The Heart of the Matter

Suddenly I was in the back of that rocking ambulance again. This time with Howard Thorpe. His pallor revealed what his silent lips did not. The wail of the siren bounced around us and the lights of the city streaked past.

He knew what was happening behind the layers of tissue, cartilage and bone. He knew what had occurred deep within his very core. The aorta is the body's largest vessel. A firefighter’s hose of blood which runs the length of the spine where it bifurcates into smaller but also high-pressured arteries at the neck and thighs. A tear in the aorta can cause a man to bleed to death in minutes.

Howard had come in with mild chest pain and leg pain while he was skiing. A neurosurgeon from Montana, he knew that chest pain wasn't to be trifled with, figuring it was nothing but wanting to be sure he came into the clinic to get checked out.

At that time the pain was in the middle of his chest, maybe a 5 or 6 out of 10. His initial exam rang no great alarms. The electrocardiogram was overtly normal, his blood pressure not too low or too high, heart rate was skipping along maybe a bit quickly, but nothing worrisome.

Howard was very personable, kind, unassuming. The clinic was busy that day but he was my primary concern. The broken wrists and dislocated shoulders could wait with ice packs and slings in various positions.

Howard’s family was still skiing on the mountain, unaware of his mid-morning check-in. I administered nitro spray under his tongue, feeling somewhat sheepish as I warned him about the possibility of a headache… like he didn't know! But then, one can’t be sure what medical people forget or fixate on when they are the patient. When suddenly they are on the them side of the ledger. Anonymous in their underwear and open backed gowns status…shuffling with their IV poles to the “patient" washrooms.

Howard said his pain had gone from a 4 to about a 1. I told Bob, the physician, and he advised me to keep his pain down with nitro and continue to monitor him. We nodded knowingly, the new onset of angina now under control. A cardiac foreshadowing. It was minor in the grand scheme of things. Thorpe was in good shape. He'd go home, and with his connections in Montana he would have the best cardiologist who would fast track him in to the cath lab where they would isolate those pesky narrowing arteries and do the things they do to them.

Howard would probably never even have to be an inpatient. He'd be tickety-boo and back operating himself in no time. All of this Bob and I were comfortable with. A nice guy with a not-too-bad diagnosis.

I went to get bed 3 ready for the next fractured wrist reduction. I heard my name from bed 1. "Erin? I just can't seem to get comfortable. Could you give me a hand?"

I walked quickly to his bedside. The head of the bed was raised and he was fidgeting in a strange way, fussing with the pillows. "I just can't seem to get comfortable. Can you lower the bed please?"

There was something about his movements that struck me as odd. Even bordering on alarming. "Where is the pain, Dr. Thorpe?"
"Right here, between my shoulder blades". He reached awkwardly around and pointed to that area on the back that immediately caused the hairs on my neck to stand. A classic sign of an aortic aneurysm. The tearing-of-the-lumen, pain referred to that area.

Trying to mask my reaction in my face or demeanor I helped him settle and quickly found Bob.
"His pain is mid-scapular, Bob...you've got to get in there now".

Bob and I exchanged looks which confirmed that we shared the same thought. Our initial apple-pie assessment of his prognosis had just soured. This was not good.

We moved Howard to the trauma room. Bilateral blood pressures on his arms and legs showed a marked discrepancy in pressure. On top of that, the pulse in his left foot had disappeared. His major blood supply was compromised somehow… his circulation wasn't going where it was supposed to. Now the leg pain made sense. Clinically it was clear that he was dissecting. If he was lucky it would be contained, with the more delicate vessel tearing inside while the thick outer lumen remained intact.

We were arranging the med-evac to the tertiary center which housed the vascular surgeon. At this point it looked like ground transport would be faster than landing the chopper. Someone had to go with him, and that someone was going to be me. Bob explained to Howard what was happening. Strange… or was it… that Howard hadn't come up with that differential on his own. Emergency staff are so versed in the tell-tale red flags of triage that Howards’s textbook discomfort immediately drew the two of us to the same conclusion. Maybe it was Howards denial and his own rosy hope that it was angina that blocked out his objective analysis of the situation. Can a man indeed be objective when he’s subjected to such an experience. …

We loaded up in the ambulance. His son-in-law had arrived but was unable to locate Howard’s wife and daughter on the hill. They had planned to meet in about an hour. His son-in-law was planning to bring them to the hospital as soon as he could but now Howard would have to go without seeing his family.

