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?

Ladies who Lunch

I haven't posted in a couple of days because I've been doing nothing. Well, not really nothing, but things that aren't very interesting. I've been a lady of leisure, which for the most part is kind of boring. So I will blog about the exceptions to the boring

I had lunch with my friend Dr. F. who is a Dr. of the Noam Chompsky sort. She's actually so cool that she's like a female version of Noam. She is the most sarcastic person I know, and that's a good thing. She absolutely kills me. We had amazing thai soup for dinner. Here's a recipe for thai soup - make it. It's like liquid crack.

Ingredients
1 tablespoon vegetable oil
1" fresh ginger root
3 scallions (green onions), chopped
2 tablespoons lemongrass, chopped
1/2 pound mushrooms, sliced
3/4 pound broccoli, cut into small chunks
2 carrots, cut into small chunks
1 quart vegetarian 'chicken' broth (I don't know what this is - I use onion broth usually or vegetable broth)
1 - 2 tablespoons Thai red curry paste
1/2 tsp saltPinch of black pepper
1 lemon, sliced thinShredded fresh Thai basil


Method
Heat the oil in a wok or saucepan, and fry the garlic until it starts to brown (to make a spicy version of this dish, start by frying one tablespoon Thai chile paste with garlic and sweet basil in the oil instead of garlic). Stir-fry broccoli and carrots until crisp-tender. Remove and set aside. Fry the ginger, scallons, and lemongrass for a few minutes, then add the mushrooms and fry for another 2-3 minutes. Add the broth, red curry paste, salt, and black pepper. Bring to a boil. Reduce heat. Simmer, covered, for 5 minutes. Add broccoli and carrots. Heat briefly.
Serve with in bowls and sprinkle with Thai pepper powder and fried garlic. Eat with steamed Thai jasmine rice. Garnish with fresh lime and a pinch of basil.

After lunch I bought cupcakes from the Cupcake Shoppe. Oh my god were they good. Especially pretty n' pink.

I also went to Pioneer Village with my boyfriend's mother who is visiting from Scotland. She's been here for 3 weeks staying with my family and she's going back home on Thursday. It's been hard to know what she wants to do and determine whether she's been having a good time. I can't read her at all. She says she wants to relax and not do anything but then my mom is all flustered about where to take her. Ben is at work all day so it has fallen to the rest of us to entertain her, which is fine except it's hard to figure out what to do. Anyways, we took her to niagara falls and the cottage and stuff so I hope she had a good time. Pioneer village was fun because we asked them all sorts of questions they couldn't answer. It was funny to see the blank looks on their faces when they had no clue what we were on about. It's even funnier because Ben's mom has been annoyed with my incessant question asking in the past but she saw the fun of it yesterday.

Today I need to work. So hopefully I will actually get dressed soon since it's 11:00 and I just woke up half an hour ago. Eventhough I've been doing nothing, I'm actually kind of enjoying it, boredom and all. Ben has started calling me betty because I've been kind of house-wifey doing the laundry and making dinner for people. He shouldn't get used to it though!

Kick in the pants

It's a real kick in the pants when on I'm-finished-work-sleep-in-day number 1, I get out of bed at 6:30 to make my boyfriend a sandwich because i feel bad that he has to get up and I don't. Thankfully I went back to sleep until 9 after he left. Then, on IFWSID number 2, at 8:45 some kind of concrete cutting machine the size of my entire house rolls into the neighbourhood and starts making so much noise I wake up wondering if some kind of natural disaster has occurred and I'm actually flying around in my bed like dorothy from the wizard of oz. What the heck? The gods of sleeping in must be against me. Excuse me while I go spend my day watching Oprah and Dr. Phil to make up for it.

Procrastination and Quarrelling

Last night I sat down to write a report that I'd been putting off since June 27th and was due August 22nd. All I wanted to do was get it over with but I was stuck (again) on what to write after the first paragraph. I had tried to write this report 3 times already and given up each time, putting it off for a later date. Tonight, however, I HAD to get it done. So, I sat down and wrote a paragraph and then asked my boyfriend to read it and let me know what he thought so far. That was my first mistake. I came back and he was surfing autotrader on my computer. Now, if I hadn't been a bit stressed about writing this thing I may have brushed this off. But, as I tend to get a bit panicky in these situations, I got angry at him for sitting on my computer wasting time. Then he tried to give me some "helpful" suggestions that sounded more to me like "what you've written is crap, but nobody will care anyways, so just write anything to fill the two pages". Now, I'm sure that's not what he meant, but whatever processing happened between his mouth and my brain resulted in that message being perceived. This led to me asking him to but out and him throwing a hissy fit and telling me I was irresponsible because I ALWAYS leave things to the last minute and that I clearly didn't love him because I would have done it already if I did. Lets just say that we both got a bit upset.

