deeds inadequately punish bad deeds.

Ideally, one would do good or bad independent of concrete reward or punishment. Do good for good's sake.

I don't think ANYONE would ever do any good if there weren't ever any reinforcement. Most of it is probably unspoken. Being nice to people usually does result in people being nicer to you.

But, I've noticed every so often that life itself does interesting things to reinforce its lessons. Odd things happen, co-incidences occur. I suppose it could be called karma.

Toronto!

I've been in the T-dot for the past week. I'm doing a placement in a community pediatrics office.

I reeeeeaallly like the kids. It makes me kind of sad that all these awesome little kiddies will eventually grow up to be teenagers... or adults. yuck.

There was a patient the other day, who called because she was unable to get her 5 year old son to take his antibiotics. The antibiotics come in liquid form and are banana flavoured. It seems odd to me that this is actually a problem. It really makes me realize how differently people are raised. It is almost outside my realm of understanding that a parent would actually need to call a doctor about getting her 5 year old to take his medication. Spank him already! haha, I joke. I don't approve of spanking. Or do I? Must admit, I am somewhat undecided.

I remember I got strep throat once when I was around ten. I told my dad that the antibiotics (which were tablets, NOT fruit-flavoured syrups) gave me tummy aches and gas. He said that it was MY problem if I wanted the strep throat instead of the antibiotics. I ended up taking the pills.

Living with the sister has been quite lovely. She makes my lunch every day. Her place is VERY cold. It's so that I have three blankets, and I still wish I had a scarf so my neck wouldn't get cold.

Also, it was my sisters' birthday yesterday! Happy birthday girls!

Stethoscope!!!

As you may or may not recall, I lost my stethoscope earlier this year. Shortly after that incident, I entered an anecdote into Stitches (a medical humour magazine) in the hopes of winning a replacement.

I didn't hear back, and I eventually got tired of borrowing the nurses' stethscopes, so got a replacement. On the company website, this scope was a 7/10, as opposed to the 9/10 that was my previous scope. I figured this would be a good thing since it would make it less steal-worthy. I was wrong. I lost this stethoscope somewhere on the ward last month.

Anyways, I've been going around without a stethoscope for the past while, and just when I was thinking I may have to cave and purchase ANOTHER one, I got an email today informing me that:


Congratulations! Your story was selected as the best medical anecdote in the November/December issue of Stitches. Please provide me with your mailing address so we can send out your prize, a 3M Littmann Master Cardiology stethoscope.


YES! You'll note that this is a 10/10 stethoscope. It's so blinging I'm gonna start wearing it as jewelry when I go out.

Last Call

I just finished my very last night on-call for clerkship. There will be many more in residency, but I think this is a milestone in one way or other.

Enrichment year is a go!

McMaster has a three year medical program. This is a year shorter than most other schools. The system has its pros and cons. Being done a year early is nothing to sniff at. On the other hand, there are fewer breaks and there is less time to make decisions.

Fortunately, McMaster has given its students the option of doing an 'enrichment year'. Not many students choose to do an enrichment year. I suppose it's always difficult to walk the path less taken.

Anyways, I started thinking about it earlier this year, and I came to the conclusion that this was the thing for me to do, for a whole variety of reasons. I wrote up my application earlier this month, and I just got notice that I've been approved!

It's official. I'm now part of the class of 2007.

It's rare to be given an opportunity like this. A blank canvas upon which to live my dreams.

I shall make this next year one to remember.

Coneheads

I did a pediatric neurosurgery(careful when scrolling down) clinic today.

Now when you're born, you have these cracks in your skull. They're there so your head can keep on growing, to accommodate your brain, which is also growing. At some point, these cracks fuse over. BUT, if these one or more of these cracks fuses prematurely, you get something called craniosynostosis.

Essentially, if your head can't grow in one direction, it'll try to compensate by growing extra in another direction. For example, if your skull can't grow width wise normally, it'll compensate by growing extra length wise and height wise.

You can end up with a bit of a conehead really. I don't think intellect and functioning are affected too much. It's "just" cosmetic.

Anyways, the point is that I saw a baby with craniosynostosis, and the parents opted against corrective surgery. They thought the kid looked fine. Apparently his older brother had the same thing, and they think he looks great.

On almost every level, I think that the parents have made a super decision. Surgery is painful. Surgery has its risks. Beauty is in the eye of the beholder. etc. etc.

And yet, I wonder if I were the kid, would I want the surgery? If not now... then someday?

In other news, I've decided that I should link more to fully take advantage of this here internet.

Bubbles

Yesterday, I saw a set of twins who were born prematurely, and a little baby girl who was born late. They're in the nursery, where they are kept in little incubators to keep them warm.

The twins are tiny little things. They meow softly when they cry, and their hands don't even fit around my pinky finger. The baby who was born late weighs more than both twins COMBINED. You can hear her crying from across the room. The one thing these babies all have in common is that they live in little bubbles of isolation. Just like I do.

My house in Hamilton, is devoid of roommates, television and internet. It's shocking to realize how dependent I've become on the internet to keep me connected, entertained and informed. I feel very cut off without it. It is remarkable how the internet has created, modified and changed the relationships I have with people.

Persons within

I should very much like to start approaching everyone I meet with my eyes closed. To ignore the husk that encloses a human spirit. Ignore it completely.

Society, and evolution itself has made us so very superficial.

It is ugly.

Sunday Soccer

I played soccer this past Sunday.

Distressingly enough, I feel as thought I've lost my skills.

I haven't scored a single goal this year! For a striker, this is not a good thing.

I think one of the issues may be my lack of fitness.

Good thing I have friends to cheer me up.

Be like Mom day.

Each morning, our team meets to divide up patients. There are seven of us: 1 senior resident, 3 junior residents, 3 medical students. The residents take care of 4-5 patients. The medical students get 2 patients each.

The first patient I get assigned is a girl from Hong Kong who only speaks Cantonese. Looks like I'll be doing some translating today.

After giving a few of the more problematic patients to the junior residents, the senior medical resident asks if there are any patients on the list who we would particularly like to take care of.

I scan through the patient list. Do I want the girl with the kidney infection? The boy with the odd rash? But no. I see something even better.

"There are twins? I'll take the twins!"

"Will you have time for 3 patients?" the senior resident asks me.

"No problem. I'm very experienced at dealing with twins," I say. He acquiesces. Looks like I'll be taking care of twins today.

So to recap. Today, I'll be doing Chinese translation and taking care of twins. I'm my Mom!

I decided to see the twins first. Two girls. Fraternal. Born just yesterday!
They're sleeping in the same basinette. I spent most of last night reading about the newborn exam. I'm feeling uniquely qualified for this. I start unwrapping Twin A. Twin B starts crying. I put Twin A down to soothe Twin B. Twin A starts crying.
If you put your finger in a babies mouth, it usually quiets them down. A trick I've picked up.

So it was that I found myself with two tiny mouths sucking on both my pinky fingers, wondering how on earth I was going to find the extra hands necessary to actually do any examining.

There was no solution. I moved valiantly onward with the examination, with both babies wailing their disapproval.

A nurse walked in a little later.

"Um, this baby pooped itself," I tell her.

She hands me a diaper.

I realize I have no idea what to do. She tells me to clean the baby off with a wet towel. I start dabbing at the baby's behind.

She grabs the towel away, "Do it like you MEAN it!", she says. I must admit her technique is much better than mine.

When I leave the twins, one hour and two diaper changes later, I am hot, sweaty, dishevelled and running late late late.

I scurry over to read the Hong Kong girl's chart. I realize that this will not be an easy translating job. She's a teenager. And she needs a psychiatry consult. My mind is swimming. I realize I may be in over my head. Understand that I've only ever really spoken Cantonese with my relatives and with family friends. Some words just never come up.

I call a friend who is fluent in Cantonese.

"Hi. How do you say 'illicit drugs' in Cantonese? Right. How about 'sexual activity'? You sure? Kay, great. How about...."

I hang up the phone a few minutes later. A friend has been listening in. He shakes his head at me, "You are so screwed."

It's not easy living up to one's mother.

Touched

I finished rounding on my patients early this morning, so I sat down to do a bit of reading. Over the hustle and bustle of the ward I heard a baby crying.

This is not unusual on a paediatric floor. On this morning, the crying just would not stop.

I decide to be curious.

I walk around the corner. There's a blond little baby, all alone in her crib. Crying, crying, crying. She is surrounded by toys which she ignores. She's lying on her belly, propping herself up with her two little arms.

I return to the nursing station. I'm told that a volunteer is due in to cuddle with the baby, but she won't arrive for another half an hour. Until then, there really is no helping things.

I throw on a hospital gown and walk into the baby's room. She almost falls over trying to reach for me. Lowering the side of her crib, I carefully pick her up from amongst her IV line and monitors. She stops her crying to chew on my gown. Her hair is soft soft soft.

Most babies are afraid of strangers. If I were to guess, I'd have to think that Mother Nature would select against genes that gave rise to babies that clung to strangers. What sort of loneliness would cause a baby to cling to a random medical student? It's so very sad.