Dusk and damp misty rain greeted us when we rolled Howard out of the clinic. The fresh evening air did nothing to untie the knot in my stomach as I carried the bulky cardiac monitor behind the stretcher, a cell phone and Doppler to amplify pulse sounds. Two large-bore IVs were running into his arms and I had a pocketful of morphine and Gravol to keep him comfortable during the ride. I had no other drugs or equipment to rely on.

Shaun pulled the ambulance out of the bay… the sirens came then. It’s an altogether different matter when you are riding inside their wail.
As we accelerated down the dewy road toward the highway Howard was asking me questions… almost talkative.
"What are my blood pressures?"
"They are dropping, Dr. Thorpe. The left side is only 70 now."
"Why are you using the Doppler?"
"I can't feel your femoral pulse on the left side. It’s gone." A place where normally the bounding heart rate kicks at your fingertips now gave me only a swoosh-swoosh-swoosh when I pressed the Doppler to his groin.
"These things are so sinister in my mind,” he said. “The only time I see them is when I am trying to repair spinal damage from them".
"I suppose it must be worse to have the medical knowledge, to know all the worst case scenarios. Worse than being blissfully unaware."
He nodded.

I have a strict pact with myself to never reassure patients when I don't know what an outcome might be. It'll be okay. You'll be fine. Are phrases that never escape my lips unless I was putting a bandage on a skinned knee.

Thorpe arched his back grimacing with pain. Said, “It feels like it’s more in my throat now.”

I thought that he was going to bleed out right in front of me. Unsure as to the best thing to do as I watched his pressure plummet, I grabbed the EHS cell phone and called the clinic to update Bob and figure out what the hell I could do in the back of this ambulance if this man suddenly blew on me.

As Bob answered the ambulance lurched to the side, passing an unaccommodating commuter. The phone slipped from my hands and fell into several pieces on the metal floor.
SHIT.

I flipped open my own cell, so thankful that I had thought to bring it. Bob came on the phone again.

"His pressure is dropping. I've lost his femoral and he's getting pain higher up the sternum".
"Nothing you can do, Erin. Keep him comfortable, pain meds, fluids, that is all you can do in the back of an ambulance. It is out of your hands."

What I already knew but couldn't swallow.

Howard refused any morphine. Looking back I think he wanted to be as clear as possible for what could be his last moments. He knew he was a time bomb ticking.

He was silent and I forced myself to respect the desire he had to be alone in his thoughts.

Was he happy with the way his life had turned out? Satisfied? What haunting thoughts came to the surface now? Was it fear… resolve… peace?

His face revealed nothing.

He turned to me.

"Erin. My wife's name is Pauline. My daughter is Isabella. This is my wife's cell phone number. If I don't make it please call them for me. Promise me you'll call them and tell them I loved them." With a shaky hand he scrawled a number on a scrap of paper from his wallet.

I took the number and folded it into my scrubs.

"I promise". Was all I could say. My own heart was thumping in my throat.

He nodded, closed his eyes and seemed to go deep within himself. I bit hard at the inside of my cheeks. I felt myself go cold. I was going to watch this man die. The tinny interior of the ambulance his last vessel, a stranger at his side. My eyes remained locked on the cardiac monitor with its reassuring blips every second.

We arrived at the hospital in record time despite the rush hour traffic and the bridge. Shaun smoothly rounding corners, passing lanes and lanes of hassled motorists.

Howard is whisked into the ER, a trauma bay and team waiting for him. I pass on my report to a disinterested male nurse who is only half listening until I get to the part about the vanished femoral pulse. He glances up at Howard, several feet away being hooked up to monitors, oxygen, new IV bags.

I squeeze Howard’s hand as I leave.
"My name, Howard. Please remember my name, so you’ll know who to leave the message for at the clinic when you call to let us know how you are doing after surgery."

He repeated my name.
“I won't forget. You all did an amazing job. It may be a small clinic, but you all know what you are doing. Had me on my way as soon as possible. Other places might have missed the diagnosis. Shaun's driving was superb. I know how bad that bridge can be. Thank you for everything."

It was weeks before I heard the end of the story. A physician friend of his came to our ER department with gifts, wine, and a letter for the staff.

