Ohhh...HARSH!

So this morning His Nibbs turns to me and says, "How long were you a nurse for?" [This being the first time he's ever actually directed any specific question at me regarding my life or previous existence...actually, it was one of probably only 5 occasions in the past 3 weeks where he actually addressed me directly with a question that required an answer.]

"Five years".

"Hmmph..."

A couple hours later on the ward round he then inquires, "What type of nursing did you do? Regular nursing I suppose...."

"I was an A & E nurse and also worked casually on acute adult psyche".

"A & E nurse??? You were an A & E nurse? Well I would have never guessed that."

"Well....er...[not sure how to respond or where he was going with that]...er...chronic diseases aren't really my area...more acute on chronic or acute presentations, I suppose..."

"No, well I mean, you must be sitting on a mountain of knowledge then, with your background...an absolute mountain...you'd never know it...I mean, I've been around you two weeks and I would have never known you had that knowledge!"

Oh. Of course. That was where he was going with that. Nice.

FML.

Can't Win for Losin'

Last week His Nibbs* tells me that he doesn't come in for rounds on Tuesday, and encourages me to take this time to "go to the gym, or do some extra reading...take time for myself". Ok. Great!

Last night I get a text from one of the other students telling me that there is a radiology meeting at 0815h today. He thinks we should go despite the fact that Tuesdays are our day "off" because we've already been marked as the most "uninterested, unenthusiastic medical students [Loafers] has ever come across". I agree (not with the fact that we're unenthusiastic, with the fact that we should show up).

So we arrive to much confusion by the other consultants as to which room the meeting is in, who is presenting, if it is happening or not, etc. We shuffle around the hospital trying to find the cluster of medical teams to no avail. So like kids who are lost in the grocery store we (another consultant and handful of meddies) decide to stay put in the hopes that the important people will find us. 


His Nibbs shows up, walks by us without a "good morning" or an "oh you're here on your day off for the radiology meeting, well done!"

Nope. He spins on his heel and says to Other Med Student and I, "it is YOUR fault that the team isn't here...where are they? It is YOUR job to organize them and let them know where and when things are occurring!"

OMS replies, "um...we didn't actually even know about this meeting until last night...and the rest of the team wouldn't be coming in for an hour and a half anyway..."

But Nibbs was already walking away (he does that---gives out to you while walking into a patient room, or before talking to a nurse, or stepping into the elevator, so that no actual discussion can occur. Just his hissy fit then, FIN.)

I am still trying to figure out how or why we were at fault. But we were.

So I clung on to the rest of the team for the morning...went to the endoscopy department to work on my research project and ended up chatting with my surgical consultant (M.C) about the issue, trying to get some advice on how to not become a shell of the woman I once was survive the next 8 weeks.

In an effort to cheer me up, he did what any former consultant preceptor would do: invited me to go to the afternoon surgical outreach clinic. YEAH! So I did. And it was great. Got to see loads of patients, a few of them even follow-ups from surgeries that I got to assist in last month. It was exactly what I needed because it reminded me of why I do love medicine, that I am not incompetent or unenthusiastic. And the drive along the Irish countryside had some therapeutic effects as well, I am sure.

Tomorrow I am going to stay late, clerk emergency patients that are being referred to medicine, go in early on Thursday to see who was newly admitted, and I am going to DAZZLE His Nibbs with my excitement for All Things Medicine. Look out a.fib / COPD / stroke! I am coming to get 'cha!!

*"His Nibbs" is my new boss. For now.

Mojooooo Where Are You???

Someone please tell me how to get motivated again.

I seem to have lost that loving feeling with being here, the constant stress, the workload that never ends, the living on campus, being away from Canada...all of it. I had a total stress meltdown last week (on *holidays* I might add) and have been dreaming of nothing more than the life I had before this.

Weird since I spent all my life before this thinking about medical school. I actually had a fantasy about re-applying to Calgary again next year and quitting school here. I know that is insane, but that is how much I want to be home.

Sigh.

I really am trying to do everything to stay positive: I am exercising 5-6 times a week, eating well, getting enough sleep, taking breaks from work when I need it, trying to laugh as much as possible. Tobie is being as helpful as he can but I am worried that me feeling down will be a wear on our relationship. He's definitely been a huge support here.

