June 10: I get in a minor fender-bender on Calgary Trail. Yes, I am an idiot, and feel free to tell me I should quit driving. My girlfriend is uninjured; my Mini, however, has a dented front bumper and two detonated front airbags.

June 17: I trade in my rental Kia Rio because a) the steering wheel vibrates like a Mexican space shuttle, and b) it smells vaguely like feet. The Toyota Corolla is marginally better.

July 10: I call the repair shop and ask what's up. Apparently they are waiting for a part from BMW, specifically an airbag.

July 13: "BMW tells me it'll be a week."

July 22: My airbag is not yet in place. Actually, my airbag is not yet in Canada. It's not even MADE yet, as it's on factory back order. In Germany. And it has to be shipped by boat, because it's an explosive device and can't be shipped by air.

Goddammit.

Things I hate

1. 1-in-4 call. 89 hours of work this week, whoo!

2. People who stand on the escalator. It. Is. Not. A. RIDE. PEOPLE.

3. Estonians. I'm an obscure bigot!

don't want no sugar in my coffee

In any modern city, you're liable to get patients who speak a multitude of languages. Fortunately, probably the most multicultural group of people in said city will be its doctors, so you're probably going to have a colleague who speaks whatever language your patient does.

Take last week; I admitted a guy whose primary language was Cantonese. He spoke a very tiny amount of English, but somewhat more than I speak Cantonese. My senior resident that night, by luck, grew up speaking Cantonese and English, so I watched as she got a much more complete history than I could have.

Now, being the culturally sensitive guy I am, I tried to pick up a couple of words. The most important word in any language for me is "pain," (and how fucked up of a statement is that, eh?) and "pain" in Cantonese sounds something like "tong" or "tung"; it's hard to tell exactly because it's an inflective language which all sounds the same to my white-guy ears.

So three days later the guy, who's had a catheter stuck in his penis for a few days (long story), pulls it out. This is more difficult to imagine than you might think, as there's an inflated balloon inside keeping it in place, so it's impossible to pull out a Foley catheter without some bleeding and, er, tearing.

I go up to his room and try to ascertain how much damage there is. I ask him, "where does it hurt?" and he looks confused. I point at his penis (which is only bleeding slightly) and ask him if it hurts, and he looks confused. I dimly remember from when I admitted him that Cantonese for pain is "tong," so I point at his penis and say "tong?" At this point he looks unbelievably befuddled and a little insulted.

After about five minutes of sign language and screaming "tong" he seems to realize what I'm getting at and says, "no, no pain." Whew! I go out and relate this story to my (also Cantonese-speaking) med student, and she starts laughing uncontrollably.

"No, no," she says. "'Tung' is pain. 'Tong' is sugar."

That's right, I spent five minutes pointing at an old guy's wang and yelling "sugar! sugar!" I can't imagine what he thinks of the health care system now.

Happy hospital thanksgiving

Today, if you live north of the border, was Canadian Thanksgiving. Most people have their turkey on Sunday night, though, and leave Monday free for digestion and hockey games.

I missed my family Thanksgiving for the third time in as many years; it seems I’m always on hospital call on that holiday. This year I’d arranged my schedule so I could travel to my cousin’s wedding the previous weekend, meaning I had to make up the call on Thanksgiving weekend.

I’m not going to lie, it had been a rough few days. Friday I admitted something like ten patients to the hospital, which doesn’t sound so bad until you realize that each internal medicine consult takes like two hours if you do it right, or if you have to do any on-the-spot reading. So either you half-ass your job, or you don’t sleep. I’m not jaded enough to half-ass it yet.

Saturday, I slept.

Sunday, I was on ward call. Now, for ward call at this particular hospital there’s one resident on for all the internal medicine patients. That’s about 300 patients, several of whom are actively dying at any one time. Ward call, as one of my colleagues put it, “is like going to hell.”

Around dinnertime I was up on the fifth floor, trying to figure out what antibiotics to give to an alcoholic who’d inhaled his own secretions. This 70-something woman came up to the desk, asking if anyone would like a plate of dinner. I took a glance at the plate, and realized it looked a damn sight better than any hospital food I’ve ever seen before. Turkey, mashed potatoes, stuffing, carrots, and cranberry sauce. And gravy.