I still have a photocopy of it in my strong box at home. His handwriting is terrible so there are many words I cannot make out. He had dissected, from iliac crest to aortic arch. 7 hours of surgery and full recovery expected. In the letter he graciously thanked all of the staff. I smiled when I saw my name underlined—I am sure as a reference to my insistence that he remember my name and update me regarding his recovery.

But in it he says, “You all saved my life that day. You saved my life. There is no greater gift we can give each other. So I feel strange presenting you with these small gifts and a card. What can I say to the people who are responsible for me being alive today? Thank you really doesn’t cover it.”

In a strange way I am still haunted by that day. It simply comes at me from nowhere sometimes. As nurses we are placed in situations where a profound intimacy with strangers can be thrust upon us. We bear witness to the most pivotal times in our patients’ lives. In crisis we share moments with patients that is normally reserved for their most treasured loved ones.

“Promise me you’ll call them…”

I can hear his voice. I am in that ambulance. And I am scared. But more than that I am grateful for the precious burden of this work. Work that pains me, pushes me, frustrates me and scares me, but also honors me. Work that takes much from me, but gives moments in return that are profound in a life where superficiality often reigns.

I’m grateful just the same to come back to the present, to be running on the treadmill wondering what I need pick up from the grocery store for dinner.

Teflon Neurons

Voici a little sheet that shows most of the reactions I'll need to know in...oh...36h or so...

Okay. I am officially hitting the wall. No, more like running at the wall, hitting it, backing up and running at it again. An entire year of organic chemistry simply should not be condensed into 6 weeks. It's just not part of the natural order of things. It simply isn't right.

At this point, the real estate in my short term memory has dwindled to nil. I'll do a question, say to myself, "okay, so if I want to turn an amide into a primary amine I need Br2 and OH". Then I go to the next question and I have no idea what I just wrote down. Things go into my brain and then immediately they are gone. It's frustrating. Plus I am just starting to go batty in other ways...I walked into the dry cleaners yesterday and said "good morning!" at 1730h. Then I went to Safeway and walked by a dude waiting in line and started putting my food on the conveyor belt in front of him!

I am getting really excited though that soon all this will be over. I have significantly lowered my standards this week. I progressed from the "must get an A" to a "meh...as long as I am breathing at the end of this I'll be happy".

Also excited about the fact that I can finally stop having this conversation.

The only sad thing about being finished o-chem is I will have to retire my mackin' lab coat. In case you missed it, here is just one part of the bling I put on my sweet little protector of fine sweat pants.


I really may have to bronze it and hang it in a display case of some kind when I get home. That is enough procrastinating for now. Must return to the reagents. Uhhhhg....reagents.

Another Day on Call in the Arctic

I miss working. I can't believe I just wrote that. It's true though. Feeling nostalgic today I was reading through my journal from last fall when I was working in a remote Inuit community in the Western Arctic. It makes me antsy to get back into the trenches. A year is a long time to be away. Here it is:

I actually was part of saving a man's life today.
Cut my finger trying to eat a muffin.
And watched some bad Canadian television.

It was so interesting to see the events of the day unfold in a dream-like sequence...I felt like I was watching it all from behind glass, yet so in it I could barely raise my head above the smell of benzoin. The benzoin was being used as a tacky assistant, since the EKG stickers were sliding off the patient as fast as we toweled him and applied them. The cold sweat seemed to travel down his body like a clear oil slick, removing all our feeble attempts at securing I.V's and electrodes to get a heart tracing. The benzoin's sap-like consistency anchored our only diagnostic tool.

A garbage bag curtain hid the unfolding ice storm as inside we swirled around our most diaphoretic, nauseated, hypotensive, peripherally shut down patient.

I had been assessing a young man's knee when Jane burst into my office. She can get a bit dramatic near the end of her stints so I wasn't fazed at first. "Uhh...I think I've got an M.I in my office." M.I is medspeak for myocardial infarction, a.k.a 'heart attack', a.k.a 'a jammer'. I asked my patient to hold tight. I love cardiac stuff. It's a throwback to my old ER stomping ground that was in the heart (pun intended) of the silver tsunami which is the West Coast. Cardiac emergencies are interesting, challenging, emergent. Emergent is a nice change from the doldrums of most ER care which revolves around abdominal pain, back pain, flus, colds, headaches, lacerations, psyche, and the odd trauma.

