Bad Dreams

I like naps. You could say that I live for naps. Ok, I'll say it, I LOVE naps. But today, my mid-afternoon nap was ruined. I had the most HORRIBLE dream. I was on the edge of a pond and two big kids were coming at me with big metal poles trying to kill me. Suddenly I had got one of the kids into the water and somehow he died... Then the other guy said that now he was no longer worried about his honor and I should kill him too. There I was in my dream bashing this guy's head with a metal pole, then I told someone I could do it and they bashed him until his head flew off.

What the heck!?!?! If this happens again, afternoon naps might be ruined forever. Dammit!

Something to look forward to...

Last night I lay in bed for a couple of hours trying to fall asleep. I kept thinking about Glasgow (where I used to live) and how everyone there was doing. I was experiencing these great visceral memories - I could feel myself riding the tube, smell the rain in the air, imagine opening the door of my little flat to Ben waiting at the end of a long day, walking through the graveyard I used to go searching for old/neat gravestones in. It was almost better than dreaming.

When I first got to Glasgow and knew nobody, I started out my adventure living with 5 other students. They all went to Glasgow University (I went to Strathclyde) and 2 of them were in medicine. I watched my friend R go through their equivalent of clerkship, come home absolutely knackered at the end of the day, and graduate and move to London to start out his life in a big city hospital with his girlfriend B. My friend P had failed a year so was graduating a year behind R. She knew how to party and introduced me to the sport of white water kayaking and the paddling club she was a member of. She was my first real friend and we're still friends to this day. P is the kind of person who can go out, drink 8 pints of some weird alcoholic concoction that includes beer, vodka and black currant, or even worse, alcoholic orange juice with extra shots of vodka, and convince herself she'll be ok to go to clinic the next day. Yes, she failed a year, but she didn't give any of it up and she learned to keep up despite her weekly 3 days of partying.

Last night I decided to write P an email before I went to bed asking how things were going. She graduated this summer and just started her first real doctoring job (they don't really do residency there... it's more a series of jobs you apply for and just move up the ranks). I got an email back this morning and two lines stood out:

"Being a doctor sucks ass and I'm not going to recommend it" and "It is like being a well paid secretary with worse hours".

It's funny but I haven't had a single friend yet who went out into the big bad world of medicine as an actual doctor and had great things to say about it. They should tell us this before we go through all that work to get accepted to medical school.

But, for now, I'm just going to hope that it's going to be better for me and enjoy the time I have left in the shelter of the university. I'm going to try to get back to Glasgow too, I miss it.

Neglecting My Blog

So,
I've been neglecting my blog a bit lately. This is due to a combination of reasons:
1) Neuroanatomy. We are having a quiz next week in which I have to look at pins in small slices of brain and identify the nucleus/tract/thingie that they point to. I have only been able to get through one chapter of the text so far and I can't retain the information I've tried to put in my brain. The worst thing by far is that all of the brain looks the same to me, and the names are SO complicated. Why can't they call the nuclei and stuff something that makes sense?!? Argh.
2) Clubs. I'm the director of one club (family medicine interest group) and an exec member of another (med students 4 choice) and they suck time. I had two meetings today and I haven't been home for 13 hours. I studied for a few hours today and I am totally pooped.
3) Nobody commented on my last entry. I'm not petty, but nobody likes thinking that nobody loves them. I will, however, suck it up now.

We had an interesting lecture the other day on depression in physicians. This tied into what I've been reading lately in barbados butterfly's blog about the hardships of surgical training and the recent tragic deaths of two surgical registrars in Australia. Did you know that male physicians are 1.5 times more likely to commit suicide than their gender matched counterparts in the general public? And female physicians? 5 times more likely to commit suicide. These are American statistics. The times of greatest depression for medical students are 1) at the end of second year right before clerkship 2) the beginning of residency (after the honeymoon period).

The worst thing is that what makes us good physicians or good at getting into medical school is often what makes us prone to being depressed and not getting help. We are private people who are good about keeping our emotions to ourselves, we strive for perfection so we are embarrassed to admit that we can't handle a problem, and we feel guilty about taking time off from work so we don't take the time to go get help. We are dedicated to our patients so we tend to put ourselves last. We can keep up appearances when things below the surface are falling apart - our colleagues and friends are often the last to know that we are having trouble so they are unable to suggest that we get help in a timely manner. All of these things contribute to us being prone to letting depression get so far that we decide to end our lives.

