I just found out that another kid I went to high school with is dead of cancer. Osteosarcoma. I haven't seen him since high school and recently found his blog where he talks about being an anesthesia resident and going through treatment for his cancer. I think he turned out to be a much better person than I thought he was in high school. Maybe he was always a better person than I gave him credit for.

The worst moment of any mountain bike race is when you see a huddle of people at the side of the road and someone you know calls out to you to stop because they know you're a doctor. Thankfully, this time it was my husband who ran out to me, so at least I knew that he was ok. Also, fortunately, my team mate was awake and alert despite going over the bars in a big crash and smashing his head into concrete. His helmet certainly saved his white matter. As people whizzed by, another teammate stopped who was a nurse and another guy stopped who is a ski patrol medic. Ben went and got our friend who is a paramedic who was at the start area. We had a great team. The volunteer fire fighter couldn't figure out how to use the oxygen tank... in retrospect, it's funny that the ski patroller had to show him how to fill the non-rebreather.

In the end, all were fine, but I only got to ride the first 1.1 km of a 60km race. But, it probably saved my ass, because I was riding despite being sick and now I feel awful. It drove home how important it is to review basic first aid if you're a doctor - no matter if you're a pathologist or a gynecologist, people trust you to know what you're doing.

I'm currently in a bit of a rut so please don't take my lack of posting to heart. I'm 3 months into a 6 month locum and feeling a bit of the 3 month itch. I'm already looking forward to my next placement... in July. Don't ask me why - the people at the practice are wonderful and the patients are like patients anywhere, but I just feel the need to move on. Maybe it's because in residency I was never anywhere for more than 3 months at a time. That must be it. I also came back from my vacation never wanting to work again. Could someone finance my vagabond biking lifestyle please? Over 400 kms ridden in 1 week with some ridiculous number of feet of elevation and I was in heaven. Work was a bit of a come-down. At least Ben and I hung up some pictures in our house today and got the basement cleaned up... I mean we've only lived here for 3 months!

I have one more week to remember how to ride a bike outside before going away to South Carolina with my hubby and teammates for an adventurous and exhausting week of bike riding in the rolling hills and mountains of north and south Carolina. Let's hope I survive. I see a lot of naps in my future. I think this is one of those vacations that I need a vacation to recover from!

In other news, tonight is the worst night of the year - we lose an hour of sleep. Too bad I have an activity planned for tomorrow and can't sleep in :(

mistakes

People don't talk about making mistakes in our offices. So, we go home and they fester in our bellies. We try to reach out to a colleague only to have them tell us not to take on too much responsibility lest the patient interpret that as guilt and sue us. There is a good TedX presentation on this from Dr. Brian Goldman. I still haven't found someone to tell about my mistakes that understands. Maybe I should email Brian.

http://www.ted.com/talks/brian_goldman_doctors_make_mistakes_can_we_talk_about_that.html

bought some pants today at the gap outlet. When I showed my husband he actually said the words "hallelujah no more MC hammer pants". I guess I didn't realize how baggy my work trousers were getting.

teaching

In two weeks I start teaching medical students clinical skills. I went to a meeting last week about the curriculum etc. I realized that this school does not have a clinical skills manual like we did when I was in med school and the expectations of the modules is not set out for the students. I find this very odd. The modules are based on clinical problems rather than body systems - i.e. heart failure, dehydration, kidney stone. I find this odd as many clinical problems have examination overlap. Relating the examination to a clinical problem is great, but one has to have the basics down. Pairing the renal and bladder examination (part of the abdominal exam) with the peripheral vascular exam and the "fluid status examination" of the JVP - which should be part of the cardiac exam, seems very odd to me. Hopefully I'll have my head wrapped around how to do this logically in the next week or so.

snap out of it

This week I became too cynical and the patients are starting to notice. For some reason, I walked in to appointments thinking that people were always going to ask me for something I didn't want to give them. Or that there was going to be a confrontation. Or that I wasn't going to know what to do. It made me a worse doctor. I need to consciously get back to giving people the benefit of the doubt. I think a lot of it revolves around the patient population. Lots of people with narcotic problems, lots of people who've been given narcotics by the doctor who I'm filling in for that I wouldn't have necessarily given narcotics to, lots of chronic pain that I feel helpless to treat. I think narcotics are one of the things I feel most uncomfortable about and thus I end up leaving people unsatisfied. I give people other things for pain, of course, but often what they're looking for and what I'm giving are different. Unfortunately, this makes it very difficult to have a trusting and pleasant relationship. I need to check my head next week.