I happily left the twisted knee and went into the trauma room. There, slumped on the stretcher was a very distressed Inuit man. He was clutching the center of his chest with one arm and failing around, grasping at air with the other. He was moaning loudly and the sweat was literally flying off him. His tan skin had somehow managed to take on a ghastly gray/green tinge and I could immediately see that we were in for the long haul with this chap.

No cardiac monitors, defibrillators, no I.V pumps. I was used to these constraints in settlements but cardiac problems are so rare that normally I don't notice it. I wheeled the EKG machine to the bedside as our only means of 'cardiac monitoring' . He was in v-tach. This was glaringly obvious the second I fired on the EKG with help from Jane, who was starting I.V's and trying desperately to have the leads stick to his chest which was as slippery as the frozen ground outside.

A heart beating 240 times a minute is more like a fluttering wing than a pumping muscle. When this happens oxygenated blood does not get to the right places. Where the blood is not perfusing the starved cells begin to die. One place that doesn't get the supply it needs is the heart in these situations. And in these cases, minutes mean muscle.

It was bad. Maybe a pressure palpable at around 65 systolic. I was scared and excited and intrigued all at the same time. I was loving it.

I hate to admit to the morbid love of real emergency situations but really it is such a charge.
At one point I remember looking at him, curled in the fetal position with his sweaty hair plastered to his face, a shiny gray, and thinking to myself, "he is going to crash. He is going to crash and we have no electricity to do anything. He is going to crash. Are we going to tube him? Is he maintaining an airway?"

He was gulping for air despite the 10L NRB mask on and the nasal prongs at 4L. Gulping! And we couldn't get an o2 sat because his fingertips were giving up no information. The sat monitor could not read how much oxygen his red blood cells were carrying around...his capillary blood had packed up and moved north.

More north than we were.

I called the doctor at the hospital which was an hour away by plane (the only way in and out of the community). As usual the security guard/answering service put me on hold for a horrifyingly long time. By this time Lawrence, our only other nurse, had taken over the duty of watching the EKG machines 2x2 inch screen for any changes while Jane worked continuously to dry off and re-tape the electrodes as they slipped off.

I hung up the phone and called the emergency line again, this time telling the security guard that I needed the MD on call toute suite. A harried doc came on the line and I apologized for raising the alarm but told him he needed to initiate a medevac for an extremely unstable cardiac patient and I needed some orders for the impending code that was going to happen. He asked me to fax the EKG and get amiodarone into the patient as soon as possible, well, as soon as he got the EKG and could confirm my v-tach diagnosis. To take care about the administration and set the pump to make sure he got the right dose. Pump! I laughed. "No pumps around here bud, I'll be giving that drug in a syringe drop by drop over 10 minutes once the loading dose is in!"


Our secretary was with the patients wife in the coffee room, trying to keep her calm so I was fiddling around with the ridiculous fax machine while trying to draw up the amiodarone and double check the dosing at the same time. Jane and Lawrence had their hands full still trying to get a basic set of vitals on the guy. Finally the janitor walked by and I managed to snag him into sorting out the fax.

In a few long minutes the doc called back and told me he'd initiated the medevac and had received the EKG. I thanked him and hung up the phone.

The loading dose of the drug went in and I shook my head at the set up we were dealing with. An impending blizzard outside, no way to properly monitor the patient, and no way to deal with him if he coded. I felt like my hands had been tied behind my back while the crisis crescendoed.

I held the 60cc syringe in my hand while watching the clock (the only real technology in the room) and dribbled in the maintenance dose.

Then lo he suddenly said--'the pain is gone'. He let go of his chest and turned his head to me in surprise.

The dregs of the amiodarone were still going in by my hand. I ran to the other side of the stretcher and happily informed him, indeed the pain was gone because he was in a sinus rhythm. I must have thought, thank God or someone.

I know that then I must have exhaled completely for the first time since seeing him floating in his own juices on that emerg stretcher from the 1950's.

The time had warped. Despite the freezing rain and the blowing snow, the fog and the ceiling the plane landed and he was scooped (infuriatingly slowly!!!) by the paramedic and med student.

And off they flew, 6h after he'd driven himself to us.