Two-Four

Another birthday has passed me by. I didn't even remember until one of my classmates reminded me that morning.

As a child, I use to wonder why birthdays seemed like no big deal to my Dad. I now know it is because he is somewhat heartless. Haha! Just joking, Dad.

Anyways, this was quite a wonderful birthday. I thank everyone who took the time to mail/email/call me. Life is all about relationships after all. I must be mellowing with age.

It's my first day of paediatrics today. It's a whole barrel of awesome. I'm at the hospital right now (I'm on call). I've done three emerg consults already. Cute little kids add a LOT to a work environment.

Feels like home to me?

As I wrote previously, this past weekend I was on call from Friday to Monday. This means I was on duty and slept at the hospital on Friday, Saturday, Sunday and Monday night.

It's not as bad as it seems. Some nights are very busy, but some nights, you might get up just the one time to deliver a baby.

Anyways, I think my living arrangements of late have really scrambled with my sense of home. Regardez:

1) I've lived in a different city roughly every 2 months this year. (In order: Hamilton, Vancouver, Grimsby, Hamilton, Ottawa, Hamilton, Vancouver, Brantford)

2) I moved to a different house in Hamilton just this past September. This means I've moved EVERY single year since leaving home. That's six moves in six years, not counting summers.

3) I spend one out of every four or five nights sleeping in a hospital.

Remember the first time you went to a sleep over? Or the first time you slept in a hotel room? I remember (vaguely) that it felt very unusual. It just didn't feel like home.

I don't have this problem any more. I can (and will) sleep anywhere. I don't get thrown off by different sheets, different mattresses, different floors, different toilets, different taps. It doesn't bother me that I'm not surrounded by "my" things, or "my" people. I think I've lost that feeling of having a place where I'm "most" comfortable.

I wonder, have I lost my sense of home?
Or have I internalized it?

Babies galore

I'm on call Fri, Sat, Sun, Mon this week.

This means that I'm writing this on a Saturday night, and that I've been working since Friday morning. Hopefully, I'll get to go home sometime Sunday afternoon to shower or something.

Call isn't always pleasant, but there is no denying that it's the time when you get to see and experience the most.

I think at last count, I've delivered around 8 babies. I think... I'm starting to lose track. And the majority of these occur while I'm on call.
And I've seen some very interesting things.

The thing about Obs/Gyn is that it's very truly life and death. The life I was expecting. Babies are born, and it's an incredible event. But I wasn't expecting the ladies who lose their pregnancies, the lady with young children who showed up with inoperable cervical cancer.

This rotation has without a doubt been the best clerkship rotation yet.

The hours can be long, but I bear them with good grace.

Je t'adore. Je t'adore.

Catch!

I did my first night of call for obs/gyn yesterday which was wonderful and mostly sleepless since there were babies and phone calls and the first baby last night came at a fairly reasonable hour and it was a boy and my supervisors hands were over my own when I delivered it but I still count it as MY delivery and the second delivery came in the morning and THAT one I did mostly by myself and all in all it is a joyful and exciting and wet time and there's nothing like holding your own breath while waiting for a baby to take his very first one because it's like you're both breathing for the very first time and did you know that the majority of women tear during a vaginal delivery which is really something I didn't expect because it would appear that Mother Nature really did make the opening too small and she's not one for mistakes like the rain that's smattering outside that tells me it's Autumn that it's another season and another day and I wonder if the rain will follow me home for Thanksgiving and when I think about it I don't think I'd mind if it did because I'm going home to hear my zany sister play the ukelele anyways.

Turkey Trot

If all goes to plan, I will be bussing home with my sister on Saturday. I think we could leave on Friday, but she's got some post-exam parties to attend. You never really remember the exams you write, but the parties stick with you.

I feel like this blog is becoming boring. I hope this is not a reflection of my life.

It's all relative

So I'm currently living with some family friends in Brantford. They are the most wonderful people, and it's been very good times.

I was talking to my sister this weekend, about our family, and other families etc... And I think that we all just assume that what one's own family does is normal. Every family has its little rituals and conversation loops and habits. And when you experience another family environment, it's a whole world of interesting to realize that there really are many many ways to skin a cat.

On another note, they have a dog and a cat in the house. I'm really not much of a pet person. In fact, I feel kind of silly calling an animal any sort of name. I usually call the dog "Hey Dog", and the cat is "Hey Cat". And while I don't mind poking them with my feet, I feel that I should wash my hands after petting them.

The fine line between Hero and Goat

I played my first soccer game of the season today. We tied 1:1.

We were down 1:0 at halftime. Then we scored quite a wonderful goal (I got an assist!).

With five minutes remaining one of my team mates got fouled within the box, and our team was awarded a penatly shot!

The referee put the ball down. I realized that my team expected ME to take the shot! I reckon this was because:
1) I am one of the strikers. We score goals. It's what we do.
2) I'm in 3rd year, so I have seniority.

Anyways, I really wasn't nervous stepping up to the ball. But I was a whole world of dismayed when I blasted the ball straight over the net. aii!
Just like Beckham and Baggio before me.

I don't want to become a punchline!

I'm really enjoying obstetrics and gynaecology. I'm giving this some serious thought as a career option.

I just got off the phone with my sister who said that her friends would make fun of her if I became a gynaecologist. That hardly seems right. All that training!

Depending on my mood, I sometimes see career decisions as being very stressful and sometimes I see them as being very exciting.

I'm living with some family friends in Brantford. It's pretty fanastic.

Babies in Brantford

I returned from BC this past weekend to start my Obs/Gyn rotation in Brantford. It is difficult to describe my time in Vancouver. I'll try in bits and pieces as time rolls on.

We had an orientation to the rotation on Monday. We were taught to do pelvic exams by a standardized patient. It's quite a bizarre experience. Our lady was SUPER talkative. It's always weird to have someone lecturing at you while your fingers are.. um.. inside. eeek.

Anyways, today was my first day at work at the Brantford General Hospital. It's pretty super so far. I spent most of my time seeing patients at clinic, but the day was punctuated by a visit to the ER to do a consult, as well as a visit to the ward for a delivery!

The birth of a child is: gross, wet, bloody, tense, painful, tiring, exhilirating, joyful.
You go from tense and painful to tearful happy in moments. It's really something quite special.

A brief from work

I'm on lunch break.

In the previous surgery, we took off someone's ear! Yow!

I don't know what Van Gogh was thinking.

Look before you leap!

Implicit in this statement, but seldom remarked upon, is the fact that sometimes in life, a leap MUST be made. Ironically, advice regarding the act of flinging oneself into scary uncertainty is ubiquitous in our society: Just Do It.

Dodgeball has an odd sort of Grace

I saw Dodgeball not too long ago.

It made me think back to those sweaty, pulse-quickening times of yore, when natural selection would make a brief visit into our daily scholastic routines, and rubber balls and aggression were mixed liberally with classrooms of children.

The rules of dodgeball are simple (Hit the person with a ball. Dodge balls thrown at you.) But as is with most things in this life, the rules supply just the baseline for what truly occurs.

To the stress of dodging balls, was always the unspoken understanding that it was infinitely preferable to be hit by one of the cool 'jocks' of the class. No matter how poorly thrown, it was very understandable that one could not avoid a projectile cast by one of the 'cool' kids. But so acute was the shame to be hit by one of the shrimpy nerdy kids!

The thing with life is,
dodge as you will,
it'll be the wee pixie girl,
the one in the sequin-flowered white sundress,
who nails you square in the chest.

Sweet sweet Vancouver

I am in Vancouver, and I am wondering why I ever left.

I watched the Sisterhood of the Travelling Pants on the flight. It had it's moments. I would possibly have shed a tear if not for the social stigma associated with boys crying at chick flicks. The lady I sat next to was a PhD student in psychology. We talked about rhesus monkeys and whatnot. It must really suck when science discovers that your species is suitable for experimentation.

In the goal driven lives of our times, we associate happiness and fulfilment with the acts of accomplishing and achieving. Rare is it that we savour the moments BEFORE something happens, be it good or bad. Childhood has taught us all that Christmas morning is at times sweeter than Christmas morning. It is rare to be in a position to know that SOMETHING's going to happen. It's important to enjoy these brief moments of anticipation when they come.

Human Analysis 101

I'm currently living in a place I'm subletting from a friend in my class. I met her for the first time at our grade 8 graduation when we shared some sort of academic award. Years later in high school, I sat behind her in physics class, and years after that, we both set off to medical school together. We're living together for a little while, since I'm going to Vancouver on Saturday, and she'll have moved to Toronto by the time I get back.

Anyways, we were talking last night, and I told her about my Puzzle Piece Theory.

Let's call it Simon's Puzzle Piece Theory (SPPT).
Assume:
1. Everyone is a puzzle piece.
2. Puzzle pieces differ in their complexity. This fits a bell curve distribution with 'simple' at one end and 'complicated' at the other.
3. Simple puzzle pieces have waaaay more potential 'fits'

SPPT is an anology: finding that 'special someone', is very much like finding a puzzle piece that fits properly with the puzzle piece that is you.

