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.

Filed under: Uncategorized

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.”

Filed under: Uncategorized

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”

Filed under: Uncategorized

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.

Filed under: Uncategorized

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.

Filed under: Uncategorized

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.

Filed under: Uncategorized

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.

Filed under: Uncategorized

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.

Filed under: Uncategorized

The Medical School Interview (II)

I had the opportunity to play tour guide and life coach last year at the interviews. It was alot of fun, much more fun than giving the actual interview I’m sure. This year however, I have been given the task of interviewing applicants mono y mono.

The obvious lure of power aside, there are so many reasons why I don’t want to do it. Everyone that walks through the door deserves to be there, the marks, the MCAT scores, the achievements… most are well-spoken and will answer the questions intelligently and appropriately. As a result, the difference between a rejection and an acceptance will come down to a meager few points that were probably determined on something subjective like… whether his tie matched his shirt, or how straight her teeth were, or.. you get the point.

Whether we like it or not, in all interviews, the interviewer will subconsciously be influenced by factors that have absolutely nothing to do with our abilities. Which sucks and now I’m gonna do it to a bunch of kids who have busted their butts for their 4.0’s.

So today I tried to get out of it, but was shut down. Oh well. Better an interviewer than an interviewee right? Who am I to complain. Anyway, here are some tips on how to pwn the medical school interview:

Filed under: Uncategorized

Strength…

The strength of others fascinates me. Or rather, the strength of people who should seemingly NOT possess such strength, fascinates me. Patients who wrestle through diagnoses of the worst degree, who overcome denial, depression and anger to become inspirations to everyone around them. Wives of dying husbands who are unwavering in their encouragement for the doctors and nurses who have grown weary, tired and defeated. Or the mothers who lose their day-old sons and daughters yet head home the next day because her other kids “need their mommy”. 

I do not understand their struggle and I do not understand their pain. What I am able to grasp I can barely handle. I sometimes try to put myself in their shoes. Would I be able to adapt? Would I even be able to survive? Rarely have I been able to answer confidently with a yes. 

It’s hard to walk away from these things unchanged, and I hope I never do walk away unchanged. My greatest desire of all though, is that my hope will be placed in things far greater than what I can see or touch. In things that do not fade with time, in things that do not break, waste or fail. And in that way, my hope is that I too will one day possess such strength. 

Let faith support us where reason fails, and we shall think because we believe, not in order that we may believe. – Tozer

Filed under: Uncategorized