Suddenly realizing that it had been too long since I'd had a chance to pee, eat, or drink water, I endeavored to change that. In the process of trying to quickly saw in half one of my 4 day old muffins the chopping knife slipped and gashed my left index finger.

That was annoying. It started bleeding and bleeding, I thought--there is no way i am getting sutures today...so I applied pressure, steristrips and a bandage. And was still annoyed. And will continue to be as the deep cut on my right index finger from climbing has only been freed from bandaids for 24h. Ugh. Oh well, I realize how pathetic a cut finger is compared to a jelly heart.

But I thank him and bless him. He gave us a rare satisfaction. The feeling that we actually did something really important that day. We worked as a team and even with our limited resources we actually saved a life. We didn't just look in throats and ears and give out septra for U.T.I's all day.

It also made me thankful that I had spent those hellish nights in the viper pit in my old emerg department. That's what all those countless cardiac cases were preparing me for.

I do hope he does well, was such a nice, funny, man. He joked with me about wanting to eat berries and that he was getting ready to 'run out' and pick some before the medivac crew arrived.

The wind is rattling my windows still and the power just went out. Thankfully he got out before the storm really hit.


My next patient of the evening:

Pommer the Pommeranian

We got the call that there was a lady with a dog who had a broken leg. Apparently she had called the RCMP first but they directed her to the health center. I was on call so agreed to see the pooch. We're not really supposed to treat animals but as the nearest vet is 4h away by plane we usually bend the rules and help out if we can.

Pommer was a rust colored fur-ball of a puppy. An adorable 4 month old who had apparently been 'dropped' by the chubby, flat affected, 8 year old---er---since when did dogs break their legs from being dropped 3 feet above the ground?

Anyway, the dog seemed settled enough in the mothers arms but with even the slightest movement the yelps of pain elicited were so ear and heart piercing that we could hardly bear it. Our attempts at x-ray had been traumatizing for everyone involved. Thus the decision was made to try and medicate and splint the poor creature.

So I called Dr. P in Whitehorse, a vet who gives over-the-phone advice and he talked me through how to create a muzzle out of kling gauze (so as to not get bitten) and how to landmark for an intramuscular injection of demerol. And so the splint was made with the bendable metal we fashion finger splints, gauze, and kling. Did you know that dogs have radius' and ulnas? I had to laugh at the learning curve of the evening.

Let's hope the rest of the night is quiet. Uh-oh. I wrote the "Q" word. I wonder if the same jinx happens when you write it as when you utter it...

The, Like, Doctors of Like, Tomorrow, Like...

The title is probably all that is needed. But I'll elaborate anyway. I just spent the last 3h in a chem lab making estriadol. It was a pretty simple procedure since we were given the estrone needed to do so. But during the lab the two girls who I share the bench isle with became unbearable to me.

One said "thank God there are so many idiots in this class asking stupid questions". Whenever any student did ask a question the two of them would exchange eye rolls or snorts of superiority. That is, of course, between the compulsive checking and texting on their pink razor phones. Maybe they are day traders and premeds, so maybe I shouldn't judge.

Yet Brittney #1 thought it was HILARIOUS that she kept spilling her hexane all over the bench. Hexane stinks, its highly flammable, and extremely volatile which meant I was praying all afternoon (in a hexane vapor cloud) her bunsen burner wouldn't set me and the bench alight.

I didn't think it was hilarious. Nor do I enjoy the fact that one of these girls will likely be doing my moms knee replacement surgery in 10 years. It is such a whack system that forces people to become these uber-achieving-competitive-petty-sociopaths to get INTO medicine, then expects them to suddenly develop a compassionate, patient, and understanding personality of good doctors (whatever that means). And don't give me the "if they are surgeons they don't need to have good bedside manner" because that is a cop out and a load of bull.

Surgeons don't work in a vacuum so why should the rest of us be expected to play nice and be professional and they get off the hook?

But I digress. The bottom line is, after being surrounded by the medical/dental hopefuls for the past year I have developed some major doubts as to the quality of the masses attempting to become doctors. It's scary folks. There is an upside though. I have a nearly photographic memory for faces. And believe me, I have been amassing a composite of wannabeMD's, which, if I ever see them in the hospital, I will hit-the-floor-running-with-my-IV-pole-trailing-behind. Because really, I've seen how they handle things like H2S04 gas and I find it worrisome that some day they'll be making life and death decisions for us all. I must say though, I do wish I could be there the day they realize that sometimes medicine means putting your finger in someones bum.

