Thursday, March 28, 2013

Intimate Insight

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

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

Monday, March 25, 2013

Insert Foot

I was in outpatient clinic recently when I called a patient in from the hall. He was awkwardly positioned in a wheelchair, looked to be in about his mid 50's, with thick brown hair neatly combed back, smartly dressed in a tie and sweater. An elderly woman wearing thick support stockings, polyester skirt and heavy woolen shawls pushed the man into my office.

I introduced myself and said hello to the man, then said to the elderly woman, "and you must be his mother?"

Now I can hear you all cringing and possibly yelling, "NOOOOooooooooooo" at the computer screen. Well as Mike Birbiglia would say,

I know....I am in the future too!!!!

See the thing is, I learned long ago never to assign relationship speculations during interactions with patients! In the emergency department I've often been surprised to discover that the young woman wearing the leather dress, knitting beside the stretcher of an elderly man isn't his daughter / girlfriend / caregiver / niece but is in fact his surrogate mother / Wiccan priestess / life coach / financial advisor.

So I don't know what was wrong with me when I said that, but the elderly woman quickly jumped in to correct me with,

I am NOT his mother, I am his WIFE. I know taking care of him has worn me down but COME ON!

Oh dear. So I apologized and attempted to carry on with the consultation. I was actually surprised that I didn't lose my composure completely. Suppose being berated for years as a basketball referee and then a triage nurse has helped me stay calm when the waters of communication get choppy.

But rather than let it go she kept bringing it up.

At one point she asked me about my "American accent" and I said, "Yeah, actually I am Canadian" to which she replied, "I know, I just said that to annoy you considering what you said to me earlier".  I was mortified. It was awful. Lesson, re-learned.

This is what medical school has done to me! All of my healthcare street smarts have been replaced with useless lists of things like the rare causes of secondary hyperparathyroidism! Thankfully I will be back in the real world soon.


Thursday, March 14, 2013

6 Minutes

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

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

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

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

I love my job!

Have you hugged your kidneys yet today?

Monday, March 11, 2013


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

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

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

Note to self: have mega life accomplishment more often!

Wednesday, March 6, 2013


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


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

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

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

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

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

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

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

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

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

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

I have a job as a doctor in Canada.

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

I have a job as a doctor in Canada.

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

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

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

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

"I am going to be a rural GP!"

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

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

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