The evening became extremely reminiscent of the time I asked him to edit my master's thesis and then proceeded to want to kill him on a train in the middle of the Scottish highlands. So, note to self in the future - not asking partner to look at work and critique it is probably a healthy way to preserve our relationship. For some reason I can take anyone else's criticism but not his - we just don't seem to mesh in that way.

It all got sorted out in the end and I apologized and we made up before going to bed but man, it was more stressful than it had to be. I'm not going to say I'm going to stop doing things at the last minute because that's just who I am, but maybe next time I'll go about it more quietly.

Back to School

It's almost time to go back to school and I'll admit it - I'm kind of looking forward to it. Mostly because I'm SO BORED. My job is winding down and I have half of next week and the entire week after off. I'm considering calling up my family physician and asking whether I can shadow her for a day. She does quite a lot of OB so it would be good to see how she balances her practice and ask some questions. I'm afraid that I've forgotten every physical exam skill I've learned along with the names of the cranial nerves and what they do (oo ooo oo to touch and feel....) so maybe i'll embarass myself royally.

The only thing I'm not looking forward to is moving away from Ben, again. I know it's not as far as me being in Canada and him being in Scotland but 3 hours is still far. I know I'll get to see him every weekend but going to bed alone again is going to be difficult. I wish I went to the medical school near his work or that he worked near where I go to school. In good news, several of my classmates are married to spouses who live in other cities and they seem to be keeping it together so maybe after 2 years of dating we can too!

I'm going to go read my bates manual now.

Too many people

When Doctor Annunciate pulled back the curtain and breezed into the small "room" with its unsheeted bed and broken down blood pressure monitor in the corner, I followed. I stood and waited for him to introduce me to the patient, "this is my medical student, she is following me around for the day". She looked over to me and said hello, asked me how I was, and we made a bit of polite conversation. In my head a voice was screaming, too many people, not enough chairs, I'm making the patient uncomfortable. Mrs. Z was there with her husband and they both looked to be in their seventies or eighties. She was quiet and looked worried, she held her husband's hand for comfort. She looked like an old fashioned sort of woman, someone for whom propriety and privacy were especially important.

They were sitting in the two chairs facing the bed. This left Dr. A and I to perch on the side of the mattress. The head of the bed was slightly inclined and didn't seem to want to flatten down. This meant that I was constantly fighting a battle with gravity, trying to avoid sliding into Dr. A's lap. I forgot my discomfort when Dr. A suddenly burst out in his very loud tenor voice, "So I hear you're having trouble with your bowels Mrs. Z." Everyone in the clinic must have heard him, especially the patients sitting in the waiting room right down the hall. Mrs. Z looked at me with pleading eyes, a bright red flush creeping from the collar of her blouse up to her forehead. She wasn't the only one who was embarassed - I wanted to help her dig a hole in the floor so we both could escape. Rest assured it's not the mention of bowels I found embarassing, it was the manner in which the doctor approached what was so obviously a private matter for the patient. We had established in our opening conversation that she was not hard of hearing, so there was no need to speak so loudly. Voice volume is an important part of speech and this doctor got it all wrong. I hope I never follow his example.

(note: names and circumstances have been changed to maintain the patient's privacy)

I've been tagged

Ok, I've been tagged by Nathan so here goes:

1. One book that changed your life: Hasidic tales of the Holocaust, Yaffa Eliach

2. One book that you’ve read more than once: The Hunter's Moon, O.R. Melling

3. One book you’d want on a desert island: Edible Wild Plants and Herbs: A Pocket Guide, Alan M. Cvancara

4. One book that made you laugh: Too Close To the Falls, Catherine Gildner

5. One book that made you cry: The Girls, Lori Lansens

6. One book that you wish had been written:
EDIT: I can't read and I thought this said "one book you wish you had written" and to that I answered: The Time Traveller's Wife, Audrey Niffenegger because it's a great book.
To the actual question "One book that you wish had been written" I would have to say: '1000 ways not to cry when being yelled at'

7. One book that you wish had never been written: Unborn Destiny, Kevin Mark Smith

8. One book you’re currently reading: The Red Tent, Anita Diamant

9. One book you’ve been meaning to read: Pilgrim, Timothy Findley

I tag... intelinurse2b and nakedtomato

Strabismus

"Strabismus, more commonly known as crossed-eyes or wall-eyed, is a vision condition in which a person can not align both eyes simultaneously under normal conditions. One or both of the eyes may turn in, out, up or down. An eye turn may be constant (when the eye turns all of the time) or intermittent (turning only some of the time, such as, under stressful situations or when ill). " (www.strabismus.org)

When researchers do research into strabismus in primates they induce strabismus by making the primates wear goggles. I went to a research presentation the other day about this topic. One word to the wise strabismus researcher, if you put pictures like this is your presentation, do not get offended when people laugh!



