I've been having a great time these 2 weeks shadowing a family doc. I can't say how great this place is enough times. I got to irrigate someone's earwax yesterday with a giant metal syringe - so much came out. It was GREAT. You wouldn't think that earwax would be so fun, but putting a giant metal plunger thing in someone's ear - fantastic! It was very satisfying.

It's good this week because I'm seeing patients I saw last week for follow-up appointments. It's nice to see familiar faces and to know a bit about people and their progress. For the most part people have been very supportive and many people have asked about which stage of the game I'm at, which school I go to, and how I like the town we're in.

I'm planning a nice surprise for the nurses and other staff on Friday. I'm going to make them some chocolate dipped strawberries and other fruits and bring them some tea and tea cups because everyone was so keen to make me tea every day.

I think the doc is starting to like me because she invited me to play in a golf tournament with her and my sister and a bunch of their friends. I hope that one day I can go back to her practice and visit or do a bit of clerkship there or something. She's just awesome. It feels good to finally have a mentor in family medicine besides my academic mentors.

Interesting Article

An interesting article about medical decision making from the New Yorker.

Someone I don't know but feel like I do is dying. I am so saddened by the news, I was hoping for a miracle. I am not a religious person but I hope that Sarah goes to the place she has always dreamed of, a place with no pain and suffering.

I hope the Derek can find the strength to go on and carry Sarah's legacy in his heart out into the world.

I'll miss your insightful posts, your humor, and your selflessness.

She does her name proud. It is of Hebrew origin, and its meaning is princess. Originally called Sarai, Sarah shared an adventurous nomadic life with her husband Abraham. She is described as being exceptionally beautiful even into her older years.

Sarah thought it was important to remind everyone to be careful of sun exposure. I want to remind you, in her honor, this summer season to cover up, wear sunscreen, and avoid going out in the middle of the day. Have moles checked by your family doctor. Take charge of your health.

Ok so, I've been away at the cottage for the long weekend and now I'm visiting with my sister and shadowing a family doc for the next 2 weeks who's a friend of my sister's. I love this doctor, I wish she was mine. She's so funny and good natured and loves her patients - you can tell. she just glows and is so good humored even with the ones that are trying. People trust her and she cherishes that trust. The past 2 days I've seen her do a lot of counseling and dealing with mental health and that's really an aspect of family practice I'd never been exposed to before. It's pretty cool. She does a few 1/2 hour talks with patients each week and has some people who really depend on her for support. I already know I want to do family medicine, I just want to figure out which parts of it I like and which not, etc. You know, I thought I'd never like office work but these past two days have been really enlightening. I really like being in the office with this doctor and her colleagues. If my office can be like this, I think I could really enjoy it!

Today we did a half day so here I am sitting on the couch. I'm going to take a nap then go to the gym. My nephew woke me up at 5 this morning with an outburst from bed - but I still love the little guy! Yesterday I made dinner for my sister's fam and today i'm going to do some cleaning to try and help her out. Life is busy with a 2 year old!

Fear

If there's one word that can strike fear into my heart it's CLERKSHIP. I will be starting clerkship next year. For those of you who don't know, clerkship is when medical students start actually working in the hospital full time. Essentially the lectures are over and the real learning begins. Clerkship is the new thing that keeps me up at night.

Having recently got my schedule for clerkship, things are becoming a lot more real to me. Fortunately, I almost got the schedule I wanted. Unfortunately, my school has a policy where one can switch their family medicine block with electives, meaning that everyone in the class put family medicine in their top 5 rotations***. This switch really disadvantages people who want to actually do family medicine. I have family medicine in the very last block, after CaRMS (Canadian Residency Matching Service). This means that when I apply for residency I will not have completed my family medicine core rotation. I wonder if this will look bad to residency program directors when I'm applying to do family medicine. Most of them probably understand that it's the luck of the draw, but what if they don't. I know that family medicine isn't very competitive but the programs I'm looking at are extremely small and I want to get the one I want! CaRMS is the point of no return - you have to take whatever position you match to, so I want it to be a good one!