People who are simple puzzle pieces don't have any problem finding people that fit. The trade off is that 'fits' are less precious since they are relatively common occurences. Complicated puzzle pieces have very few fits. The trade off being that a 'fit' is a very obvious and special occurence.

Additional conclusions to be drawn from SPPT:
1. You can 'force' a fit, but then unhappiness ensues (It's not optimal to have to change your shape to fit another!).

2. With age, puzzle pieces lose their edges, so what WAS a horridly complicated puzzle piece can simplify.


Anyways, my friend thought this theory to be fine and dandy but then proposed a twist! Which I shall name after her:

-------------------------------------------------------------------
Hamidah's Addendum to SPPT (HASPPT):
Assume that complication goes up with education and ambition. THEN

1. Complicated puzzle pieces should NOT try and find other complicated puzzle pieces. It is too rare an occurence, and, given the general life course complicated puzzle pieces would follow given the initial assumption, it is unrealistic for two complicated puzzle pieces to be able to fit into eachother's lives. Instead, complicated puzzle pieces should seek out a different set of individuals, hereby dubbed 'plasticines' who are able to MOLD themselves around a complicated puzzle piece.

-------------------------------------------------------------------------

Intriguing. An attempt at characterizing complicated puzzle pieces AND a whole new subset of people! I will have to consider this in future revisions of SPPT.

Hamidah's addendum tackles one of the key issues that I haven't yet the gumption to address: What determines the complexity of a puzzle piece?

Connect Four

I played Connect Four with my old housemate the other day. I won many times in a row. I think he got discouraged about his mental muscles.

On one hand, I think it would be silly to make any judgements about one's intellect from games of Connect Four. What exactly are you testing with such a simple game? (For those in the dark, connect four is like tic-tac-toe, only you need to... connect four.)

On the other hand, if you lose consistently at such a simple and pure test of logic, it's gotta infer something right?

I should have let him win a couple games.

Take out or delivery?

I'm sitting behind the counter of my cousin's Chinese take-0ut place. There is a corpulent man in a black ballcap waiting for his sweet and sour pork. He specified that it couldn't be burnt. Before him, a mesomorph with army pants ordered two egg rolls. He paid for them in cash and was very careful to pocket the penny that was returned as change.

I have friends whom I only see once in awhile, but when I do see them, I know exactly what to expect. Things don't really change. Then there are the people with whom I speak with more regularly, but each encounter is sorta like that game you see on Extreme Elimination Challenge. You know the one where there's a wall with three paper doors, but behind two of the doors is concrete? The contestants have to run at full tilt and crash through a door, hoping that the one they choose isn't a painful one.

What is it that makes some relationships change so quickly, and some not at all? What makes a relationship stable? Be it a love relationship, a hate relationship, a love-hate relationship. Why do some relationships flow smooth while others jitter like waterbeetles on a pond? I have my theories.

My friend Greg has mentioned that my posts have been light on substance lately. So I shall supplement this entry with a bit of hospital gore. And a promise to clean his clock at foosball this weekend.

Anaesthetic drugs are frequently kept in little glass ampoules. When needed, the neck of the ampoule snaps off, and the drug can be drawn with a syringe. (It is not a good idea to have me around so many needles. I have already poked myself after just one day on the job. Luckily, the needle hadn't yet gone into the patient.) Anyways, the trick with opening these ampoules is that you must snap the neck off in the opposite direction to a little mark on the ampoule itself.

No one told me about this little mark. So it was that I was squeezing and wrenching on this little glass ampoule when it shattered into tiny little pieces in my hand. I wimpered pitifully and pressed my bleeding fingers into my scrubs. Fortunately, I managed to manfully draw up enough drug for the patient with my other hand. The OR staff where most unsympathetic. It is apparently bad form when the medical student loses more blood than the patient does.

Two for three

It's my first day of clinical anesthesia. We've spent the earlier part of this week in the classroom. I must say, my classmates and I have had crazy good times being in a didactic environment. It's a nice break to be spoonfed knowledge.

Anyways, it's back to the practical now. So far, I've gotten two of three intubations today. I wish I could have another crack at that last fellow. I was so hoping to carry a perfect intubation record.

Since my new place doesn't have a laundry machine, I made my very first visit to a laundromat yesterday. It was very warm inside, and so I got a bit drowsy. Just inside the door to the laundromat there's long bench. Naturally, I lay myself down on it and fell fast asleep. I woke up half an hour later.

I've had the ability to fall asleep ANYWHERE for awhile now (buses, trains, parkbenches, museums etc.). My niece attributes this to my trusting, somewhat oblivious nature. She said that she would never be able to sleep in some random laundromat. She said she'd worry about people taking her stuff and whatnot.

I think at a certain level, I just believe that things will be alright. It's not that I believe that unfortunate things won't occur, it's just that I think things will be alright in the end.

Souliers

I went with my niece for a spot of shopping today. They've issued special edition Terry Fox runners, and it was my intention to acquire a pair.

The concept is really quite lovely. They're replicas of the the shoes that Terry Fox wore when he did his run. Proceeds go to his foundation. They're blue shoes, with his name written in gold along the side.

Unfortunately, they make my feet look fat.

ah well.

On a brighter note, I did get some nice brown shoes.

Almost done!

I'm at the hospital. It's the last day of my surgery rotation, and I'm the unfortunate soul who lucked into being on call. It's the end of rotation for a lot of my friends, and it sounds like tonite will be quite a night out. Ah well.

I did very well on the written half of my surgical exam. I believe this is the only exam in my entire life (outside of piano exams), where I didn't rely on last minute cramming. It's an entirely different feeling. I find that I know things without remembering exactly when/where I read or saw them. I think there are a few things that made my studying successful:
1. Study with purpose. You have to plan what you want to accomplish/set goals, or else it just doesn't work. You need a plan!
2. Study away from home. I'm much too easily distracted. I went to the hospital to study. Ain't nothing to distract me in a hospital!
3. Study consistently. Commit to leaving your house to study. And then leave. No matter what.

It kinda makes me wonder what I was up to before. Who knows.

On another note, there was a retirement party for one of the nurses, and I'm STILL snacking on the leftovers. I can not describe how wonderful this is. I think if med school included an all you can eat buffet, it would be perfect.

So. Ticked. Off.

I returned to the hospital today after my exam. This may not have been a good idea.

To make a long story short, one of my residents acted in a way I thought was very mean-spirited and unprofessional. In the minutes that followed, I questioned an attending about whether her requested consult really needed to be done stat.

She evidently took this the wrong way, because she gave me a bit of a talk. And then, her medical student gave me another talk. (In retrospect, I suppose at my current level, I have to just accept the abuse of attendings. But I will not have another medical student talk to me like that.)

Anyways, the net result was that I spent a good part of the day quite worked up, and quite furious at my resident. I'm not sure what my next course of action will be. I will likely talk to the resident tomorrow to try and clear the air. I also plan to talk to one of the nice ladies at the MD office. The real question is whether I should bring this to the attention of one of the attending surgeons. We shall see.

This surgical clerkship rotation has not been easy. I don't understand an educational system where you give people with just ONE more year of experience absolute power over those under them. They need to give medical students some sort of protection. Some rules that apply absolutely, that defend our purpose in the hospital. Which is primarily to learn things.

My friends have advised that I sleep on this. And I will. I won't vandalize any vehicles or anything. I've also promised that I will consult with someone before I decide to confront the resident or a staff.

On my way to the hospital, someone driving by threw an egg at me. It splattered on the sidewalk in front of me.

Why aren't people kind?

Something a little more concrete

I passed my surgery oral exam!
The only question that caught me a bit off-guard was the one on kidney stones. I was expecting a question on scrotal masses.

Either way, it's nice to have that over with. I was nervous initially, but thing settled down quickly and all in all went quite well. I have my written exam on Wednesday, one more week of surgery after that, and then I'm on to the much less demanding world of anaesthesia. phew.

If there is anything I'll be taking away from this rotation, it's the importance of being nice to those lower on the totempole. It goes a long way in terms of overall karma, I think.

Hopefully will get to have dinner with niece tonite. We shall see.

On ambiguity

We, that is to say humans, don't deal with ambiguity terribly well. Among the many dissapointments that life keeps in store for us is the realization that the razor line between right and wrong cut into the words of fairy tales, fables and legends does not in fact exist at all.

It's all in greyscale! No absolutes. Sliding standards and slippery slopes.

It is time to change. Time to aim for a purity of intention so clear that any grey looks dark by comparison. Right for the sake of right itself.

All this will one day be yours

6am, and I'm leaning against the computer desk, waiting to round on the patients on the floor. I was up too late last night (note to father: I was studying. Really.), and so I accept my current state with all the grace I can muster.

I think to myself, wouldn't it be interesting if little Simon (say Simon when he was 9 years old) was suddenly presented with a box. The contents of the box would be whatever is currently on my person. I suppose the box would say : Little Simon! This box contains what you will be wearing on Aug. 18 2005. Love, Big Simon.