Go Long---May Long!

I forgot about this picture. John and I ended up lost, wandering the streets of Geneva like a couple of oafs after a fabulous dinner at a restaurant Hank recommended. But before we ended up an hour and a half in the wrong direction from our hotel, we stumbled upon this park where many chess games were underfoot (literally) among an interesting cross section of Genevians (Genevioans?). There were toothless old dudes, hipsters, punks, yuppies, huppies, nerds, and goths all claiming their little piece of painted concrete.

I was entertained as we walked around and John shredded every players strategy, mumbled about their inferior chess playing abilities, scoffed at their moves, and guffawed about slow and painful endings to games that had such "obvious check mates". Thats my man. Chess snob number one.

Enter, Edmonton.

After our beautiful little Swiss getaway the reality of Edmonton hit like a ton of bricks. Or should I say, a ton of pavement?


Right now I am spending roughly 2-3h a day in traffic. Not just the 'getting from A to B is a long way off' kind of traffic, but the 'inching along in construction zones' kind. The worst kind. Also, the two main veins that empty into the heart of the university are under construction. So there is no way to avoid it. It is heinous. My calculations have shown roughly 30+ hours in the car in the past 2 weeks. Life is just too damn short for that kind of nonsense if you ask me. No wonder coronary artery disease is directly correlated to how far one has to commute!


So last weekend I got in the car again. But this time I drove to Red Deer. And got to see my beautiful little niece and nephews.

The reward was certainly worth the trip.

This is Rachel, she's 6 which means she still is young enough to think she has a cool auntie. I like hanging out with her, a lot.

This is my bro Shandy. He's pictured here, in his happy place, i.e his garage where he is assembling a replica AC Cobra.


His plan is to be finished by fall so he can drive Rachel to her first day of grade one in it.
I asked if he'd maybe make another one for me so I could have it for my first day of MD school, to which he made some smart-assed remark about "well...at the rate you're going...".

"Have I been looking at the directions upside down the whole time? Hmmmm


Speaking of boys and toys. Here is my brother in law's new toy. He's pretty pumped. Though I am sad he didn't get the insane zodiac with the roll bars. That boat looked waaaay more fun!



So Davey took us out for a day of fishing. We were absentmindedly enjoying our V8 juices and the sun when suddenly the weather turned on us and lightening started showing itself in the north. So we hot-footed it back to the trucks to wait for the storm to pass. Good thing, for as soon as we were ensconced in our vehicles a crazy hail storm decided to hit us full throttle.


In about 20 mins the wild storm had passed and we had bluebird sky again.


Here is 'Little Man' eying his catch with some trepidation. Who knew one could catch such brilliantly colored fish in the 7 foot depths of an Alberta lake?? Sorry Verena, no macros of that guy.



So now I am back in the big smoke. Doing my fair bit of couch surfing. It has been great catching up with some friends that I haven't seen in years. I am tired of living out of a duffel bag though. The past year in Kelowna with John and I having to go back and forth on weekends, trying to keep track of my coat/toothbrush/footwear was tiring and it just seems to continue. When I leave my moms place in the morning I have to make a couple of trips, my car is full of textbooks (in case I have a spare minute to MCAT cram), an emergency supply of powerbar meal replacement drinks, spare runners, running clothes, some cans of tuna, change of clothes and shoes in case I end up going out for dinner, breakfast/lunch/coffee/tea/snacks, computer, ipod, camera, and their various charging and downloading devices. Really, it's ridiculous. Last week I slept at four different locations. Turns out all I need to add to my Mary-Poppins-Bag of a car is my fan and a pillow and I am set.

I wrote the above posting a couple of weeks ago but due to some issues with my tags (?) it wouldn't publish. I have since started the next o chem class and my schedule looks like this now:

0600h: wake
0730h-1000h: meet tutor at university after eating breakfast in car
1000h-1230h: class
1230h-1330h: study for daily lab exam/eat lunch/finish lab write up/pre-lab
1330h-1630h: make like duck in lab for 3h (scrambling around but trying to look calm on the surface)
1630h-1830h: run, eat, start lab write up, pre-lab, stare at wall, drool, fantasize about being a kept woman/winning lottery
1830h-2030h: meet with tutor (again!)
2030h-0030h: study, study, study...
0030h-0040h: read
0040h-0600h: sleep

So please forgive the lag in postings until after this is all over.