Right now I'm trying to plan electives in order to show my interest in family medicine but also my diversity as a student and my other interests. So far know I'm doing a rural family elective way up north which is confirmed. My other elective time I hope to spend in Obstetrics, ER and dermatology. A fellow blogger suggested that derm would be a perfect elective for family medicine, and I really appreciate the suggestion as I hadn't really thought about it until then! My big dilemma is whether to do an ER elective that's family medicine based (part of the time is spent in the office) or one that is purely ER based.

I find it hard to make decisions so far in advance, but elective forms for some schools are due up to 12 months in advance and you really have to get on it if you want to get your first choice! And then, on top of that, is the huge amount of money in administration fees we have to pay other schools to process our applications. I wish there was some kind of reciprocal agreement between schools that this would be rolled into our tuition. Medical school is a giant money pit!

*** I've been asked for an explanation of this so here goes: Because at my school we only have one set of electives before CaRMS and they're in the second slot after block 1 of our clerkship you don't have lot of experience before you go out and try to impress people. If, say, you got family medicine in block 4 you could put your family medicine in the electives time and electives in block 4, meaning that you would have much more time to get experience (blocks 1-3 + family) before you went on electives and thus would seem a lot smarter. In addition, some electives require you to have done your core rotation in that subject before you can do an elective in it. By doing the family switch you can get in more core blocks, meaning that you can complete your core prerequisite more easily.

But, only a set amount of people can have family medicine in each block. People who want to do the switch really want to have family medicine in blocks 3 or 4. We get to put in a request sheet for our top 5 subjects and which block we want our number 1 subject to go in. So, if say 50% of my class wants family in block 3, and they submit request slips saying family is their top choice and they want it in block3, it is likely that trying to accommodate all of those people will fill up a lot of the family spots in early blocks because if they don't get it in block 3, the algorithm is likely to give them family in other blocks around the same time, i.e. block 4 or 5. To make a long story short, this makes it hard to get a family medicine rotation in a top block. Especially since I wanted to rank Obs/gyn as my number 1 block in order to get a prerequisite for electives. I know it's all complicated and this probably doesn't make sense to a lot of people!

Grrrr

Despite the fact that I just had some tomatoes on toast which were really yummy, today has been frustrating. I've finally been able to get down to work on my summer research project (mandatory for graduating from my med school) and I have run into a few stumbling blocks.

#1 - Scope: The scope of the project is really large and I'm trying to write my background. I'm not sure how much information about the topic of the survey itself I should put into the background. If I put it all in, it will be a very large background. For my lit review I'm focusing on papers that look at clinician education in this area more than the actual research in this area because it's so broad. Ugh. This has been my stumbling block since the beginning.

#2 - Supervisor: My supervisor(s) are very unhelpful. They keep asking me what I think and the when I ask them what they thing they sort of say 'yeah, what you said sounds good'. I ask for guidance and they just kind of avoid the subject. It's really frustrating. I know that they're busy clinicians who don't have a lot of time and don't do very much research so maybe they aren't aware or can't answer my questions, but it's still frustrating. Anybody want to volunteer to be my new research supervisor?

Random Things Meme

I've been tagged by Xavier Emmanuelle

Here are the rules: Each player starts with eight random facts/habits about themselves. Write a post about your own random things. Post these rules. At the end of your blog, tag 8 people and post their names. Don't forget to leave them a comment and tell them they're tagged.

WARNING: Some of the things in this post are a bit gross... just so you know now. Don't say I didn't warn you.



1. I pick the skin off my feet because my heels are constantly itchy... it's gross but I can't help it and nobody has ever been able to tell me why they're SO ITCHY

2. I really like to count things in a sort of subconscious way. I walk down the street and suddenly realize I've been counting my footsteps, it's a bit OCD, I know.

3. I'm really interested in sexuality and other people's sex lives.

4. I LOVE THE CBC - if I could have an 'I heart CBC' t-shirt I would (sorry Xavier, kind of stole this one from you, but it's true)

5. Tomato sandwiches with a bit of salt and margarine are one of my all time favorite things

6. I often wear shoes that are 1/2 size too small to make my feet look smaller

7. When I do something new I always convince myself that I'm fearless, then about 15 minutes in I realize that I'm scared shitless and can't get out of it

8. I am a crier, anything touching, sad, bitter sweet, etc. makes me cry. Especially in books or other works of fiction.

9. I have pooping attacks all the time where I suddenly have to poop so badly I think I'm going to die and I get hot flashes because of it and need to find a bathroom pronto - sorry if that's more information than you wanted to know about me.