I just can't seem to concentrate or retain anything it seems. I suppose one of the downsides to having worked in healthcare is knowing what is in store at the end. I always thought that was a plus--but you know my classmates get theses starry looks in their eyes and wistful expressions when they talk about getting to be in the hospital. I know what awaits, and though yes it is obviously a great job overall, I have no misconceptions of the realities of residency and work.

I feel the need to be inspired or excited about something again instead of just slogging.

You Guys Are The Best

Thanks so much for all the words of encouragement in comments and emails!

I am such a whiner! Sigh.

But if I didn't whine then I wouldn't learn catchy phrases like "Bugger Canada right up the bugger pipe", and life would somehow be less hilarious. Thanks Ry.

Yes Canada is being dumb dumb dumb and yes it is just another hurdle. But I am reminded of how many things I have to be thankful for in this life and if my greatest hardship is living away from Canada or having to continue training in Auz, NZ, UK, or US then really I have very little to complain about and should be happy. It does fell like Canada is further and further away on the horizon though, which is a bit of a throat lumper. AMG--just think of the vacation opportunities depending on where I end up!

I made the decision to undertake this, no one held a gun to my head (well except that one time when John was really drunk and he thought I was a squirrel...but I digress...kidding).

Unfortunately the NWT, NU and Yukon do not have medical residency programs per se as there are no schools up there...their affiliations with students are all through southern universities---though that does seem like a no brainer, it's true....no doctors for 20 000sq km? How about a few residents then to mind the fort?

In other news, life here continues to trundle along. I am debating a race in May...the knee (she spits in corner) is constantly teetering on the edge of functional to painful and I don't know if training would be a good thing or a bad thing.  Still enjoying weights and fitness classes though I do feel like a complete doofus when I have to sit out (or drop the weights) for anything that involves bending the Rt knee (spits in corner) while the 75 year old lady who came in on a walker is doing her 50th squat with a bar slung behind her neck.

I mentioned on Asystole that this week was kinda tough as our patient was a heart attack who eventually died day 4 post M.I. During the class when we were discussing the sudden death I felt myself getting upset and made a trip to the loo to collect myself. I never get upset usually when thinking about/talking about/learning about/treating M.I patients (even though that is how my dad died) so it did take me a little off guard.

I was actually glad that I still have that soft spot there though, it's normal (and healthy) I think to get upset over upsetting things (despite what our medical education teaches us). I was fine after a few minutes and went back to finish the class. Our case this week is a 30 wk premie baby so that will be a nice change to the opposite side of the universe.

Tobie is in NY, NY for a concert with the Irish Chamber Orchestra this week. Of course I miss him but having him gone will give me a chance to catch up on some things and start the daunting task of making new notes again from last semester (lost everything on memory stick last week).  I do wish I could have gone to NY for a week for a holiday but....maybe in 10 years when I have an income again. :)

Anyway, thanks again for all the support...I am done having my little on-line temper tantrum (for now).

Here's to 'what doesn't kill you makes you stronger'.

Fine then, be that way Canada

I am super pissed right now at the Canadian medical system. Probably even more pissed than the two times I went through the application process to get INTO medical school in Canada (and wasn't even interviewed).

On Asystole I eluded to the CaRMS meeting we had last week with regards to returning to Canada to complete our residencies once we're medical graduates.

I feel seriously betrayed by the Canadian medical education system and their completely myopic approach to solving the horrendous shortage of MD's in Canada.

First off...I am a resident in BC and AB. My family lives in AB and my friends (and lifestyle of choice) is found in BC. So it would seem logical that I want to return to one of those places if I'd like to have a residency there. Yeah, not an option. My third choice was Quebec because Tobie is Quebecois and we'd like to go there together as he's moving back there in 2 years once he's done his program here. Strike three.

