Why I believe the Alberta Children’s Hospital is the nicest hospital in the country.

I’ve had the opportunity to work in many of the major hospitals in Canada. Over the next few weeks, I’ll tour the remaining major centres. But for now, ACH takes the cake. Here’s why.

Huge-ass (and clean) washrooms.

wide-ass hallways with the kid's art work displayed throughout.

a cafeteria equipped with a stage for patient performances. Apparently first-run movies can also be played here. Note the aquarium under the staircase.

exterior designed by the kiddies themselves. Those light posts also change all sorts of colors

HEATED garages. Will save your life in the Calgary winters.

The following pictures are jacked. For fear of being fired, I was unable to take my own pictures when real patients were in the shot.

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cafeteria with a breath-taking view of the Rocky Mountains

when the ER looks like this, everything is just less scary.

Patient rooms with a built-in bed for parents to stay the night.

all sorts of activity rooms for the sick kids. This is a sun-room for oncology patients.

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My issue with affirmation and encouragement

I’m not the biggest American Idol fan but whenever I do watch it, I am utterly amazed at the blatant lack of singing ability that people possess. However, what amazes me even more are the countless contestants that break into tears and cry when the judges tell them they suck, as if its any surprise at all.

“I know i can sing. All my friends and family say I have a voice like Mariah or Whitney. My singing coach says I have the voice of an angel.”

Then they go on to cuss out the judges and make a fool of themselves.

I feel like this is a much bigger issue than a simple singing contest. How are people to better themselves when the people closest to them are too stupid or too consumed by liberalism to discipline or to offer constructive criticism? Whatever happened to the concept of ‘tough love’?

I don’t know how many parents I’ve encountered that applaud their child’s C and D averages because he’s “doing his best”, when in actuality, he’s smoking weed with his buddies and getting suspended every couple of months. Or how many teachers I’ve talked to who complain about their inability to discipline or fail undeserving students because the school board doesn’t want to hurt anyone’s feelings.

Little Jonny wants to be a doctor? Let’s all celebrate and have a party because he has BIG dreams and works towards these dreams by watching Gray’s Anatomy every week. Gimme a break, this culture of entitlement, laziness and instilling false sense of confidence is going to destroy the youth of our generation.

There is a place for affirmation, encouragement and positive reinforcement – when someone has ACHIEVED. If his absolute best is a C, then hell, I’ll give your son a pat on his back for you, but I am sick of parents and teachers that feel that they are ‘protecting’ their kids from the big bad rejection of the real world when in reality they’re cutting their legs from under them.

Now that’s what I’m talking about.

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I rarely have the time to read for fun, but this is a must read.

The honor of worrying – of caring, of easing suffering, of being present – may be our most important task, not only as friends but as physicians, too.

And when we are finally capable of that, we will have become true healers.

- Final Exam, Pauline Chen.

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KN

I’ve been thinking lately about the psychiatry rotation I was on for 6 weeks back in the summer and I found this little excerpt. I think it’s good practice for me to remember my patients. What I learned from them, how they affected me, and they made me a better doctor, and hopefully a better person. Maybe even how I can pray for them. I will try to make this more of a habit.

“The weird thing is that most of the pts assigned to me are little old ladies in their 70’s and 80’s and 90’s suffering from depression, bipolar and dementia. On my first day I looked at the slate and groaned since old patients with dementia and depression are the least exciting and the most difficult to treat. Everyone felt for me, my classmates, the nursing staff, even my preceptor felt bad for me.

Over the past six weeks I have learned to embrace all my little old ladies to the point where i see them as my own grandmothers. Sounds lame I know, but its true and I laugh everytime I think about them – grumpy old , super depressed ladies who just want to be left alone, getting bothered every morning by this goofy kid who jokes around and laughs at his own jokes (because they haven’t smiled in a month).

IP with the brain tumor and the toothless smile. GH with the intractable depression who upon discharge, went home and broke her hip, and who will likely never leave the hospital again… and MJ, with the overbearing/useless daughter who used the hospital as a babysitting service despite her mother’s great response to treatment.

