This exam is going to be the death of me... so much material and so easy to flip through it all convincing myself that I know it already..

Teaching Practice

So far my teaching practice placement in Collingwood has been awesome; this is in no small part because my Aunt and Uncle have rolled out the red carpet of hospitality. If I keep drinking wine at this rate, I'll never get any studying done. On Friday my supervisor was gone so after rounds I snuck out snowboarding. Hopefully this week I'll get out night boarding one of the days. The hospital is small but offers lots of opportunity for family doctors to work in the full scope of their practice. The family docs basically look after all the in-patients both medical and ortho and ICU! I'm scared S***less for the first time I have an ICU patient to look after, but my supervisor strikes a really good balance between pushing for independence and having good backup, which is great.

I am also spending my weekends trying to get in some good xc-ski training and bike training and quality time with Ben. This hasn't left a lot of time for cracking the books but I've vowed to start this week now that I have my feet under me. I'm sad that this weekend has gone by so fast.

I passed!

Whew. I passed the LMCC II! One more step (the CFPC exam) and I'll officially be a family doctor! I've been passively studying (reading journals, doing self learning modules) for a month now but need to ramp things up and start more active studying to prepare for this exam. The hardest thing is that I'm going to be away doing 2 months of rural practice during a large amount of the study period. Thankfully, there are some other family med residents who are also going to be there and hopefully we can form a study group. And helpful hints/study materials from those of you out there who have passed it?

I'm feeling marginally better, although I now just can't stop coughing and coughing and coughing. But, unfortunately, today the husband started coughing. Uh oh. No good for plane journey on Wednesday. Cross your fingers for me that he's a quick healer.

so sick

I've never been this sick in my life. I was on call last Thursday and got what I thought was a migraine. Early Friday a.m. I was woken up to do 2 deliveries and 1 had a pph, that got rid of the tail end of the headache that lingered on. I went back to bed and woke up for rounds at 6:30 - bam. worst headache I've ever had + body aches. That progressed to body aches + headache + cough and 6 days later bam! now I have diarrhea. If the big guy upstairs thought this was a way to re-fill my empathy bank, I'm not laughing.

Going out to do a very challenging mountain bike trail with a group of people who are WAY better than you are on a day when you're getting your period = bad idea. 2 hours in, I was feeling great, I had accomplished more than I could ever imagine, then I went over the bars twice in about 5 minutes. 4 of those minutes were spent lying on the ground trying not to cry (as tears involuntarily streamed down my face) after crash #1. Thankfully, crash #2 wasn't half as bad. Now I'm having trouble bending my left leg because I'm pretty sure I have a big hematoma in my rectus femoris sheath. Oh well. Tomorrow will reveal the severity of the bruising. Thankful I didn't do anything worse.

It really bothers me when people say it's their "right" to have a child. I believe that it is a privilege to have a child, not a right that I should guarantee every woman who lives in my country. I know that not being able to have children is heart breaking and difficult for many people, but just because something is sad, doesn't mean it's your right not to experience it. There is no right to happiness.

Now, that doesn't mean that I don't support fertility treatments or funding of fertility treatments through the public system. I think that is a separate issue. Would providing single embryo transfer reduce health care costs for multiple premature babies enough to cover IVF? That's where the question lies for me.

The Canadian study Too early, too small released by the Canadian Institute for Health Information concludes that the average lifetime cost for each and every multiple birth baby is $616,800, mostly due to premature birth. 56% of twins and 98% of triplets are born premature.

With Quebec's new publicly funded IVF single-embryo-transfer system, I guess we'll see how things pan out over the next few years.

This week two astounding things happened:
1) a person actually came to me and ASKED to quit smoking
2) a person in my practice came to me having LOST a large amount of weight.

Day after day after day I feel like I harp on people about the importance of weight loss, exercise, a healthy diet and smoking cessation. I try different techniques for different people. I place them on the spectrum of change and use different techniques to try and move them from one stage to another. Most of the time, I know it's going in one ear and out the other. They've heard it before, they'll hear it again. How nice to have two individuals in one week seemingly follow or want to follow my advice. hurrah.

Today is SOO prep day. For anyone who doesn't know - SOO stands for structured office orals and they are an integral part of the Canadian College of Family Physicians exam. We have some medical students visiting our family practice unit this month so we're using them as standardized patients to practice our SOO skills. I'm not sure how this is going to go! SOOs are complex and you really need to figure out a pattern of how to approach them because the patient always has a primary problem and then a secondary problem you need to tease out of them during the interview. This second problem can be totally unrelated or be related to the presenting problem (when it's unrelated it can be difficult to pry it out of them and at times I've resorted to "is there anything else you would like to talk about today"). I worry about running out of time at the stations. We'll see how things go today!

Why is November such a hard month? Daylight savings should have made my mood better, but coming home now with it being darker and darker I'm finding it difficult to get my shit together. I've been managing to follow my turboing and biking regime to try and stay sane, but I just can't find the motivation to read and learn. The journals and piling up and I feel like I'm getting dumber. I'd better snap out of this soon because I need to start studying for the CCFP. Guidelines Guidelines Guidelines!

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie,
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

let's all insult family doctors

I'm working with a specialist right now who is VERY good at what he does, but constantly insults family doctors. Most of his stories revolve around how a family doctor sent him a ridiculous consult or screwed up or gave the wrong med or was manning the ER when someone died. Does he not realize that I'm a family medicine resident? Or does he not care? Or does he not see how insulting his stories are.

I had a very nice day with my Mom today. Is it the sign of a youngest child that I still go home to hang out with my parents when my husband is away?

Today I had a non-alcoholic beer. I think this is a sign of progress in my recovery from the LMCC-II. Now I have until December 16th to try and forget about it before results come out.

That was the worst exam I've ever done. Seriously. There are 2 stations I absolutely bombed.

I'm SO OVER EXAMS. Damn you LMCC II.

When I see children dying and I read about children dying and the PAIN that their parents go through, I can't help but ask - how can people do it? Is it insanity that people want to bring a life into this world when there's a chance that life will be cut too short and cause them immeasurable pain? Or is it the promise that most people make it to adulthood alive that drives the need to reproduce? Or the opportunity to bring a new and wondrous life into the world?

I struggle with the fact that right now I have no desire to have a baby. I'm too worried. I am content to bring them into the world and hand them off to those more prepared.

And then she was 29.

Kitty

So,
Kitty is still alive but now unable to walk, use the litter box without help, or manipulate his position very well. He often looks like me in an undergrad lecture, nodding off to sleep with his head on his chest only to jerk awake realizing that he can't sleep and hold his head up at the same time. The prednisone is at least increasing his appetite, although he's just skin and bones. Poor thing's owners can't get home soon enough - they'll need to put him down soon and I just can't bring myself to do it without them seeing him. Friday seems like such a long time away.

What kind of karma do I have? I am cat sitting one of my attending's cats while he is on vacation for 3 weeks and 1 week in one of the cats contracts a deadly neurological disease... I guess I should have helped that old lady across the street last week.

When I said I had an interest in palliative care, this isn't what I had in mind.