The good news is that this problem is being addressed. Not only through educational lectures and physician wellness sessions in med school but through making help very accessible and confidential. If you think you might be depressed and need help and you are in Ontario, you can call the OMA physician help-line at 1-800-851-6606 . If you're in another province find out if you have a physician help line, or find a counseling service. Remember that if you're dead or ill, you can't help your patients so taking some time now to take care of yourself is worth it.

Montreal

I was absolutely shocked to hear about what happened in at a cegep (junior college equivalent) in Montreal yesterday. The incident has been compared to Columbine and to the Montreal Massacre. I think that the comparisons to Marc Lepine's horrific acts are somewhat misleading (read more about the Montreal Massacre here) because this incident seems to be more of a random act of violence; however, this is definitely reminiscent of other school shootings such as that in Columbine. Interestingly, there are many more school shootings that have occurred world-wide than most of us know of.

I don't have anything profound to say. I'm deeply saddened by the loss of 1 student so far, the wounding of 20 others, and the psychological trauma that so many students will have to live through. I hope that something constructive happens from this, but judging from the fact that school shootings have been happening for 10 years or more now and we still haven't been able to prevent them, I'm not optimistic. There is an article here that talks about the difficulty of profiling and predicting school shootings.

As I said before, this will not make me afraid to attend university or to speak my mind or make me support administrators who want to kick every goth kid out of school. I was a punk, I had a mohawk at one time amongst other ridiculous hairstyles (see below), I didn't shoot anybody. Neither did any of my friends. My mom works at a university. She wears a black trenchcoat... I don't think she's going to shoot anybody either. What we do from here on out has to be constructive, not reactionary.

Ridiculous looking, perhaps, but not a shooter

September 12th

So,
I didn't put up a post on my blog discussing September 11th and the anniversary of the world trade center attacks. Primarily, because I didn't have much to add. I didn't even know anything had happened on September 11th until September 12th because I was camping. Yes, the events were tragic and I feel for those who were directly affected by the tragedy. I was proud that many Canadians pitched in and helped out stranded Americans and other travelers who were grounded. But, many other people have much more meaningful things to say about this event. What I want to say in this post is a little bit about yesterday.

I happened to watch a few American network television shows yesterday (surprise surprise) and there was something I was really struck by. There were lots of people talking on TV about how afraid they are. Afraid that a terrorist is going to kill them. Afraid that they will be part of the next September 11th. I heard more than one person repeat the sentiment that it was not "if" but "when" the next attack is going to happen. I think it's perhaps an even bigger tragedy than the September 11th attacks itself that these people live in constant fear for their lives.

It's this kind of fear that gives certain people a lot of power, like those in charge of governments. It's the kind of fear that blurs lines of civil rights. There was a show on TLC the other day about balancing security and liberty, unfortunately I missed it. If anyone saw it I would be interested to hear what they thought of it.

Anyways, if we lived in fear every day of dying in all the many ways we can possibly die, we'd be paralyzed into staying in bed - although I'm sure there's a way in which your bed could kill you too (think morbid obesity). Carpe Diem folks, carpe diem.

My eye

Ok, so I have an eye thing. I constantly think there's something in my eye. This morning I woke up with the puffiest allergic eyes every. Then, as of an hour ago, I'm convinced I have a worm in my eye socket because i've got these creepy crawly feeling. It sounds funny, but I'd rather there WAS actually a worm in my eye because then I wouldn't be crazy.

Yet again asking the question

Yet again today I was asking myself the question: is it always going to be this hard?

Ben just left again for home to go to work tomorrow morning. We had a great weekend, lots of walking, relaxing, reading, etc. We went out for dinner last night and ate lunch today down by the lake shore. I can't believe it's over already. Next weekend I go there. This weekend is going to be pretty heavy and hectic, but all I can think about is being together again. Somehow this seems harder than when we lived on different continents - the goodbyes are more frequent and the visits shorter. Either way, I don't love him any less. I might just love him a little bit more.

I promise I won't make a post like this every Sunday - I guess I'm just going to have to get used to this.