I CAN'T ACTUALLY APPLY to any of those three provinces for residency. Why you ask? Because if you are an IMG (international med grad) you have to have *permission* to apply to those provinces for Residency (when I say 'Residency' I am referring to the post-grad training you have to do in order to develop your specialty in Canada...you don't just graduate with MD and start working in a clinic the next day). To gain this great privilege you have to have written all of the qualifying exams that foreign doctors have to write, and you have to have passed them. Fine, I get that. BUT you have to do that AFTER you graduate which means I will graduate in the summer and then have to wait until Sept or Nov to write the exams and since I wont be done all of the exams until the CARMS intake is closed for that year I will have to SIT ON MY ASS for an entire year waiting for the next match with all of my passing grades. Plus Quebec has the added barrier which is you have to LIVE there for a year before you can apply for *permission* to be a Resident.

Which would be fine if I had money. Then I could travel the world, take my yoga instructor course, play mandolin all day long, etc. However I will be a QUARTER OF A MILLION DOLLARS in debt when I am done school which means that I will have thousands of dollars of payments to make each month while also observing my total debt rise with the unpaid chunk still accumulating interest. Yes, because most of my tuition was paid for by a LINE OF CREDIT not a STUDENT LOAN.

Screw you Canada.

So my options are Ontario (5 year return of service), Sask (7 year ROS), NFLD (3 year ROS) or Manitoba. If I actually choose a specialty I will be free from Ontario when I am 44 years old. Yeah, that is 14 years from now.

All because I wanted to be a doctor.

If I had known then what I know now...I can definitely say I would have done SOOOO many things differently.

Like stayed a nurse for one.
Reapplied in Canada for two.
Applied in the US for medical school for three.

Also, guess what, I don't want to be a plastic surgeon living in TO doing boob jobs all day. I actually want to work in underserviced areas and as a volunteer overseas. Where is the support from the government? From the medical schools to promote physicians who want to serve RURAL communities?

Grrrrrrr...... *snaps pencil in half*

Cheap as Chips

Tobie and I have been savoring these last few days of freedom before the great education thrust begins again. I am back to school tomorrow and am pretty excited about the new start but also slightly dreading the immediate loss-of-having-a-life that comes with it.

We're both poor, and that isn't fun. But we've figured out low budget ways to enjoy our pauper-dom.

Right now I am on the 10 year window shopping plan. We go to these lovely grocery stores, artisan boutiques, art galleries and I pick out all the things I'm buying and then say "I'll be back in 10 years to pick those up".

At the liquor store which is only a 40 min walk away, they sell these mini bottles of wine (not half litres, they are actually 300mL) at the bargain price of 3 for 5 Euro. We make a large batch of popcorn, walk to the liquor store, get our three minis, and go to the movies (about another 10 mins walk). Flash the student cards and voilà! it is a cheap night at the movies, with wine.

I am getting groceries on-line these days. That has significantly improved my quality of life. When you don't have a car, bike, or reliable bus service you have to somehow get to and fro your closest grocery store (2.6 km away). I know that doesn't sound far but when you have to carry them back (and you're not a masochist like AMG) it is not fun. Plus you don't want to buy heavy things like vegetables and fruits and beans...you want to buy pringles and twinkies because of their weight. Turns out, healthy things are heavy things. Who knew? I guess the Northern stores...

This week our patient has chronic heart disease. I am going to hit the 'Rapid Interpretation EKG' book for a few hours while Tobie practices. Life marches on. 

I am a Lazy Double Poster...

I know, I know...double posting is LAZY. But really...Asystole appears to be taking over as my main blog...I sometimes wonder if I should just put it on ice and only have that one now..

Hmmm...

In the meantime, until I decide...

I can't believe I am actually here.

The goal of getting to this place seemed so very very far off that for a long time I hardly lifted my head to look up and see how many more stairs there were to the top. I would just focus on the two or three ones directly in my line of vision...keep my head down, and push on.

I remember very clearly talking to Vern about it one day on a walk in Revelstoke. It was the summer I first moved there and I could feel the contemplation stage of change slowly working it's way into action. I told her that at some time I'd have to give up work completely, move somewhere with a university, take 8 or so prerequisites, write the MCAT, apply to schools, then wait almost a year to find out if I was accepted or not.
She was also looking into a long application process at the same time, applying to school in Scotland to undertake her masters. We both sorta shook our heads at how daunting it all was.