Apart from my surgery block, I still find those six weeks some of the best weeks I had in clerkship. Strange now that I think about it since I went in with such a poor attitude. I feel like there is a lesson to take from this somewhere.”

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These days.

Currently at UBC for vascular surgery.

my most memorable patient will be this man.
a 60-70 something year old who underwent an abdominal aortic aneurysm (AAA) repair on my first day. The procedure went well. Then on the first post-op day he threw a clot to his left leg and we had to bypass his femoral. On the third day, he threw a clot to his brain and he stroked.

We are 5 days out now and he has since gone into renal and liver failure, has had an MI (heart attack), infarcted his spleen and his spinal cord leading to paraplegia (paralysis of his legs) and is currently in ARDS (acute respiratory distress).

If my pager goes off tonight it’ll likely be announcing his coding on the unit.

I think the response of the team this morning sums up best how I’m feeling.

jr resident – “CAD, COPD, renal failure, liver failure, splenic infarct, spinal cord infarct, paraplegia, CVA”

chief resident – “shit”
staff surgeon – “shiiiit”

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Just another day in the neighbourhood

As I was crawling into bed last night, eagerly anticipating the next few hours of sweet sweet sleep, my pager goes off.

Figuring it was just another broken arm or sprained ankle, I dragged myself to the ED only to discover, to my selfish glee, that a man had fallen into a grain auger and had partially amputated his left foot.

As doctors there is an inherent struggle in balancing the boredom of stable/healthy patients and the excitement of weird, wacky and usually unstable patients. I always feel a little guilty when my heart skips with happiness when half-dead patients roll in through the door, because in most instances, it’s something totally disgusting, gory and uncommon.

So anyway, this guy comes in, we unwrap the dressing around his stump, exposing arteries which proceed to pump half a litre of blood onto the curtains. We managed to pick out a few corn kernels and wild oats from his wound, but his ‘foot’ was pretty much a mash of dead muscle, bone fragments, cartilage and… grain. So we brought him to the OR, sawed off all the dead bits and that was that.

I forgot to steal a copy of the actual x-rays but this is a pretty good reenactment.

and this was after.

All in all, a great night.

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My predicament

What differentiates a Christian doctor from a non-Christian doctor? or a Muslim, Hindu or Buddhist doctor for that matter? I struggle greatly with this issue.

I know fantastic doctors on both sides… those who have the bedside manner of Mother Teresa, and others who have the surgical dexterity of Dr. Ben Carson himself.

But the more carefully I look for some semblance of a line that differentiates the two, the more blurred and undefined it gets… the more I realize that it probably has less to do with what I can see and quantify and a whole lot more to do with what goes on in their heads.

Or maybe I’ve just missed all of the patient-centered prayer meetings… har har.

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Goodbye sleep.

I woke up today at 7:30am. I will not be able to wake up this late on a weekday for the next while. This is something that scares me greatly. If you know me, I have 3 fundamental joys in life. Sneezing, staring and most of all, sleeping.

When people choose specialties, the issue of “sacrifice” always comes up. “If i were to do family, I’d sacrifice some of the procedural skills but i’d get a better lifestyle in return” or “Emerg has lots of procedural skills but i’d have to give up my Christmas and New Year’s Eve ever other year”. In surgery, people talk about having to sacrifice family, friendships, long-term interaction with patients etc. which are, of course, all substantial sacrifices… but to me, none is greater than the sacrifice of sleep.

So the next little bit will give me great insight into whether i can hack it or not. How do you balance a true desire for something with… not sleeping ever? I guess you don’t, I’m probably just being a huge panzy.

Sagging eye bags here I come!!

Hillary knows what I’m talking about.
Also, her face made me vomit a little just now.

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I’m a creeper

I used to bring my ipod to the gym. One day, the battery ran out and I left it at home. I never again used my ipod at the gym. At first, it was because I was too lazy to charge it, but then, I discovered that having ear buds plugging my ears prevented me from eavesdropping on the conversations that swirled around me – which surprisingly are much more interesting than the music on my ipod.

Here are their stories.