Xavier already tagged most of my blogging buddies! I'll tag Couz, Cal, Angry (although I suspect he's not the meme type), Nathan, MWWAK, Obgyn Kenobi, TriThinkingPink's Captain Pants AND Captain Cactus

The Story of Ben and I

So, a while ago someone asked in the comments section how Ben and I met since he's Scottish and I'm Canadian. Well, it all started when I got a scholarship to do my masters in the UK. I chose Scotland because they have a great engineering school in Glasgow, anyone who's an engineer should know which one it is (hint, not Glasgow Uni). I also knew two people who had gone there before so they were able to give me guidance about where to live and hook me up with a few friends etc. So, I decided that for my great adventure I'd pack off to Scotland for a year and goof around doing my thesis based Masters degree and traveling in Europe.

When I got there I moved into a flat with 4 Glasgow Uni students. They were all awesome, two of them medics. One of the medics and I became instant friends and she convinced me to go out with her to the Glasgow Uni canoe club one night. I though it would be good for a laugh to canoe around in the Glasgow Uni swimming pool and, being Canadian, I had canoeing experience. Little did I know, crazy Glaswegians call kayaking canoeing. So, anyhoo, I went along a few times and it was awesome and I learned how to roll and all that good stuff. They also took me out to the bar and got me so drunk I thought I was going to die - those Glaswegians can really hold their liquor... never before have I seen someone drink a mixture of coolers with extra vodka...

Sometime after that I realized that the time had come for me to join the paddling club at my own Uni because soon someone was going to realize that I didn't actually go to Glasgow Uni. So, I joined and was signed up for my first river trip. We were taken to the river Tay rapids at Grandtully where there is a white water course at the end of a nice paddle down the river.

Someone padding the Grandtully white water course.
(Picture from the UK Rivers Guidebook)

On the bus on the way to Grandtully I sat beside this guy who I thought looked a bit like Tom Cruise and had a really hot Scottish accent. His name turned out to be Ben. Later on I got to see him change into a very tight wetsuit by the side of a road... hot (just kidding). Later still when I didn't want to go down the rapids because I was slightly FREAKED OUT on my first kayaking river experience, he convinced me to go down it. Thankfully I didn't swim until I had cleared the rapids and then did something silly. On the way back we stopped in a pub and he bought me a drink.

This is me on that first crazy day of paddling... I'm not sure why I had my eyes closed!
As you can see from this and the previous mountain biking pictures, I look great in helmets!

The next week when the canoe club met we hung out together in the pub and I brought him apple pie because it was thanksgiving and I had leftovers and we had talked about pie the week before. Then we snogged and the rest is history! Almost 3 years later we're still together but neither of us paddles anymore!

A face only a mother can love
My awesome moves

Disappointed

I was given a temp assignment and today it fell though. I'm very disappointed. I want to feel like I'm earning money and contributing to my household. I feel useless being around here all day baking cookies even if people say they're the best they've ever had. I can hardly afford to buy Ben a birthday present and pay next month's rent. Bah humbug.

Steamed

A radio interview with Dr. Chaoulli, a Québécois entrepreneur/physician in Montreal, yesterday on the CBC's (Canadian Broadcasting Corporation) As It Happens really got me steamed. Dr. Chaoulli is opening a new private health care business that is basically an agency to match up paying customers with private health care in the province of Quebec. He says they have members for whom they will find ways to match them up with specialists who will either see them on top of their regular medicare practice at an expedited pace for a fee+medicare payment or with specialists who run private clinics.