Today I got to sit in a lecture room and look at my fellow classmates for the next 4 years. I've been so lucky since my arrival (save for the baggage incident) to have connected with some very amazing folks in my class. Musicians, chefs, dancers, researchers, engineers...we're all meshing into these interesting combinations. Our res unit of 4 has basically become the meeting point for our group of friends from res. We've already had two late night jams, "Flight of the Conchords" showings, big group meals, and kitchen partying--and it's only been 5 days. My roommates are first years as well, and though they are a few years younger than me, it hasn't seemed weird. Just funny more than anything else...like watching my one roommate figure out how to make a sandwich after coming home from the bar.

It was a long day of orientation today, and though I had ants in my pants after sitting for so many hours (8!) I must admit I was on the edge of my seat as they talked about clinical skills, labs, textbooks, the PBL groups, and our eventual hospital rotations. Next week we will be assigned our patients from the 'early patient contact program' which involves us following a prenatal woman from now through to 3rd year as she goes through the pregnancy and eventual birth/growth and development of the child. We're also being assigned a patient with a chronic disease who we will also be paired with until 3rd year. We'll be expected to attend hospital visits/doctor appointments/home visits with these patients...and be another resource for them as they work their way through the system. I am very excited to meet these people who will be a big part of my learning for the next 2 years.

After orientation we had a quick snack and headed out to the pub for a medical society social event. This was an event for 1-3rd years which included a life sized (timed) game of 'operation' as well as the normal mini version. I was terrible at the life sized one and wouldn't have come close to the top time even if I hadn't been buzzed out after 16 seconds. Instead of claiming fame and status with a win, I ate two free hotdogs (apparently my 'mystery meat' rule doesn't apply in Ireland) and drank some Guinness. The hot dog guy said that evidently I wasn't going to be a surgeon (I told him maybe I'd just be a slow one...) Came back to our place and had another jam session with my two new music-playing pals, drank some tea, and then called it a night.

It's strange to be in place finally. In the place that has been so far off in the distance for so long. It is also lovely to be able to embrace the now--feel that my life has truly gone to the place it was meant to go, at the time it was meant to happen, and with the people I was meant to be surrounded by.

Sláinte!

Canada D'eh!

To celebrate Canada Day, my occasional housemates Kara and Stephen suggested we go for a hike in our neck of the woods. I thought that was a dandy idea. My knee has been doing well since I've stopped running/biking for the past 7 weeks so hiking has been an option again. On Tuesday Kara and I did a mini hike up Teapot and my knee was fine so we gassed up the 4X4 and headed off to Mt. Cheam on July 1st.

Super crazy logging road to the trail head, but the nice thing was not having to slog through the miles and miles of dense forest to start getting some views. Still plenty of snow around in the alpine we enjoyed amazing views of the Fraser Valley, the Fraser River, Mt. Baker and even Harrison Lake from the summit. On the way up we came across a couple in their 70's on their way down, the husband had a giant Canadian flag tied to his pack like a cape and they were all smiles and 'HAPPY CANADA DAY!!!' as they passed.

I feel like I have been trying to memorize all of these moments like stills in my mind for those times when I am homesick in Ireland. I am wanting to hold on to these last few days in the lower mainland, cherish them. My dogsitting/housesitting all week in Whistler has been a bittersweet time as I love the people, food, landscape, and recreation that surrounds me here. It is a perfect reminder of all of the things I will be giving up for the next, oh, decade. Wish I knew what propelled this desire to keep moving forward. Sometimes it doesn't seem like I am moving forward, just constantly in a new direction.

Nothing Is Sacred

I couldn't help it...John sent me this email today and it is by far the funniest thing I've received as a result of my recent acceptance to medical school.

I had to post it.

Sorry John.

Nothing is sacred...(The funniest part is I almost look like I almost have a smile on my face or like I am humming "hum de hum de hum...I love ironing my man's shirts for him....hum de hum"!) Here is the email:

yeah baby!!!

'bout friggin time eh?

finally an admissions crew with a head on their shoulders...well done! (you should get your SAS qualifications while you're at it)

Ireland is sooo much cooler than some island in the baking sun.

but don't get ahead of yourself...'cuz you'll always have people to remind you who.....you REALLY are!!!! (see incriminating photo below...)

...you missed a wrinkle....