I think part of why I wonder this is because it seems that a lot of little things combined can say an awful lot about you. To whit:

Little Simon opens box to find:

1. One pair of New Balance sneakers
Desccription: These are comfortable shoes. They are also the cheapest possible pair I could find. The also are so worn that I have a pebble lodged into the heel that will not be gouged out.
Conclusion: Big Simon is not so stylish a guy.

2. One pair of scrubs. Size large pants. Size medium top.
Description: I have notes scribbled up both pant legs. Random blood pressures, room numbers etc...
Conclusion: Big Simon appears to be doing something medical. He probably has a palm pilot like most medical students (He does.), but clearly can't be bothered to use it. He also appears to have a disproportionately small upper body, or a disproportionately large lower body.

3. One lab coat. Little medical books in pockets
Description: Short. Stained.
Conclusion: Aaah. A medical student.

4. One stethoscope.
Description: An exceedingly low functioning cheap-o affair.
Conclusion: Big Simon's good stethoscope must have been stolen!

5. Various sraps of paper
Description: One shopping list (Bread, Gelato, Yogourt, Cheese, Meat, Pepper). One learning list (Bowel Obstruction, Appendicitis, Biliary Colic). One patient list (Names confidential). A letter addressed to nobody. (Hastily written. Words crossed in and crossed out. Will never be sent.)
Conclusion: Big Simon thinks too much or thinks too little.

In all likelihood, Little Simon will be thinking simpler things like:
Wow, I'll be taller than Dad!
I hope those stains aren't what I think they are!

But, it would be so wonderful,
so very, very special,
to be able to sit Little Simon down. And explain everything to him. Explain why I carry what I carry. Explain what it means. Explain where I am. Explain where he'll be. And then I'd give the kid a hug. Because all children (even Little Simon's!) could do with more hugs.

100 entries in Simonscapes

100 moments, 100 windows into my day, into my life.

I wonder if the gestalt of who I am can be understood by the truths that slip between the cracks of these, my carefully/carelessly edited digital tracings?

Will the truth set you free if you're unable to differentiate between it and fiction?

simon

Hospital High

I was on call yesterday, so I'm now sitting at home, tip-tapping on my computer as the afternoon sun lights up the dust around me.

Actually, my resident suggested I should stay, but after consideration of several factors,
1. I'm entitled to go home.
2. No one will notice my absence.
3. It is not in the best interests of my learning to stay,
I decided to hoof it.

This recent rotation has some aspects of early high school to it. My residents are virtually all PGY-1's. That is to say that they graduated from medical school just this year. This makes for a very bizarre social dynamic because although we're all about the same age, the residents:

1. Help to evaluate our performance
2. Order us around
3. Are much more directly responsible for patient care

The bottom line, I suppose is that residents, despite being our peers, hold power over us. And we medical students do our best to impress them.

We pander to the residents much as 'geeky' kids would to the 'cool' kids.

I did not like this in high school. And I do not like it now.

Internetting

The use of the internet as a source of information has ballooned before my eyes. There was time when my teachers in high school would not allow internet sources due to their suspect validity.

Now, medical students 'google' questions about patient managment!

The only thing more astounding than the propagation of facts has been the propagation of thoughts and opinions.

Take for example, the recent Eric Lindros trade. A quick search will reveal the details about the trade. Who got what for how much. But this isn't anything newsprint won't bring you.

If you look a little bit online, you'll find all SORTS of commentary about the trade. From personal websites, to blogs, to message forums etc...

More than likely, you'll run across someone who's opinion is exactly like your own.

Why I mention this is because I think it's easy to use the internet as a crutch. Before forming your own opinion, it's possible to sample thousands of others! Indeed, sometimes it hardly seems worth forming an opinion if you can just go read and adopt someone else's.

A thought use to be worth a penny. With such an excess of thoughts floating around, they can't possibly be worth even that much nowadays.

And the truth shall set you free.

Sometimes, if one is lucky (or unlucky depending on one's point of view), sheer happenstance and unlikely circumstance will combine just so...

..and you'll get a glimpse of yourself from the eyes of another. The rose coloured glasses we customarily put on while wiping the vestiges of slumber from our heavy lids are torn off, and we can see, if just for a moment, what others see.

Clutch lamely at the shreds of pride which had formerly cloaked and hidden you so well. But live with more clarity as cobwebs are swept mercilessly from your mind!

Reputations

If you move your finger laterally across your field of view, at some point, it disappears as it moves into your blindspot.

How is it that we don't remark upon this blindspot in our day to day activities?

Our brains fill in the space. It takes the information it DOES have, and uses it to fill the gap.

I think the human mind has a tendency towards this on a much more macroscopic scale. We are quick to classify, to sort people based on very little information.

To wit, you see a man with multiple piercings and tattoos who sits smoking in dirty clothing on the curb. Immediately, you assume a whole constellation of things about this man.

Now, I doubt we could function without the ability to make quick judgements about those around us. And in the context of strangers, this is for the most part a harmless habit.

However, I think we should stop and think about the judgements we make about those closer to us. What do we assume about those we know well? On what basis do we believe what we believe? Do we believe what we believe to hide from a more unpleasant truth?

Australians in Toronto

Cousins Roy and Leo were both Toronto this past weekend!

They had gone for a weeklong jaunt to Cuba. I recently saw Leo in Vancouver, but I haven't seen Roy in.. 8 or 9 years I think.

They brought the expected goodies back from Cuba, some of which were enjoyed in lazy fashion upon Uncle Alex and Auntie Elaine's backyard deck.

After a lifetime of being the oldest cousin, it was refreshing to be youngest.

Thanks to Cousin Roy for giving me his copy of the latest Harry Potter book!

To the people who keep taking my stuff...

Stop it!

I hung my white coat in the hallway last week (I had to gown and glove for a quarantined room.). I went back today to retrieve it. The coat was there, but the stethoscope in the pocket was gone!

aaaaargh.

It had sentimental value too! It was Uncle Alex's old stethoscope. Albeit souped up with burgundy tubing.

I wish I hadn't been so absent minded about leaving my white coat lying around. I wish I could safely leave a stethoscope lying around in a hospital. I wish that people would steal things that weren't essential to my transportation, or function at work. I wish people wouldn't take my things.

Ah well.

I shall do my darndest to craft a happy ending out of this sorry affair.

Dexterity check!

To treat recurrent middle ear infections, little drainage tubes are inserted into the ear drum. I'd estimate that they're roughly a millimetre or two long. Someone at clinic yesterday needed one removed from his ear. After sitting him under a microscope, the doctor handed me the most tiny little tweezers. It was a small thing, but I must admit it was a big thrill taking out that ear tube.

Another weekend, another wedding.

This past Saturday, Carol from Queen's got married. It was the first mixed wedding I've ever been to. I sat at a table of Queen's students, most of whom were in the Marching band with me. I had meant to go home that very night, but festive occasions such as these always get a bit out of hand. Six of us ended up crashing in a hotel room. I love weddings.

Now, I'm sure many of you are familiar with the concept of orientation week at university. Second year students lead around first year students in wholesome (and sometimes less wholesome) fun. At Queen's we call orientation leaders Gaels. Carol was my Gael, and when I think of it, I'm amazed at the ripple effect meeting her has had on my life.

Carol played the cymbals in the Queen's Bands. Her enthusiasm throughout Orientation week was truly unflagging, and her message was always "Join the Bands!"

Now. I've never played an instrument one can carry. I had no experience in gymnastics or in dancing...

So it only made sense (in my first year, I'll try anything kind of thinking), that I tried out for tenor drum, cheerleading and highland dancing.

I actually remember asking if asian kids were allowed to try out for Scottish marching bands.

Anyways, I ended up highland dancing every single year I was at Queen's. I spent virtually every weekend either at a football game or at some sort of parade. I can not imagine my undergraduate experience without the Queen's Bands.

I would never have marched in the Toronto Santa Clause parade, or the Boston St. Patrick's day parade. Basically all the extracurriculars I did at Queen's were in some way related to people I had met in Bands (Orientation Week, P&CC, AMS). And finally, some of the best friends I made at Queen's are from the Band.

And all because I was fortunate enough to meet Carol.

Walking home from work

I was on call yesterday for General Surgery. It was a fairly quiet night. I got a respectable amount of sleep and arrived fairly well rested for Clinic this morning.

At the end of the day, I went outside in a futile attempt to find my bicycle. Futile because the search was unsuccessful. My bike has been stolen again.

While walking home from the hospital, I was greeted by two young men in slacks and dress shirts. They introduced themselves as missionaries from the Church of Latter Day Saints. Now the heat in Hamilton is just merciless right now. So I was right impressed by the gentlemen and their dedication.

That is how it came to be that I found myself being walked home by two Mormons, my spandex cycling shorts tight (and utterly redudant) against my skin, in the boggy heat of downtown Hamilton.

My knees

To ensure that one doesn't develop a "wound tattoo", it is important that an abrasion be cleansed thoroughly of dirt particles.

I learn this from a textbook. A textbook propped against my knees. My eyes go from text to patella, from theory to application in a glance.

Search out a child. One who is quick to laugh and squirrelly in movement. They are not hard to find. Examine the knees. They will be blemished. Patterned by previous trips, skins and scrapes. They are a sign of time well spent.

