I am a lazy, lazy bastard

(Note: this was written Dec. 6 but my internet access has been limited for the last few weeks)

But a busy one, however. Hopefully that’ll excuse my neglect of this page for several months; apparently that’s starting to become an issue thanks to this nascent ex-GW webring, what with everyone linking to this ossified site and all. I promise I’ll get some links up of my own as soon as I figure out how to HTML myself out of a wet paper bag.

Before I was so rudely interrupted, I was returning home via Saskatchewan. Yep. Still flat. The final day of a long, long road trip seems to drag on endlessly. Any joy one feels at returning home finally is muted compared to the primal need to curl up in a ball and sleep for three days. At least, that’s how it felt to me. Maybe I’m strange.

The Monday following my return to Edmonton was something of a watershed, because it marked the first time I’d worked in a hospital for any length of time as a student. As trials by fire go, my elective in Neurology wasn’t particularly bad; not least of which because they didn’t expect me to do call. Probably a good idea, as I hadn’t gone through Link Block and didn’t know a medical chart from my ass. I was able to see some pretty neat cases, too: some strange forms of cerebellar degeneration that nobody – staff, residents, and least of all students – were able to explain; a case of somatization disorder, which is where the patient is, upon close examination, pretty obviously faking their symptoms and needs either a psychiatrist or an exorcist; and some hydrocephalic disorders which mimic Parkinson’s Disease.

If anyone reading this really, really wants to know what any of the above means, drop me an e-mail and I’ll explain it in gory detail. Professional curiosity is the worst kind of enthusiasm if you’re not in that profession, eh?

Of course, there’s the depressing downside of Neurology: stroke service. I can’t imagine a more awful way to go out than to spend the last several years of my life as an incontinent, incoherent semi-vegetable. We had one case of a basilar artery blockage – that’ll take out the connection between your brain and the rest of your body, but leave everything else intact. So you’re able to be kept alive on a ventilator, and you’re able to think and hear and see, but you can’t move anything except maybe your eyes. It’s called ‘Locked-In Syndrome’ for a very real and very horrible reason: you’re a head in a box, essentially. I still get goosebumps thinking about it. It bites on the medical side, too; we’re very, very good at diagnosing strokes, but since there’s essentially nothing you can do after the first six hours or so, it becomes a depressing roundabout of futility.

“Good news! We found out what’s wrong with you!”
“Great! Can you fix me?”
“…no. I’ll have the nurse bring you your bedpan.”

Neuro was followed by a return to school for ‘Link Block,’ which is where they teach you all that practical stuff – like filling in charts, for example – that they didn’t quite get around to in the first two years while they were rehashing my undergraduate classes. Oh, and they do this in three weeks. The highlight of this block was doing my ‘mock ward day’ where I interviewed a patient. This patient had developed some kind of infection and had been laid up in bed for two weeks. Not a huge problem, except this patient developed pressure sores because she weighed well over five hundred pounds. I try and think of needing three nurses to turn me whenever I want to curb my appetite for whatever reason – works like a charm.

After Link comes not Zelda (ehl oh ehl) but the rotations. These are where the bulk of learning happens, where you remember everything you’d forgotten in the first two years of medical school because you had nothing practical to which you could relate all the information pouring into your skull. I lucked out and started with Psychiatry, which is a sweetheart of a rotation by any measure. Days started late: my preceptor didn’t arrive until 9:45, usually, which meant I could get up around nine, come in at 9:30, say hi to our THREE patients, and be halfway done my coffee by the time she got there. I got full marks for punctuality – and remember, I’m a man who’s routinely slept through an entire week of classes at a time. A woman after my own heart, this doctor is. Days also ended early, as we only had three to five inpatients at most times. And call was a joke: at no point did I get called past 9:30 PM, for any reason. Oh, and the nurses in the clinic gave me cookies. Psych ruled: I’m half-thinking of making my career in it simply due to lifestyle reasons.

The cases we saw were pretty interesting, too: at one point, one of the doctors called me downstairs to talk to a patient who’d decided to remove his genitals with liquid nitrogen and a hammer. Talking to schizophrenics is also fascinating, especially when they don’t trust you. To wit:

ME: So, do you feel you have any special powers?
PATIENT: (long, unblinking pause) No.
PATIENT’S HELPFUL ROOMMATE: Now, that’s not what you told me earlier.
PATIENT: (almost bashfully) OK, I’m a wizard.
ME: So, uh, do you use your powers for good or for evil?
PATIENT: For good. Mostly.

I also had a three-hundred pound manic woman with fifteen rotten teeth (I know how many there were, because she had them all removed on her seventh day of admission) try to hit on me. She gradually realized that it wasn’t going to happen, in no small part because her medication was kicking in and she was becoming a little more in touch with reality. I found I could measure her progress by how sullen and bitchy she was towards me.

After psych came a month in Grande Prairie doing rural family medicine. There is NOTHING to do in Grande Prairie, except apparently pick up at bars. And, from my privileged position in the health clinic, I knew that was a bad idea due to the RAGING CHLAMYDIA EPIDEMIC going ‘round town. You treat symptomatic STDs with Cipro. We ran out of Cipro.

Finally – and I promise I’ll write more later, but it’s late and my battery’s running low – I came down to Calgary to do two weeks at the medical examiner’s office, working with the deaddies (as I like to call them). And I realize how much I need to write, which is why I’m up at 2:30 in the AM writing on my laptop: can’t sleep because of ideas going through head. Great feeling, that. More later.