The part that I found very interesting about his interview was his claim that this would be good for the public health care system. How, you may ask? Well, Chaoulli claims that this is not a case of skipping the queue but merely a way to facilitate practitioners moonlighting on top of their regular medicare clientèle to both expedite the care of the paying and to shorten the wait times for others who are waiting in the public system. I have a few problems with this argument. First, there is a shortage of specialists in this country and most specialists are working as many hours as they can in a safe manner. By moonlighting on top of their regular hours in the public health care system they may be 1) putting patients at risk because they are working too much or 2) cutting back on the hours they are working in the public system to accommodate the higher paying 'medicare plus' or private patients. And, since when is getting care faster than everyone else not skipping the queue? There are a finite number of hours of doctors time in a situation like ours where there aren't enough doctors to go around, so by paying more to see a doctor earlier you are skipping the cue and bumping someone out of a spot - not freeing up the time of a doctor to treat more patients in the public system since you are essentially using the SAME resource, not a different one from a different pool.

Furthermore, Dr. Chaoulli also claims that his organization is a 'watchdog' of the public health care system. He states that patients don't know enough about hospitals' track records with hospital acquired infections and other problems before they choose to go to that hospital for an operation. A patient who pays can have the hospital they go to hand picked to ensure that it is the best public hospital around. So, essentially what he's saying is that rich people deserve good clean hospitals and to know everything about the hospital they are going into for an operation and poor people do not. I think this reasoning is deplorable. Perhaps if he wanted to be a real 'watchdog' of the public health care system he would allow his information about hospital safety to be shared amongst all people so that individuals and groups in society can lobby the government for better and safer hospitals with better infection control policies.

Dr. Chaoulli tried to make it sound like he was doing all of Canadian society a favor by opening up his service but I just don't buy it. You're doing the general public a disservice by taking doctors' time away from the public system and by keeping information about public safety hazards to yourself. You, Dr., are greedy.

Dreams again...

I had a weird marriage dream last night. I was marrying Ben (but although I knew it was Ben in my head, it didn't look like him) but half my family forgot to show up or couldn't be bothered. For some reason we were really just having a reception (we skipped the actual 'I do' bit) and we were having salmon with dill (not sure if that's an important detail, but I remember it) and steak. Then I leaned on something and got a big stain on my dress - uh oh. The dress was quite nice. Then my aunt and cousin showed up the next day and they said they went shopping instead of coming to my wedding... so I told them I'd never speak to them again. It was very surreal because I never imagined a wedding with 10 people at it, most of them men, and most sitting in one corner snickering.

is it a sign?

So, I got scolded by the angry medic for not updating my blog and aiding in his procrastination. Just for you, I will update today.

Much like last week, I really don't have a lot to talk about. I'm starting today on my research elective for school. I have to complete a lit search strategy by May 28... shouldn't be too hard. Hopefully there's lots of stuff out there on my topic, but I'm not sure there is. To do this, I have to formulate a research question, which is where things get tough. I wrote to the lead investigator on the project I am supposed to do some work on and she hasn't replied to my email - thus, I have no idea what the motivations, goals, or anything for the project are, what the study hypothesis is, and have no idea how they came up with the survey questions they used. It's hard to write a proposal, an abstract, and do a lit review when you're not quite sure what the project is. I hope I didn't offend this woman in some way by asking her these questions. It's a bit awkward because my supervisor is kind of on the fringe of this project but she doesn't have anything for me to do directly on her work at the moment so this was the best I could get. I hope it doesn't all blow up in my face!

Anyways, on to other things. Ben and I went biking this weekend and played golf, it was fun. By the end of the weekend I was tired out, but that's probably a good thing. Weekends are just so much better than weekdays right now because I have someone to spend them with!

Tardy

You would think that since I do nothing all day I would have lots of time to post on my blog. But, the problem with doing nothing is that you become a big blob of nothing with no opinions or interesting tidbits to tell or stories from your day because... you didn't do anything.

I'm still waiting for the temp agency to call with something. I broke up this week's monotony of nothingness with some gym, a little bit of lunch with medic friends, a bit of brunch with a highschool friend I haven't seen in forever, and I'm going to go visit my grandparents tomorrow.

I don't know how people live their lives doing nothing. I mean, out there there must be someone who's unemployed at not looking who has no desire to work... but I just couldn't do it. Even if I had a hobby or 30, I feel so unproductive and like such a leech off society. And I'm not even on welfare!

I was going to write a long post about facebook, and I probably still will, just not today. I just turned into the menstrual monster and it's sucking all the life out of me. So, maybe tomorrow when I've regained some of my will to live.