A group of highschool kids:
A: “yo, would you go to space if you had the chance?”
B: “hellz ya man, that would be awesome.”
C: “too bad it costs like… a million dollars or something i read it somewhere, only billionaires could go”
A: “if i was a billionaire i wouldnt go to space”
B: “ya, what if the spaceship blew up and i died?”
A: “ya thats gay man, i mean, if i was a billionaire, life on earth would be so much better than space anyway”
C: “ya like, i’d have a big ‘ol mansion and stuff”
A: “if someone was like “hey wanna go to space?” i’d be like “ya sure, i got nothing better to do”, but if i was a billionaire i’d be like “hell no, i’m gonna drive my lambo and pick up chicks” “
[at this point, i had to walk away cuz i was laughing so hard, but after i regained my composure, i went back over to see what was up]
A: “yo guy, i had the best sleep last night, i’m getting so good at sleeping on my back, i’ve been practicing”
B: “i love sleep man, its the best”
A: “like, normally i sleep on my stomach, but my sleeps suck cuz i cant breath and i always have to wake up and breath, so i started practicing sleeping on my side and back and stuff”
C: “ohh ya, back sleep is the best man”
A: “ya, but i cant fall asleep as easy on my back, but if i do fall asleep i have the best sleeps ever”

A group of jr high kids talking about their girlfriends:
A: “ya, she lives so far away, its annoying”
B: “so when do you see her?”
A: “i dunno, sometimes at night, i walk over but it takes like 2 hours”
B: “but thats good right? like it shows youre committed right?”
A: “ya but 2 hours man. i get in trouble cuz i get home so late, and my legs are so tired the next day”

HAHAHAHAHAHAAHAHAHAHAHAH

A group of 5 year olds:
A: “STOP STEPPING ON MY SHOES”
B: “i’m not!”
A: “youre a stupid head”
C: “did you call me a foofoo?”
A: “youre a foofoo head”
B: “youre a doodoo head”
C: “poopoohead”
A: “peepee face”
B: “you smell like poo”

My friends call me a creep. I probably wouldn’t disagree with them at this point, but i can’t help it, these kids bring so much joy into my life.

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Want to give advice? Don’t, you suck.

I find that most of the advice given to med school applicants these days is highly unhelpful. The advice given to me when I was an applicant was no exception. Now, I don’t want to sound ungrateful, because I know that advice is always given with good intentions, but I just need to point out the fact that advice that is subjective, variable and that often conflicts with previous advice is useless.

For example, person A may say “Bob, try to be funny, humor will lighten the mood and make them more psychologically inclined to give you a favorable recommendation”. On the surface this seems like sound advice, but lets break it down a little bit.

Point #1 – Bob may be the most unfunny person in the world. In fact, his idea of ‘humor’ may involve cracking racist jokes. This leads us to…
Fun Fact #1 – Person A’s humor may open all sorts of doors for him, but Bob’s humor may not, who’s to know?

Point #2 – Two weeks later Bob bumps into person B who’s advice is to avoid humor as humor can come off as a lack of maturity and humility on Bob’s part.
Fun Fact #2 – Advice is incredibly subjective and contradictory, which is only confusing and unhelpful.

Point #3 – What if the interviewer has a soft spot for racist jokes? Now Bob, having taken person B’s advice has resorted to talking about his turnip farm in northern Saskatchewan when instead, he could’ve stolen the show with a quick derogatory joke about asians.
Fun Fact #3 – Good advice that works for one interviewer can be terrible advice for the next.

Point #4 – Bob, having now received completely useless advice from 2 people now consults a third, person C. Person C is what I like to call a fence sitter. We all know advice-givers like this. They talk with an heir of wisdom that is neither believable nor real, always trying to sound thoughtful, deep and insightful. His advice sounds something like “well, just be yourself, be funny, but not too funny, be heard but unheard, yet quietly vigorous”.
Fun Fact #4 – Some people just give garbage advice that makes no sense.

Soo, that being said, Tammy I’m not going to give out advice of what anyone SHOULD do, but between my personal experience and the experience of some of my buddies, I have compiled a list of what NOT to do or say in an interview. But for now, just stare at this picture.

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