I examine the fading markings upon my own knees, and hear the brisk brrrring of the recess bell, remember squeezing through the narrow alleyway between portables, and feel the cool relief of the water fountain upon my monkey-bar blistered palms.

My knees tell of reckless play, of epic schoolyard battles! Of risking, of taking risks, of ignoring risks, in the pursuit of fun. I'm very proud of my knees.

And my hearing is..........

I just started ENT this week. So far it's quite good. The doctors are very nice. The specialty itself is very varied. Quite a grab bag of medicine.

Yesterday, they were showing me how a hearing assessment is done. The explanation was quite detailed, and a bit over my head.

"Any questions?" the audiologist asked.

"Can you test my ears?" I ask.

I'm led into a sound proof room. The padding is such that there aren't any echoes. Now I know most of us associate echoes with caverns, caves and gullies, but you will know immediately when you're in a room without echoes. It's as if any noise you make is swallowed up by the walls. I sit in a chair and little hearing pieces are inserted into my ears. The task is simple. Little buzzes of varying frequencies and volumes will be played into my ears. All I do is give a sign if I hear a sound.

I have a classmate watching me through the glass. I ignore him completely. I screw my eyes tight. I focus until sweat appears on my brow, like the dew that kisses a can of soda in the summer heat. I've played piano all my life. I sing all the time. I should have super hearing. BAT-like hearing.

There! Was that a buzz? On the very edge of my consciousness! Was that a buzz? Why am I hearing constant buzzing? Is my mind creating noises? Focus focus focus focus focus focu..

I feel a tap on my back.

"Your tests are abnormal. One ear is hearing better than the other. I'm going to replace the right earpiece to make sure."

WHAT! I don't know what to feel. What's this mean? Maybe I should be glad that we caught this on random testing.

More buzzes.

And I'm normal. The ear-piece was malfunctioning. My hearing is normal. Not hyperacute, not asymmetric. Normal.

A Visit from the Boys of Summer

I went to a Baseball game this afternoon with some of my housemates from last year. It was Blue Jays vs. Tampa Bay. The Jays lost. It was a close game though. Baseball is a very peculiar spectator sport. We all fell asleep at some point during the game. Baseball is just that relaxing. The only thing keeping you from going into a really sound slumber is the fear that a ball could come out of nowhere to clobber you.

It was excellent to see people again and catch up. These fellows are truly among the nicest I've met. There's:

Steve - Super tall. Use to play basketball for Mac. Just finished teacher's college at Western and will be starting a job in Kitchener-Waterloo this September! He got married last summer, and it sounds like that's going pretty well. From the sounds of it, he's going to be quite a hard-ass of a teacher. During one of his placements, he kicked a kid off the team because of his bad attitude. The kid wrote him a note apologizing, and he STILL wouldn't let him on the team! He's also been teaching sex ed to grade 10's.

Zeb - Currently studying Social Work at Mac. He just got engaged maybe 2 weeks ago. The wedding is at the end of the year.

Dave - Currently studying physiotherapy at Mac. Just last week, he just broke up with a girl I set him up with. Ah well.

Apparently, while Steve and Dave were working at a summer camp a few summers back, they met a girl without the sense of satiety. Like, she was physically unable to feel full. Anyways, Steve found this out, and organized an eating contest between this girl (who apparently is a wee pixie of a thing) and Dave.
Not only did Dave lose the contest, he threw up twice. To top it all off, the girl ate an apple when the contest was over. egads.

I also learned that both Steve and Zeb talked to their then girlfriends' parents before popping the question. Zeb said that he had some sort of elaborate speech planned, but got nervous and so ended up saying something along the lines of "So I've been dating your daughter for awhile now..."
Either way, I think it's a very nice gesture to talk to the parents. The only thing is that you'll look a bit sillier if she were to turn you down.

Don't make friends with the recently concussed

He was a driver in a t-bone collision with another car. Something I've been seeing with some regularity. A young man with light eyes, he lay in the aseptic glare of the trauma suites fluorescent lights.

While waiting for one of his many tests, I got to talking to the fellow. It was an engaging dialogue about the cars James Bond drives.

"Aha! I think to myself! I'm establishing a sound physician-patient relationship! Truly, this must be the rewards of medicine."

We lapse into happy silence, as I contemplate the importance of my role. He looks up at me.

"Hi! What's your name again?" he asks.

We proceed to have the same conversation. Again. And again. And again.

All quiet on the Western Front

I'm at the hospital right now. I'm on call. It's been fairy quiet so far. The case that was supposed to go the ER has been cancelled.

Although, now that I have remarked on the tranquility of the evening, I am sure that it will quickly become hectic, harried, and ultimately, sleepless. We shall have to see.

I have an elective block coming up in early September. I am trying to think where I should do it, and what I should do it in.

We are spoiled for choice. Too many choices makes people unhappy!

My parents, one uncle and two aunts came to visit me in Hamilton yesterday. We went to eat Thai food. Since they were visiting me at my 'home', it was deemed appropriate that I should foot the bill. And truly, it is very appropriate. An honour in fact! But it really left me feeling very ... old! Not only did I have to choose the restaurant, I also got the bill! I don't understand. It seems like yesterday when visiting relatives would bring me a gift and take me to lunch.
When did I leave the 'child' loop and join the adult one?

In many ways, I suppose it's about time. There are things I think the 'adult' Simon should be. I always thought that I'd just make an natural transition from "kid Simon" into "grown-up Simon". I don't think this is the case. I think I may have to make conscious decisions about how I need to be more 'mature', and then act on them in a very deliberate manner.

So the question is: Which of my qualities are too childish to keep, and which are too simon-ish to lose?

So much family!

I've been thinking back to my recent two week vacation. I spent the first week recovering from dental surgery. I should apologize to my mother for being whiney. It wasn't me. It was those dang drugs. I spent the first half of the second week just sort of hanging around, playing tennis with my father. The end of my vacation was brilliant and hectic. EVERYONE arrived in Ottawa at once. High school friends en masse and family aplenty.

I am too lazy to arrange my memories in chronological order, I shall instead just fire my thoughts onto the page in random fashion.

- When you have a family reunion, all you're really doing is constantly wondering how you're going to feed people.

- My cousin Ryan is a dancing machine. Things are going to get interesting when he hits puberty.

- If I ever wonder where any one of my peculiar habits comes from, chances are I picked it up from someone else in my family.

- Of all the happy events in life to look forward too, family reunions are one of the few that will never let you down.

- Where did Justine learn to catch a frisbee?

- Badminton with my family is very different without Sarah there to beat us.

- It's nice to have cousin Leo to back me up when involved in complex conversations with Uncle Ming about life and morality and true love.

- My high school friends are seriously kinda growing up. But road hockey is as fun as it's always been.

It's late so must sleep. More later if my head is clear enough.

90 and loving it.

I'm back at school now. In fact, I'm at the hospital right now. I'm on-call for orthopedics. I just saw this 90 year old fellow who broke his pelvis after falling down on the 18th hole of a golf course. He plays snooker on Tuesdays, euchre on Wednesdays and Thursdays, dances (40's style) on Fridays and is the chairman of 5 clubs. He was in the airforce during WWII and was married to his wife for 55 years.

He's an inspiring old chap. Whenever I meet someone who has done such a bang up job with living life, I ask them how they knew to marry the person they did. (This may seem silly, but I'm inclined to think that it's really something that can contribute greatly to one's overall happiness. I think if I ask enough people, I'll be able to assemble some sort of case series. While this obviously lacks the power of a randomized control trial, it is still a valuable tool in generating hypotheses. It's a McMaster kind of thing.)

Anyways, I've run across some common themes. It appears common sense may be the over-riding factor. How boring.

Pangs of existential angst

It is human nature to search for greater meaning in life. Is it possible to find this without religion? I think it's very hard to figure out what really matters to you. And it's really really hard to act on it.

My sister was complaining the other day, about how she got very bored when biking to work. This made me wonder why I'm never bored despite the daily commutes on blade or bike that I make to and from the hospital.
I've concluded that I live in fantasy worlds much more than the average person. Let's just say I'm biking to work. I'll be thinking about things like:

1) If I were an NBA athlete. What would it be like? I'd be a point guard of course. But how would I handle the fame and adoration? Would I be as big as Yao in Asia?
2) What if suddenly, everyone on the planet was endowed with 'animal' powers. Like wings, or fins, or tails. I'd have wings of course. And they'd be impossibly grand and beautiful. And I'd fly to Vancouver and have wonderful fun there.
3) What if I had taken a slightly different path somewhere along the line? Where would I be? I always seem to imagine better scenarios, where I'm more than I am now.

Anyways, the bottom line is that I'm thinking that all my daydreaming has really been like junkfood for the mind. Like watching a sitcom if you will. Other people get bored, I just tune into whatever is playing in my head. I'm beginning to feel like this is a waste of 'thinking' time.

Imagine, instead of daydreaming, I were to go over medicine concepts instead. Harder work, surely, but certainly more productive. In fact, I feel that all this thinking about what never will be is actually counterproductive, in many ways. It is time to be happier with the life I have, not imagine an impossible world where things are better! I think some more realistic thought will help me live the life I have.