In other news, this week I go back to clinical skills. We have a "back to the bedside" session in which I'm going to meet my new tutors, my new group, and hopefully remember something about examining patients. It's time to get out bates! I also have to review the neuro exam and significance of findings for PBL. For those of you who are not familiar with it, PBL is problem based learning. It was invented at McMaster university in Hamilton Ontario (Canada :) and has spread worldwide. When I lived in Scotland they were using PBL as a teaching strategy at Glasgow University. Some people love it, some people hate it. Basically we're given a case study in small bites and within our group of students have to read it over, discuss teaching points in the cases, and identify learning goals for the next session. There is a faculty member there to supervise but they're not meant to participate at all in the discussion - only get us back on track if we need it. My new supervisor went to McMaster university and is a bit of PBL nut. Overall my group seems to be full of nice people who are willing to contribute which is good - although one girl is always looking for zebras when the horse is trying to lick the salt off her hands.

This session was about MS. Well, we're pretty sure it was about MS - since we haven't actually had any more neuro than 3 neuroanatomy lectures and one neuroimaging lecture we can't be sure, but it was what we came up with anyways. Pre-teen girl presents with bilateral symmetrical parasthesias and muscle weakness in her lower extremity which spreads to the hands (also symmetrical and bilat). Normal sensory perception (proprioception, pain, light touch) and normal bladder and bowel function. Apparently this is a very typical presentation of something - We guessed MS. The only thing we were confused about is that it was progressing day by day which we weren't sure is consistent. I guess I'll find out with my research this evening! Something to do to keep my mind off being lonely.

Skipper

I am here writing this because I am SKIPPING. That's right. I did NOT go to my neuro lab today. You may be thinking: she is so craptacular at neuro that she should perhaps be attending her lab. BUT, friends, let me tell you - this lab sucks. We were given sheets with questions organized into "modules" to fill in. Then we basically went from table to table and filled in the questions from the book... That's right, there was no actual lab equipment or specimens involved. So, I decided to do the questions at home and meet up with some friends to figure stuff out that we don't know. Plus, i'm doing my laundry and getting ready for the history of medicine tour I'm reading a station for tonight.

My station is cool. I'm talking about women in medicine at my university. It's pretty crazy, my university allowed women into the medical school and then kicked them out and didn't let them in for another 60 YEARS. This is an example of how universities sometimes succumb to pressure from the masses eventhough they know what they're doing is wrong. They knew it was right to let women in but folded when people complained. It's pretty shameful.

sad

It's sad that on the first day of school I'm already regretting volunteering for the few things I did. Neuro is going to KILL me. I have absolutely no knowledge base for this subject and I was lost the first day. I am going off tomorrow to buy Blumenfeld's Neuroanatomy through clinical cases. Please god make it help me!

Naked Tomato

Ok... so I just found out from flea's blog that apparently someone left him this comment when medical pathetical unexpectedly came down :

"flea i think it only fair to tell you that naked tomato was actually a 18 year old college student using the online anonimity to pass herself off as a doctor. her name is jessica and she has taken her blog down since someone called her on the fact that she is not in any way shape or form a doctor but a child living out a sick fantasy in crying fake rape and impersontaing a doctor. she has never been out of massachusetts she is a only child not 1 of 11 and her mother also lives in ma not ireland. she has removed her board but wanted to let you know this in case she tries to contact you. thought it fair"

I also really hope that this is a farce. I believe that Naked Tomato was frightened after writing her post about rape and possibly someone was able to discern her real identity and scared her enough to take her blog down. Naked tomato, if you're still reading this, I hope that you're ok. I respect you and your right to take down your blog whenever you want, but I fear that it was forced and not what you wanted.

If you're not who you said you were, then I think you probably need some help. Lots of people within the medical community will be able to support and get you the help you need if you reach out to someone. You're in my thoughts.

cheers

Saying Goodbye

No matter how long or short the time between meetings, saying goodbye never gets easier. Today I came back to medical school after my summer vacation and had to say goodbye to Ben before he headed back to big city and to work tomorrow. He's also moving into a new place so we're both stressed out and feeling very alone. We've had more goodbyes than the average couple, we lived together for a year, then apart for another - separated by an ocean and 7 hours of air travel - and now we're in the same country again; the same province even. No matter where we're going, ever time I say goodbye to him it feels like he's taking a piece of me with him, a piece that it's very hard to live without. I worry that something will happen to him and I'll never be whole again. I wish he was with me always.

P.S. Where have you gone naked tomato? I've been trying to access your blog all day but it seems to be gone?