Oh, great.

I think my shingles are coming back. I heard they are really in this summer....

Shingles, they are so hot right now, shingles.

One...last...pre req!

This just in...got an A in organic chem 261!

Woot!

Three weeks to go and I will be freed from the 7th circle of pre requisite hell that I have been living in for the past year!

Double Woot!

Procrastination at its Finest

You know when you come across a work of literary genius that makes you WISH will all your might that you could turn back the hands of time and be the author that fashioned such art?

Well that was me 2 days ago when I came across this post on The Best of Craigslist. I suggest, next time you need a good GOL (guffaw out loud) read the rant entitled "Person With the Wooden Leg That Lives Above ME".

Everything Turn Turn Turn

A few final shots from our Swiss trip. John and I biked up a very sketchy road to burn off some cheese. I couldn't decide, as we ascended the windy mountain road if I'd rather be hit by a car or go tumbling down the steep embankment. Luckily I never had to make the choice.
A couple of photos from our last night in town, where we took Hank out for dinner at a medieval castle.

This is our "band" shot. I don't think we look aloof enough.

Hanks town. Not bad eh?

John chowing on some Peter Rabbit with a large wooden spoon. Mmmmm...rabbit.

And now I am back in E-town. It's like groundhog year here. I am here for another round of organic chem. Yes, the very same from last year, well, with a twist. Last year the course was a first year organic class, now it is a second year course and the students are expected to have a year of inorganic under their belts. So it is a bit more challenging, but so far nothing compared to the Dr.N boot camp a la chemistry that I just finished at UBC. To the non-chem folks I know I am just rambling in a "wah wah wah wah" voice so I'll stop.

E-town is so weird. There are overpasses where there never used to be, the entire city seems to be under construction, and rush hour appears to be more like rush-12 hour. I went to the Sugar Bowl the other day to grab lunch. In the good old days I knew every server and half the clientèle. Now it is seems all the prototypes (the chain smoking post doc, the tortured photographer, the drummer from that band) are represented but they are all strangers.

My secret washroom in the Varscona Hotel (where one can go for a pee break when shopping) now has an electric lock on it for hotel guests--guess it wasn't so secret after all. The trick was to walk into the lobby like you owned the place, then no one questioned your intentions.

The only constant seems to be the homeless man with the stutter who sells "Our Voice" on the corner of 82 Ave and 104 St. I bought a paper from him. Relieved to finally see a familiar face, someone to orient myself with. Oh that and the uber trendy suspender and skinny-legged-jeans wearing staff at Gravity Pope where I, for traditions sake only, went and picked up a new pair of Fluevogs. Heck, they were on sale, and it was my early birthday present to self.

So UBC c'est fini. My marks proved to be pleasing. Managed to score honors for the year, which is sweet--is that the beckon of a medical school I hear in the distance? I hope so...I guess all those hours sitting in a plastic lawn chair for the past 8 months paid off. Now I just have to wail on the MCAT and these last two courses and...7-10 more years of school--here I come!!!

Life is good. I hate crawling along in traffic. It reminds me of why I live in a town where I can walk everywhere I could want to go in 45 mins or less.

Back to the books I go.

Sun Up My Nose

Have skis will travel.

We had a good chuckle over the fact that apparently the Swiss have figured out a way to get nature out of the gas pump!

Two days ago we were able to catch a ride with George and Andy to St.Bernard Pass for a nice day tour. The sun was unrelenting and there was quite a bit of activity all around us so we weren't able to ski the face that we had hoped.

It was a spectacular day, nonetheless.

John trying to pick his way through the crowds.

George ascending.

We stopped frequently to sunscreen up. Despite the fact that I put 30, 45, and 60 SPF all over myself several times, some was sweat off and in some places (like my armpits and inside my nose) I just didn't think to apply sunscreen. Yowza! I am paying the price. Yup, burned the inside of my nose and posterior axillae. Let me tell you how pleasant that is every time I blow my nose or put on a backpack/bra/shirt.

It really was this hot.

Not such a bad view for the lunch break.