I had one of those cold sweat mornings where you wake up worried about a patient and wondering if they're ok. On the intellectual side, I'm 90% sure of my diagnosis and that I did the right thing, on the emotional side, I am worried. Sometimes being a doctor sucks.

I know I should say that my first day was great and that it was so much fun and I loved it, but it was completely and utterly exhausting, mind numbing and scary. I only had to see 15 patients because they're going easy on me for the first little while, and at times I was twiddling my thumbs, but at times I had real head scratchers. And, at times, I was just at a loss. Apparently I'm bad at chronic msk pain. I already knew I was bad at that, but I feel like I'm failing at it. I guess there's some reading to do.

tomorrow I become an attending physician. eek. Wish me luck.

Ok, I found curtains that I like but Ben doesn't like them. How long will I leave them up pinned to the door frame before he groooows to like them?

In other news, I love these:

Both sets of curtains have been rejected. Back to the drawing board. Just as a note - those are website pictures, our walls are actually a taupe/mushroom colour!

Who knew that buying a house didn't end with buying a house... it involves toothbrush holders and toilet brushes and laundry hampers and blinds and curtains and mini garbage bins for the loo and kitchen islands and dining tables and .... lots of stuff. Stuff that involves going to 20 different shops because you can't find the right one!!!!! Our apartment seemed full. Our house seems empty and somewhat pathetic :)

Right now I'm trying to decide on curtains that both Ben and I will like. He's not available to go to the shop so I keep bringing them home and hanging them up for him to veto... we're on curtains number 4 and 5, let's keep our fingers crossed! What I have realized is that I'm going to have to sew blackout material on the back of these fashion curtains because they're much more sheer then they look in the shop! Even the ones that are lined! (oh, and while I"m on that, why line a dark brown curtain in white fabric, it totally discolours the curtain when the light shines through it, making it look purple). I think they'll look better at night. Now hanging:


opinions?!?

Happy New Year everyone! As usual, I didn't actually see the new year come in as I was in bed at 10 o'clock. However, I did drink to the Scottish new year (7pm EST) and we had our new year's Haggis, Neeps and Tatties.

I have one more week off before starting REAL work. I'm scared and unsure of how things will go. I hope well. There are a few key study points for this week to get me ready... most namely the new Ontario immunization schedule, which came out while I was doing my fellowship and is a bit of a pain to remember the ins and outs of. Need to read up on rotateq. Also need to complete getting my OB privileges at the hospital. Today, though, is new year's day and a day of rest! May the new year bring you happiness, health, and reduced work hours :)

House

So, some photos of our house...


The outside, we're the right half of the semi.

The open concept kitchen/living room/dining room
we're going to put an island with an eating bar area in to add counter space and fill in the tiled area.
The view from the kitchen.

The master bedroom with view into ensuite and hallway
Giant Bathtub!

A friend kindly gave us a gift certificate to a home store so we can buy a few things to make it feel like we've decorated. We only have our couch and bed that we're determined to keep, everything else can go, so we're looking for decorating ideas!!!

Vacation day 4... realized how bad I am at vacation when I'm the only one on vacation. Stress, stress, stress!

Marriage

So, buying a house will tell you all sorts of things about your husband that you never knew. For example, that he dislikes light coloured countertops and doesn't like a stone backsplash. Also, that he likes carpet in bedrooms and hates top loading washing machines. That he loves Dyson hoovers and hates California shutters (which I love). That we will have lots of compromises ahead!

Our mortgage finally went through to the lawyer. looks like we're going to own a house on Friday after all. I still can't sleep.

Sometimes when you can't cry about real life you can really have a good bawl fest during a sad TV show.