(Invest Ophthalmol Vis Sci. 2004;45:821–827)

Ashamed

I have never been so ashamed of the Canadian government as I was this morning when I heard that Stephen Harper will not be attending the international AIDS conference going on right now in Toronto. Do you know why he isn't attending something so important? Because he's afraid of being booed. That's right. He's afraid that those who do not agree with his government's views on same-sex marriage will boo him. So, let's think about this for a minute. What's more important? Representing the host country of a very important scientific conference with a great many very influential delegates OR the fear of people reacting negatively to one of your policies? As Andy Barry said this morning on the CBC, this conference is an opportunity for the government to have open and honest discourse with the people about their policies including their stance on aid for AIDS research and victims. Instead, they chose to throw away that opportunity and not even SHOW UP. It's disgusting.

The Great Thing About Siblings

There are some great things about siblings. Especially when they're funny. Ben and I went to a baseball game with my brother Dave and his wife Erin a few weekends ago. Apparently I missed the fact that they now play music when the player goes up to bat. According to Dave, they can choose their own music. We had a conversation that went like this:

me: wouldn't it be awsome if you played a prank on your teammate and switched up his music to something really embarassing like 'Lady in Red' or "Itsy Bitsy Yellow Polka Dot Bikini"
Dave: I think if I ever go into major league baseball I'm going to use 'You make me feel like a natural woman'
Ben: How about 'It's Raining Men'
Erin: how about 'Man! I feel like a woman'

I almost peed myself I was laughing so hard.

It's great to have siblings you can hang out with and enjoy their company. Not like when we were kids and they just sat on my head.

Things that are good

So, I just finished reading a trilogy called "His Dark Matters" by Philip Pullman. I don't really read fantasy, but these books were great. I even cried at the end of two of the books. They're lovely and sentimental at times and exciting at others. I really recommend them. And if you have read them, I reckon my daemon is a chipmunk.






Right at this very moment (and for the past few days) I have been listening obsessively to this album. It came out in Scotland while I was there with the first single "Black horse and the Cherry Tree" - I liked it right away. Lately the song "Suddenly I see" has been getting a lot of airplay due to its use in the TV show So You Think You Can Dance. I am very pleased that KT has started to make her dent in North America because I think she's extremely talented. She's like a modern Carol King or Laura Niro. By far my favorite song on this album is "Under the Weather". It was the theme to my first few weeks after Ben left last September and it's very bittersweet. "When I turn out the light, you're out of sight, although I know that I'm not alone. It feels like home."



Last but not least, PC Cookies 'n' Creme Ice Cream. I can't explain how good this ice cream is. It's like taking a normal cookies and creme ice cream (good in itself) and adding to it the middle white bit of oreos. Seriously. It's good.

The Rant

Well, my dear friend Elissa has been calling for me to re-post the rant that I posted a few days ago. The subject of this rant was the anti-social behavior that has resulted from kids being allowed to practice their social lives completely over the internerd and how parents need to make sure that there is a balance struck between kids finding a group of their peers (on the internet in the case of the kids I was talking about) and kids being educated in social graces that they will need later in life, like the art of conversation and the arts of interacting with one's peers in a face to face manner (and in some cases being able to resolve conflict that may arise in a civil manner). These are things that CAN be learned. Yes, some people are naturals, but that doesn't mean that the shy kid that loves talking about slip knot on the internet with other kids who might be a bit nerdy can't learn to also interact well with people outside his/her peer group. I think parents are doing a great disservice to their kids by not encouraging them/forcing them to join social activities and allowing them to hang out on the internet all day. When they grow up to be adults they are going to have to find jobs and interact with others and they will need to draw on social skills they should be learning as kids. I was forced to go do things i didn't like as a kid but I can honestly say that I'm better for it now. I was and still am a huge nerd, but if my parents hadn't forced me to get out and interact with people I'd probably be a socially awkward nerd, which I'm not. I'm not saying it's cold-turkey, no internet, what I am saying is that they need a diverse range of interactions with others. Always hanging out with people just like you prevents you from growing socially.

Letting your kids sit in their rooms and play on the internet is EASY. Making them get involved is HARD. Parenting should not be easy. Some things that your kids hate now will make them better people in the future. Balance in important. I hope this sounded a lot less a-hole-ish this time.