Curious incident of the Dog in the Night-Time

I just finished reading the above mentioned book. It's a story told from the point of view of an autistic boy, as he tries to solve a mystery involving the death of his neighbour's dog.

I found it to be quite a tragic book. The idea of using an autistic child as a narrator is really quite novel. I'm told the author does quite a good job of it. In fact, the child psychiatrist I worked with recommended the book to people looking for better understanding into the autistic spectrum of disorders. In the end, I do recommend the book. It is a short and easy read. I'm not sure whether I enjoyed it though.

I played road hockey today with some friends from high school. It's wonderful how some things don't change.

May the Force be with you.

The idyllic days of my all too short vacation continue to glide past.

Yesterday, I went with my parents and sister to see the newest Star Wars movie. We all agreed that it was goodly entertaining. Thoughts:

1) I want to be a Jedi. But not one of those wussy Jedi who get killed off quickly and without fuss.
2) My sister and I are in agreement that there is not enough time devoted to Anakin's decent into Darth Vader. He goes from being quite nice to killing younglings too quickly.
3) Yoda talks ridiculous. Imagine the difficulties that could come out of giving an order Yoda style. "Kill him...do not." oops. too late.
4) A real friend would not just stand around if you were on fire. I hope.

Earlier that day, I had gone with my parents to see a one-man play at the Fringe Festival while my sister was at art class. It was really not very good. I think I'd like to write a play.

Post-op day two

All four of my wisdom teeth escaped the confines of my jaws this past Monday.

My recovery thus far has thankfully been smooth and uneventful. I stopped taking tylenol 3's today, although I'll admit that I have likely been overaggressive with my pain management. There was a time when I tried to stay away from pills for as long as I could bear to. Those days have long since passed. I now pop pills with happy abandon.

I'd type more but I've hurt my left thumb learning to play a Mozart Sonatina, and am thus limited to typing with one hand. Woe is me.

Home!

I'm going back to Ottawa today!

A LOT of my classmates will be in Ottawa doing electives, so hopefully we'll be able to meet up and fun and whatnot.

There's a ginormous family reunion happening in just over a week. This shall be spectacular.

I'm having my wisdom teeth removed tomorrow!

I'm done psychiatry! This is sorta good, because things went haywire with my rotation midway through (battles between admin and my supervisor, which meant that she was never there.) I start surgery next. I'm looking forward to this, because I have mad mad skillz.

I'm living by myself starting in September! I'm really looking forward to this.

I played at another classmates wedding yesterday! It was WAAAAAY up north in the boonies. But good times.

My ride is coming in mere minutes. Must fly!

Rollersafety

Since the appropriation of my bicycle seat by parties yet unknown, I have taken to rollerblading the streets of hamilton as my primary mode of transport.

While I am speedier on my bicycle, I like to think that I am quite a bit more mobile and nimble whilst on blades.

The trouble with the blades is that stopping is a slow process. I'd estimate that it takes me roughly two sidewalk squares to come to a complete stop. This hasn't been too problematic as yet, but this morning on the way to work, it almost got messy.

I was approaching an intersection. Lucky for me, the green 'walk' sign was flashing. Unlucky for me, the bus making a turn didn't seem to want to recognize my right of way. It became apparent to me roughly 1.5 sidewalk squares away from the intersection, that the bus was determined to make a turn. I braked. Roughly 1/2 sidewalk squares away from the intersection, I realized that unless the time-space continuum were to warp in my vicinity, I WOULD be running into the side of a moving bus. At this point, I attempted a hockey stop. Naturally, I fell and rolled over into the road. At this point, the bus was midway through it's turn. From my vantage point on the road, the rear wheel of the bus was on course to roll over at least part of my body. So I did an Indiana Jones type roll back onto the sidewalk.

Fortunately for me, all is suffered was a scraped elbow and bruised hip. As I continued more cautiously to work, I thought how things such as 'right' and 'wrong' are sometimes not that relevant in real life. It was 'wrong' for the bus to turn, given that I had right of way... but if I had been squished under a bus, I don't think such thoughts would have been much solace.

Simon in red.

I streaked my hair red this past weekend. I got it done at the hair school.

I'm a big believer in hair schools. I think that if patients are willing to have students like me 'doctor' them, the least I can do is give back to the learning process and let students 'barber' me. It's kinda neat, because the instructors get really excited when you ask for different things (ie, like streaks, or like when I asked for a fauxhawk awhile ago), and the students are happy to be learning new things.

I try and alternate between the hair school and cutting it myself. That way I only look silly half the time.

Chez Simon

For dinner tonite, I made my first conscious foray into the arena of fusion food. East meets West, so to speak.

Generally speaking, my current culinary system is to cook some sort of dish and eat it with either rice or noodles. It occurred to me that for many, bread takes the place of rice as a staple food. With this thought in mind, I made an ambitious leap, producing my very first Stir Fried Bread dish, as opposed to the very standard, Stir Fried Rice. To the best of my knowledge, there have been no previous attempts to stir fry bread. I'm currently trying to think of the best possible name for this whole new category of food. My ideas so far:

1. Stir Fried Bread
2. Gwai Lo Stir Fry
3. Chinese Bread Party

I'm open to any other suggestions. Anyways, this is what it looked like:



Recipe: Stir fry some vegetables. Mix some corn starch with water and throw it in. Add honey mustard. Tear up some bread and throw it in.

The honey mustard turned out better than I thought it would. I threw it in on a lark, and I worried for a few moments that I had ruined everything. The bread was a bit stale, but you really couldn't tell once it had been stir fried.

Bottom line: Resounding success. No need to go through the hassle of cooking rice, tasted good, and an excellent use of old bread. I am a genius.

In other news, I bought an Umbro brand, full sized indoor soccer ball for $2.99. The original price is $24.99. I might go back tomorrow and buy another one.

Telerevisionism

I've just watched season one of Grey's Anatomy. (I watch while I eat. Honest. It's not like I have buckets of time or anything. Seriously). It's an alright show, but it's made me think about the positive cornucopia of doctor type shows currently on the telly.

1. ER - I've never really watched ER. My uncle Alex is an emergency doctor, and it just doesn't seem likely that some TV show could possibly compare to the excitement and manliness that is his life.

2. Scrubs - My friend Richard introduced me to this odd little comedy. I've seen basically every episode. They have a nice formula (quirky lead character, every episode has three story lines, all of which resolve neatly and simultaneously during a touching voice over.) Medical school keeps me busy. Really.

3. Nip/Tuck - I've seen a few episodes of this. I think my sister Sarah likes it. She was always one for the gruesome. It's kinda racy actually. Sarah, stop watching this show!

4. Grey's Anatomy - Recommended by Gaby. It's about surgical interns. OK so far. The title is a play on a well known anatomy text, Gray's Anatomy.

5. House - I've never seen this, but someone wiser than I absolutely adores it.

Generally speaking, I think there are some misconceptions about medicine that one could acquire from watching these shows.

Truths about medicine (as seen by me, at this point in time. not a comprehensive list.)

1. Doctors, nurses, patients etc... are not usually that good looking.

2. The role of medical students is somewhat... peripheral usually. We're not the ones chopping/dicing things.

3. Hospital wards smell funny. (This isn't properly appreciated on TV.)

4. Renegade doctors who break rules and piss people off don't get idolized.

5. Medicine is a LOT of waiting around. And a LOT of common, not so exciting things.

I've heard that there is going to be a shortage of tradespeople in coming years. They need to make some exciting shows about plumbers, carpenters etc. That would encourage people to pursue those fields, I think.

In the end, all these programs are chasing the same gold standard anyways.

Square

Sixteen years ago, my parents brought me to my first protest rally. It was on Parliament Hill.
I remember being interviewed by newsreporters. I was young and the bright lights of their video cameras dazzled me. They asked me why I was there. I said something to the effect of "I don't know. My dad brought me."
I'm certain my parents would have explained the situation to me. But I honestly don't think I had a clue what I was there to protest. I wish that I could go back in time and give my answer again.
"Never doubt that a small group of thoughtful, committed individuals can change the world. Indeed, it's the only thing that ever has" - Margaret Mead

The sorting hat says...

be sorted @ nimbo.net

I actually thought I'd be a hufflepuff. Can't fight the sorting hat! Everyone take the quiz and write down what house you get sorted into in the comments section.

Oh what fun!

EPT - Emergency Psychiatric Team

Last night, I was on call for emergency psychiatry. As usual, I saw many fascinating things, and had a very enjoyable (if rather sleepless) night.

I've heard tell of a 'medical student syndrome', where medical students start worrying that they themselves are suffering from the afflictions which they are studying. Until psychiatry, I've been fairly immune to this. (In stark contrast to my one friend, who worried that he was getting diabetes, and went so far as to test his urine for protein. Odd fellow.) In studying psychiatry, I'm beginning to wonder whether I have shades of hypomania or borderline personality disorder.

I've also noticed that as a group, the psychiatry residents are definitely among the most homely. And by that I mean... least pretty. At least in the conventional sense. However, despite their peculiar appearances, I've noticed that the psychiatry residents are almost all married. There's a lesson in here somewhere.