I asked if she’d brought this from home, and she confirmed that impression. Her husband wasn’t going to eat his home-cooked dinner today, and she wondered if the nice young doctor would like to have it instead? Considering I hadn’t eaten anything but coffee and vending machine Mars bars all day, I gladly accepted. I did have to ask, however, why her husband wasn’t going to finish it, and if he was OK if I had it.

“Oh,” she said, “I’d brought this turkey to give to him, but they put a tube down his throat to help him breathe today, so he can’t eat. We didn’t want it to go to waste.” I’m still amazed she said this without tears in her eyes. She assured me it was all right, and walked back to her husband’s room, leaving me standing there flabbergasted with a plate of delicious turkey in my hands.

It amazes me sometimes how well people are able to maintain their humanity in the face of the indignities perpetuated by old age, infirmity, and the health care system. And if I’m thankful for anything today, it’s that. Happy Thanksgiving.

Medicine ate my life

So. Sorry about the downtime, folks, but it's been kind of... hellish lately.

I've been doing internal medicine the past month and a half. It wasn't so bad at the University; I usually would get home by 7 o'clock or so and have a little time to pretend to set up my new condo. By the way, I moved into a new condo about four weeks ago. Haven't done shit to get it set up, mind you.

But now I'm at the Alex (another big hospital). I am the sole resident in charge of my team, which currently has about 10 patients but will likely have about 40 after a couple of nights of admissions. My staff doctor is essentially absent. I am NOT FUCKING READY FOR THIS.

Also the power company shut off my juice and it took a week to come back on. I forgot to set it up in the first place, you see; I think a sign of how much this job drains you is when you forget to do very obvious and simple tasks in the rest of your life.

I'll see you all in a few weeks. Life will get better some day soon, this I promise myself.

He can die after I've had my coffee

Those of you in the health care field may be familiar with the concept of "report", which is where nurses sign over care of their patients. This is, of course, supposed to be put off for a bit in the event of an emergency, but some nurses seem to look at it as a sacred time that brooks no interruption. Seriously, I'm sure more people die in those fifteen minutes when the nurses are shut in that little room...

Also, I don't know why "report" never takes an article. It's always just "report," or "in report." Like it's a city. Report, Alberta, population 8 angry nurses.

Which led to this conversation yesterday:

ME: Hey, could you -
NURSE 1: WE'RE IN REPORT.
ME: I know, but -
NURSE 2: Look, my shift is over and I just want to sign out and go home.
ME: Yes, I'm sorry, but -
NURSE 1: Come back in five minutes.
ME: THIS MAN IS HAVING A HEART ATTACK. HE IS IN THE PROCESS OF DYING.
NURSE 1: (sighs, rolls eyes) All right, all right...

I mean, fuck. Sometimes things can't wait for you to finish report, or finish your break. This isn't paperwork. This isn't a phone call you can put off until you've had your smoke. This is someone's life; and if he's having a heart attack "time is heart" as the saying goes.

This isn't to say that the vast majority of nurses aren't dedicated, caring and hardworking. But some seem to see their career as a shit job rather than a vocation, and that's when you run into trouble and dead patients.

Oh, the guy totally wasn't having a heart attack. But when you're having "9/10 crushing chest pain," best not to take chances, eh? So anyways, that's why I'm now pretty sure I'm known as "that asshole resident." Whoops.

great balls of fire

Patient: Hi, doc. I've been ejaculating blood for the past week.

Me: Sweet zombie Jesus. I mean, any other symptoms?

Patient: Well, my left testicle has seemed really enlarged and sore lately.

It is; twice the size of his left, in fact.

Me: Yeah, that's probably what's causing the blood-jizz. This can be caused by chlamydia or gonorrhea; so, uh, any affairs lately?

Patient: Absolutely not! But I have been having some pretty active sex lately. I thought I'd injured myself.

Me: *chuckling* No, that's just an infection. We'll clear that right up. But seriously, if you've been going hard enough that you thought you fucked your balls off, good work.

Patient: Thanks, doc.

Hey, everybody! Watch the resident fuck up!