Finally, all this psychiatry has got me thinking about personal autonomy. It seems that some diagnoses by and large excuse a patient for the majority of his/her behaviour. And I have to admit, in many cases, this appears to make sense. Personally though, I believe free will to be one of the fundamental things that makes us human and alive. There are many more grey zones in life than one would expect!

Super fun times at McMaster

I should tell you all about a game we played today in tutorial (our psychiatrist-facilitator dude was late). I read about the game in a book. You should all play it with your friends. The kids in my class were all like, "Simon, we're too cool for games. Sit down you big loser. And get a haircut." But they were loving it by the end. Truly.

Kay, here's what happens. You split into two teams. Each team then nominates a person. Let's call them Carol and Simon.
Kay, Carol and Simon then put their heads together and come up with a word. Any word. The object of the game is to get their team to say the word. Carol and Simon then take turns saying one word ONLY to their team, and then their team tries to guess the word. If they don't get it, the other team gets a turn. Clear as mud. I shall give an example.

The first word we chose was "Pencil". Since Carol chose this word, Simon goes first.

"Pen" says Simon.
"Writing" guesses his team.
Wrong, so now it's Carol's turn.
"Lead" she says.
Her team, having heard Simon say pen, and Carol say lead, guess "Pencil!"

And they get a point.

It's waaaay cool with neat words.
For example, I chose the word Munchausen.
Carol goes first, and says "Illness". Her team guesses "Medicine".
I say "Psychiatric". My team guesses "Schizophrenia".
Carol says "Dependent". Her team guesses "Borderline".
I say "Proxy!". My team gets "Munchausen" immediately!

It's truly super wackloads of fun.

Congratulations Justine!

My little sister got into medical school!

It's incredible how fast kids grow up. Just yesterday she was a wee tyke...

Feeling fragile

The wedding was a ludicrously good time. In all, something like 15 of my classmates were there. Things in medical school are such that we don't get to party much any more, so I think everyone had piles of pent up energy. I must off to bed now.

A (hopefully non-eventful) stroll down the aisle

Today is the wedding. Angela, one of my friends in third year, is getting married, and I'm part of the musical act.

Yesterday, we had our first (and only) practice for today's wedding. Aside from the piano (me), there are two violins (Terence and Shermeen, both classmates of mine), and a flautist (Jessica, a friend of the bride). Practice was good fun. The flautist is excellent. Shermeen is a wonderful musician. And Terence... well Terence can be kinda neurotic, but he seems to know his way around a violin.

In fact... if there was to be a weak link... it would probably have to be me.
Ironically enough, I have no problem with the pieces we're going to be playing as background music. Oh no, the piece I have trouble with is "Here Comes the Bride". I have a feeling that Angela will hunt me down and gut me if I screw this up. Can you imagine the bride walking down the aisle to rickety music? oh dear.

But I will be strong. Have faith. I must believe in my fingers.

Home and back again.

My mother convinced me at 9:30pm on Friday night to take the 10:10pm bus back to Ottawa for the long weekend. And so it was that I arrived at 5:45am on Saturday morning ready for a weekend of familial fun.

If not for the absence Sarah the weekend would have been completely complete. As it was, I ate, played piano, watched Kicking and Screaming with Greg, ate, played badminton, ate, shopped, went mountain biking with Greg, ate, and went to see that gigantic spider at the art gallery.

My thoughts:
1. I will have to practice more piano if I don't want to stink up my friend's wedding this weekend.
2. Will Ferrell is an acquired taste.
3. Exercise has made my sister noticeably less lethargic.
4. Sarah is DEFINITELY the best badminton player in the family. Although this is not saying so much.
5. Greg's mountain bike is super awesome. The pedals on it are quite spiky though... and can really do some damage on your shins.
6. I shall quit school and become a spider maker.
7. My parents feed me super.

On the way home on the bus, I met the newest flautist for the TSO. She's the first flautist they've hired in TWENTY years! I think playing in a professional symphony is one of the elitest jobs ever. It's like meeting an astronaut!

Anyways, long story short, I'm glad I went home. As always, mother knows best.

Noooooooooooo!

Tragedy has once again struck the small world that is Simon and his bicycle.

As you may recall, I ride a older bicycle that I outfitted with a super snazzy, high-tech bicycle seat. I awoke this morning bright-eyed and ready to cycle to work. Imagine my surprise and dismay to find my precious bicycle seat gone!

Actually to be completely honest, the most vexing part of the whole thing was that it made me late for a meeting. Maybe I'm just getting beaten down, but the fact that someone stole something from me doesn't really surprise or upset me too much. This may be related to my friend Greg's recent woes regarding bike theft. My faith in random strangers is at quite a low right now.

I actually don't think that my laissez-faire attitude is very good. I think my moral standards are drooping and dropping. For the past while, it really hasn't seemed worth the battle to lead a the more difficult virtuous life. We're all taught tha virtue is its own reward. I don't think this reward is enough anymore!

Actually, without religion, and fear of consequences from "higher up", it is very difficult to make a case against the existential "ends justify the means" philosophy of life.

This type of thinking is not very pleasant.

Walking!

Today was my first full day back on my feet. The past two days, I've had to bike to work with my crutches strapped to my back. It's quite a nuissance because the crutches hit the back of my bicycle helmet, which forces me to tilt my head at a 45 degree angle. I'm just that cool.

I fixed the brake line on my bicycle today. I snapped it last year while biking home in the rain. I've had to use my feet to stop for the past while. This was really a problem when one of my ankles wasn't working so well. Things are all back in working order now!

Finally, I've been alerted to the fact that my roommate is going to be living with her brother as of September. This means that I must once again search for a home. I'm really quite the nomad.

Not again!

As I type this entry, a frozen bag of french fries defrosts on my right ankle. The twisting of this same ankle 3 years ago while playing soccer put me on crutches for three weeks.

Needless to say, I was having a stellar day, soccer wise, when once again, my ankle took a turn for the worse. It's not as serious a sprain as last time... but my ability to weight bear isn't so great. Hopefully this will ameliorate by the morning, else I'll be forced hop to my psych consults!

A week of psychiatry later...

Head shrinking is proving to be vastly more interesting than previously imagined. I was expecting very mundane 'depressed'' people, but some of the patients I've seen are right out of television shows.

I spend two days a week at the hospital doing medical psychiatry, and two days a week in a clinic doing pediatric psychiatry. Some mornings, the pediatric shrink and I do school visits. As I was mentioning to my nephew (at our inaugural fruit smoothie movie marathon), I was never one of those kids who got to see what happened in the principal's office. Indeed, if the whole office had ceased to exist, I doubt whether this would have influenced my school career in the slightest (With the possible exception of the 'student of the week' award I won in grade 5. I had to go to the office to have my polaroid taken. I remember the picture very well. I wonder why my mother liked dressing me in matching jumpsuits so much. Not really a problem in grade 5... but the first day of middle school was a rude awakening.).

Anyways, I suppose the point is that I never realized that principals and vice-principals actually have productive things to do with their days. The reality, I think, is that a majority of their time is devoted to guiding/caring for a segment of the student population that has different needs. I'm also amazed at some of the teachers I've met. They're really quite extraordinary.

In other news, I had to get my photo taken to updated my hospital ID tag. With one of my friends goading me on, I struck a somewhat peculiar pose for the camera. The only word my classmates have used to describe the pose is "seductive". Oh maturity... why have you bypassed me?

Plan for the day: read, soccer, read, coffee, read.

Out of Grimsby and into Hamilton

With the end of my sixth week in Grimsby, my stint in rural family medicine comes to a close, and I return to Hamilton.

I must say, the entire Grimsby experience was very agreeable. I had ideal accomodations and I ate better than I have since first year undergrad. I also feel I have a much better grasp of the whole patient-physician relationship. This should come in handy, because tomorrow, I start six weeks of psychiatry here in Hamilton.

I'm looking forward to it. I'm told that psychiatry is one of the more relaxing rotations. I hope it's true! I need the time to start preparing for all the weddings!

In other news, I spent all weekend re-arranging the furniture in my room. It's way better now. Better lighting, better work environment, better view, better karma!

Happy Mother's Day, Mom!

Backpacks and bookbags

Now I have a cousin who is in the habit of having various male classmates carry her bookbags from class to class.

I expressed surprise at this. She doesn't seem to think it's a big deal. Apparently, they're all 'just friends'.

Now.

Is this possible? I just think that these fellows MUST have romantic intentions. I'm told this is because I am ungentlemanly. I was also told that I should start carrying girls' bookbags.

crazy.

Only a week left

I've only a week remaining in my stint here in Grimsby. Time certainly has a habit of flying by.

I must say that I've really enjoyed the small town medicine experience. I've learned some very interesting things during my family medicine rotation here in small town Ontario.