Today was my first day as a resident. If I've talked to you recently, you probably know that I matched to Family Medicine (not quite Emergency, I know, I know...) here in Edmonton. If I haven't talked to you recently, we should chat, guy.


I started my rotations with Emerg at the University hospital - at 6 am, on the day after Canada Day. I was, of course, nervous beyond belief the night before. If I could put a finger on it, I'd say it was akin to that combination of excitement, joy, and gut-wrenching nauseating fear that you just won't be good enough that you feel right before you lose your cherry.

Or was that just me?

I couldn't sleep last night. I went to bed early - couldn't sleep through the fireworks. Shit, I missed the fireworks. I set my alarm to wake me early - 4:15, so I'd have plenty of time to wake up and prepare myself. The fact that it's cockmeltingly hot (that phrase is copyrighted, by the way) in my apartment didn't help. Finally I managed to pass out around 1:15.

When I woke up, it wasn't to the sound of my alarm for once. I think the sun reflecting off the opposite building was what got me up. And a good thing, too, because I woke up at 6:20 - 20 minutes AFTER my shift began. My initial response, of course, was SHIT SHIT SHIT MOTHERFUCKER. My next thought was that I'd set the alarm to 4:16 PM like the retard that I am. My next thought was that, someday, I'll look back on this and laugh.

Today is not yet that day.

Fortunately, I had a fairly easygoing staff doc the first day. He was, surprisingly, OK with my display of raw unprofessionalism. And, fortunately, I didn't cock up too bad on any of my patients. Yay.

In other news I passed all my exams, went to Spain for a month, became a doctor and also bought a condo. Life, she keeps you busy. And I wonder why I don't have time to clean my room...

Damn you, Seth!

I'm off work for the next week and a half - conveniently, just in time for the Olympics.

It's ironic that I'm such an Olympics junkie, given that I have the rough physical coordination of a spastic CP quad patient (I can make jokes like this because I help treat them. That makes it OK, right?)

Anyhow, this has been making the rounds of the ex-GW blogs, and since I'm currently sitting at home in my bathrobe and boxers at 10:20 am, I figure now's as good a time as ever to fill 'er out. I was tagged by Seth, incidentally; burn in hell, Seth.

Four jobs I’ve had
* Bagel Sandwich Maker
* Data Entry Clerk at an immunization office; I know what shots you've had.
* Laboratory Assistant
* Doctor (pending)

Four movies I can watch over and over
* The Party (1968, Peter Sellers/Blake Edwards)
* Super Troopers
* 28 Days Later
* Ronin

Four places I have lived
* Edmonton, Alberta
* Yellowknife, Northwest Territories
* Kungshamn, Sweden (briefly)
* Kingston, Ontario

Four TV shows I love to watch
* Arrested Development
* Scrubs
* 24
* The Sopranos

Four places I have been on vacation
* Quintana Roo, Mexico
* Fairbank Lake, Ontario
* Puerto Rico, St. Thomas, Tortola (same cruise)
* Dinney World!

Four websites I visit daily
* Something Awful
* Wikipedia
* Globeandmail.com
* gmail.com

Four of my favourite foods
* Pepperoni and sausage pizza
* Pasta with bolognese sauce
* All-Bran Buds (no, really)
* This crazy fucking Indian thing with yogurt that my sister makes

Four places I would rather be right now
* On a beach somewhere in the Carribean, away from the hotels and the tourists
* Spain. Always wanted to go to Spain.
* In the emergency room (no, really)
* Montreal

Been a while, I know

I'm briefly back home between interviews right now. Quick recap of the past few months:

1. Pediatric subspecialty kind of boring. ICU stressful but interesting; I got to throw in a few central lines, which is always awesome. Family med OK. Emerg elective in Kingston went well.

2. CaRMS did NOT go so well; landed five interviews off of fifteen applications. Only one of eleven for emerg went through; looks like I'll be doing family med emergency!

3. Just interviewed at my only five-year emerg program in Manitoba. Great program, and I think I stand a good chance at matching there. Unfortunately, I don't know if I can convince myself to live in Winnipeg for five years. I'll be having this debate with myself often over the next two weeks.

4. Next week will be interviewing family med in Kingston and Montreal. Drinks will be had.

Later, peeps.