There's quite a neat memory trick I'd like to share. I picked it up from my preceptor as a way of remembering a whole bunch of blood pressure readings.
Each number is assigned a sound:

0-S
1-T
2-N
3-M
4-R
5-L
6-J or SH
7-K or G
8-F or V
9-B or P

And these are used to create words. As an example, if Mr. Smith had a blood pressure of 120/80, this might translate into ToNS/VaSe. You get vowels for free. So now, you picture Mr. Smith with tons of vases. This works well if you get a whole bunch of blood pressure readings in a row. You pull out the mental picture you've built and voila: you get patient and his/her blood pressure.

You'll find that you start making words with license plates, and PIN numbers and telephone numbers etc... It's like being involved in a constant game of scrabble!

Weddings and such.

As some of you may remember, I spent a good deal of time during high school seated at a piano bench. Each day, Herr Beethoven and I would try to coax music out of an instrument which seemed all too aware of the shortcomings of its player. And while the occasional missed road hockey game was felt very keenly, I must admit that the hours spent tripping up and down the black and white steps were not so ill spent.

Some of the perks are just now beginning to rear their heads. As my classmates arrange their nuptials, they naturally begin to search for classy musicians to add a little "Je ne sais quoi" to the affairs. This summer, my fingers shall glide over the ivories while no less than three couples take their vows.

Actually let's be honest. I'm accompanying Shermeen, who's an incredible violinist. I'm kinda window dressing. There to look pretty. But pretty I do look.

The glitz and the glamour of the ER

Now I'm sure everyone is familiar with "ER", the television show. If you haven't, here's a synopsis: Beautiful young doctors working frantically and brilliantly in a high pressure environment with adoring young nurses.

Well let me tell you. Working in the emergency room here in Grimsby is EXACTLY like that. Only the environment is less frantic. And the nurses are less adoring. In fact, if it weren't for my movie star good looks, there would be very little in common with "ER" the tv show, and the ER here in Grimsby.

Even so, my day was chock full of interesting things:
1. chicken pox! (I don't remember it being so... gooey.)
2. motor vehicle accident! (I think the car was moving at 1 km/hr.)
3. chest pain (yawn... not very interesting. Cardiology is for eggheads! and my Dad. Hi Dad!)
4. lateral epicondylitis (aka Tennis Elbow)

and... the highlight of my day:

5. laceration! Boy was this cool. A carpenter accidentally sat on a lilac plant, and gave himself a deep, long gash on the back of his thigh. The ER doc I was working with was like, "That cut may be too big to do in the ER."
And I was like, "But I have mad, mad skills."
And she was like, "You're crazy, boy! We'll never do it without general anaesthetic!"
And I was like, "Just give me this one chance. I swear, if I let you down, I'll walk out that door and you won't ever have to see me again. I can do this. I KNOW I can do this."
And she was like, "No! You're too wild! You're good... too good. But you got no control!"
And I was like, "I don't need control. Let the pencil pushers show control. I need to let my hands go free."
And she was like, "No! You're not a team player! Look at Hatfield over there. Gets his work done... doesn't make mistakes..."
And I was like, "He doesn't make mistakes because he doesn't take risks! We BOTH know I'm twice the medical student he is. Don't give this laceration to Hatfield. I worked this up. This is MY laceration. I blow this , I'll do all the DRE's for the next week."
And she was like, "....Fine... but I'm warning you..."
but I was already running out the door.

Anyways, long story short, there is one happy carpenter walking around with a Simon original on the back of his thigh. It went better than I expected.

Oh the shame.

I bought biking pants today. I decided that my rump needed more protection since I was biking over 50 km a week. I had thought that I could buy some sort of stylish cargo pant that was specially designed for biking.

No such luck.

Today, I bought what I swore I'd never buy. Today, I bought my very first pair of...
spandex pants.

What can I say? They are very tight fitting, and leave little to the imagination. Luckily, I have monster thighs. Well, not really.

Currently, I wear them underneath my sweat pants. I'm not yet ready to face the world clothed only in spandex.

To recap:
cost of my current bicycle = $99 (all figures before tax)
cost of my current bike seat = $55
cost of my current bike pants = $54
cost of my current bike helmet = $30

Priorities, priorities.

On another note, I just read a book by David Sedaris called Me Talk Pretty One Day. It's very funny. I think it's a modern classic. I really do.

I was there the night Boys II Men played Casinorama

May I commence this concert review with the observation that Casinorama is waaaaay out in the middle of nowhere. I'm shocked that they were able to book Boys II Men, much less Alicia Keys the week previous.

First off, it should be known that only three of quarters of Boys II Men showed up. Instead of a quartet, a trio performed. They didn't explain what happened to the fourth fellow. Feeling somewhat ripped off, my cousin and I sat in the crowd debating what their opening number would/should be.

Before we knew it, the moment was on us, and Boys II Men (minus 1) burst onto stage. Two merciless facts were quickly unveiled.

1. They're not so young anymore. As someone commented, "Men II Geriatrics" may be more suitable a monicker.

2. They're really good! As in they sound very much like they do on the radio. Which, in this jaded era of Britney Spears, is pretty great!

There was the skinny guy, who was really good. There was a larger guy (I don't remember Boys II Men having a such a... well-built fellow.) who was really, really good. And then there was the medium sized guy who always sang falsetto and was clearly the weakest link.

They opened with some song I didn't know. After a bit of chitchat to settle the crowd, they launched into On Bended Knee. The crowd went nuts, and duly applauded their overly drawn out notes. (The last word of the song was drawn out for what seemed like a minute. The guy would stop in the middle of the word, wait for us to applaud, and then continue. He stopped at least THREE times. It was ludicrous. I loved it.)

I think they may have sang another song or two before announcing that they were going to be performing songs from their new "throwback" album. (ie, Oldies songs, redone with a little Boys II Men flavour.) Well, that just sucked the life out of the room. At one point, the skinny guy did that thing where he sings a line, and then points the mic at the crowd so that they sing the next line. Dead silence.

How on earth would they redeem this mess of a concert? I'm glad you asked.

After four or five of their "new" songs, they announced that it was time to go back to their "classic" songs. Instantly a charge went through the crowd. People started waking up. Did this mean what we thought it did?

YES! In quick succession came Water Runs Dry (My new favourite Boys II Men song. Though they didn't do a very good job of it.), A Song for Mama (They encouraged us to use our cellphones to call our mothers, so that they could hear the song. I phoned, but I think I got the machine.), and then... I'll Make Love to You (For this number, the boys each walked out with a dozen roses. That cued a MOB of women to descend to the stage to try and catch one.) I'll admit at this point, the concert was rocking pretty hard. Everyone was singing along, taking pictures etc... I was really FEELING my Boys II Men.

They did that ABCDEFG song as part of their encore. It was great, but I think it was pretty clear that everyone had been there to hear "I'll Make Love to You". And with that being done, everything else was just extra pickles in the sandwich. They finished with End of the Road, and that was that.

So. In summary.

1. I loved concert. Heard all the songs I wanted to hear. Not too many songs I didn't want to hear. It really brought me back to those middle school days.

2. The Boys have tried to incorporate some dance moves into their act. This is a big, big mistake. A really skinny guy and a really, uh, big-boned guy dancing BADLY, while another guy sings falsetto is just... well...

3. That being said, it'd be really cool to be able to do what they do. For awhile at least. Maybe not for as long as they've been at it... but for awhile.


Simon


A somewhat unrelated point: Coolest site on the internet!

Boys II Men

Tomorrow, I'm going with my cousin (well technically, she's my niece.) to see Boys II Men. They are playing at Casino Rama outside Orillia.

I remember them being HUGE when I was in grade eight or nine. I had no idea that they were still at it. I have such fond memories of my father denouncing their smutty smutty music. Seems positively wholesome by today's standards!

I am a wizard. A culinary wizard.

As some of you may know already, I'm living in the home of a retired couple. They are luvly people, and our arrangement is such that I not only have a wonderful place to stay, but I am also free to eat any and all food that is in their house. I almost pity them their folly.

Anyways, in a gesture of good will, and in appreciation for all the times they've fixed me dinner, I made some of my mother's famous chicken curry tonite. It was a super hit. They asked me for the recipe and everything. They particularly liked the apples I threw in on a lark. How about that?

Unfortunately, I've now managed to exhaust all my culinary expertise in one fell swoop. I won't likely be doing any more cooking... unless they want the chicken curry again!

Life as a deck of cards

There is a song in the movie Pocahontas, comparing life to a river, always changing, always flowing.

It is an analogy that I think most people would agree with. Indeed, I've always perceived life to be a continuous stream of events. Time is linear and like water, only flows in one direction.

A more wordly and educated man would expand on this analogy. I am not this man, so I will continue my writing letting you, the reader, expand in your head.

I've decided to try out a new life perspective. Life is a deck of cards. The Simon of yesterday, ISN'T the Simon of tomorrow. Rather, he is an altogether different Simon. Both Simon's have always, and will always continue to exist, and each Simon is confined in a self contained, unique universe. Time is an illusion which each Simon (of which there are infinite) uses as to help him explain his experiences in his particular universe.

A more erudite and scholarly man would explain this further. Not me!

I had a conclusion. But unfortunately, I've just realized that I've contradicted myself in formulating it.

Goodness. Much ado about nothing? I wonder.


simon